Comparison of accuracy of physical examination findings in initial progress notes between paper charts and a newly implemented electronic health record.

PubMed

Yadav, Siddhartha; Kazanji, Noora; K C, Narayan; Paudel, Sudarshan; Falatko, John; Shoichet, Sandor; Maddens, Michael; Barnes, Michael A

2017-01-01

There have been several concerns about the quality of documentation in electronic health records (EHRs) when compared to paper charts. This study compares the accuracy of physical examination findings documentation between the two in initial progress notes. Initial progress notes from patients with 5 specific diagnoses with invariable physical findings admitted to Beaumont Hospital, Royal Oak, between August 2011 and July 2013 were randomly selected for this study. A total of 500 progress notes were retrospectively reviewed. The paper chart arm consisted of progress notes completed prior to the transition to an EHR on July 1, 2012. The remaining charts were placed in the EHR arm. The primary endpoints were accuracy, inaccuracy, and omission of information. Secondary endpoints were time of initiation of progress note, word count, number of systems documented, and accuracy based on level of training. The rate of inaccurate documentation was significantly higher in the EHRs compared to the paper charts (24.4% vs 4.4%). However, expected physical examination findings were more likely to be omitted in the paper notes compared to EHRs (41.2% vs 17.6%). Resident physicians had a smaller number of inaccuracies (5.3% vs 17.3%) and omissions (16.8% vs 33.9%) compared to attending physicians. During the initial phase of implementation of an EHR, inaccuracies were more common in progress notes in the EHR compared to the paper charts. Residents had a lower rate of inaccuracies and omissions compared to attending physicians. Further research is needed to identify training methods and incentives that can reduce inaccuracies in EHRs during initial implementation. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

On the Role of Mathematics in Physics: A Constructivist Epistemic Perspective

ERIC Educational Resources Information Center

Quale, Andreas

2011-01-01

The association between the observable physical world and the mathematical models used in theoretical physics to describe this world is examined. Such models will frequently exhibit solutions that are "unexpected," in the sense that they describe physical situations which are different from that which the physicist may initially have had in mind…

The biasing effect of clinical history on physical examination diagnostic accuracy.

PubMed

Sibbald, Matthew; Cavalcanti, Rodrigo B

2011-08-01

Literature on diagnostic test interpretation has shown that access to clinical history can both enhance diagnostic accuracy and increase diagnostic error. Knowledge of clinical history has also been shown to enhance the more complex cognitive task of physical examination diagnosis, possibly by enabling early hypothesis generation. However, it is unclear whether clinicians adhere to these early hypotheses in the face of unexpected physical findings, thus resulting in diagnostic error. A sample of 180 internal medicine residents received a short clinical history and conducted a cardiac physical examination on a high-fidelity simulator. Resident Doctors (Residents) were randomised to three groups based on the physical findings in the simulator. The concordant group received physical examination findings consistent with the diagnosis that was most probable based on the clinical history. Discordant groups received findings associated with plausible alternative diagnoses which either lacked expected findings (indistinct discordant) or contained unexpected findings (distinct discordant). Physical examination diagnostic accuracy and physical examination findings were analysed. Physical examination diagnostic accuracy varied significantly among groups (75 ± 44%, 2 ± 13% and 31 ± 47% in the concordant, indistinct discordant and distinct discordant groups, respectively (F(2,177)  = 53, p < 0.0001). Of the 115 Residents who were diagnostically unsuccessful, 33% adhered to their original incorrect hypotheses. Residents verbalised an average of 12 findings (interquartile range: 10-14); 58 ± 17% were correct and the percentage of correct findings was similar in all three groups (p = 0.44). Residents showed substantially decreased diagnostic accuracy when faced with discordant physical findings. The majority of trainees given discordant physical findings rejected their initial hypotheses, but were still diagnostically unsuccessful. These results suggest that overcoming the bias induced by a misleading clinical history may involve two independent steps: rejection of the incorrect initial hypothesis, and selection of the correct diagnosis. Educational strategies focused solely on prompting clinicians to re-examine their hypotheses may be insufficient to reduce diagnostic error. © Blackwell Publishing Ltd 2011.

One Physical Educator's Career Cycle: Strong Start, Great Run, Approaching Finish

ERIC Educational Resources Information Center

Woods, Amelia Mays; Lynn, Susan K.

2014-01-01

Purpose: This article is nested within a longitudinal project examining 6 teachers' journeys along their career cycles (Lynn & Woods, 2010; Woods & Earls, 1995; Woods & Lynn, 2001). Two participants from the initial 6 continue to teach K-12 physical education; 1 of these participants, Everett, is examined in the current study.…

“Heidelberg standard examination” and “Heidelberg standard procedures” – Development of faculty-wide standards for physical examination techniques and clinical procedures in undergraduate medical education

PubMed Central

Nikendei, C.; Ganschow, P.; Groener, J. B.; Huwendiek, S.; Köchel, A.; Köhl-Hackert, N.; Pjontek, R.; Rodrian, J.; Scheibe, F.; Stadler, A.-K.; Steiner, T.; Stiepak, J.; Tabatabai, J.; Utz, A.; Kadmon, M.

2016-01-01

The competent physical examination of patients and the safe and professional implementation of clinical procedures constitute essential components of medical practice in nearly all areas of medicine. The central objective of the projects “Heidelberg standard examination” and “Heidelberg standard procedures”, which were initiated by students, was to establish uniform interdisciplinary standards for physical examination and clinical procedures, and to distribute them in coordination with all clinical disciplines at the Heidelberg University Hospital. The presented project report illuminates the background of the initiative and its methodological implementation. Moreover, it describes the multimedia documentation in the form of pocketbooks and a multimedia internet-based platform, as well as the integration into the curriculum. The project presentation aims to provide orientation and action guidelines to facilitate similar processes in other faculties. PMID:27579354

Physical examination and history-taking skills in a prostate clinic.

PubMed

Wareing, Mark

The proliferation of nurse-led initiatives arising from nurse specialist/practitioner posts in urology is reflected in areas such as the management of bladder cancer, erectile dysfunction, stoma care, and prostate disease. The establishment of the role of urology specialist nurse in one North Oxfordshire hospital led to the development of a nurse-led prostate assessment clinic for male patients with lower urinary tract symptoms arising from benign prostatic hyperplasia. A description of how training was conducted, and the subsequent reappraisal of competency, is given in relation to physical examination and history-taking skills necessary for the development of this initiative.

The Association Between Vestibular Physical Examination, Vertigo Questionnaires, and the Electronystagmography in Patients With Vestibular Symptoms.

PubMed

Gofrit, Shany G; Mayler, Yulia; Eliashar, Ron; Bdolah-Abram, Tali; Ilan, Ophir; Gross, Menachem

2017-04-01

Dizziness makes up a diagnostic and treatment challenge. The diagnostic accuracy of the medical history and vestibular physical examination in cases of vestibular symptoms is not clear. The aim of this study is to determine the association between vestibular physical examination, vestibular questionnaires, and electronystagmography (ENG) test in patients with vestibular symptoms. This is a prospective study of 135 adults with vestibular symptoms. The subjects underwent targeted physical examination and filled vestibular questionnaires, including the Dizziness Handicap Inventory (DHI), before ENG testing. The results of the physical examination and questionnaires were compared with the final ENG findings. Of patients who had normal ENG results, 32.1% (17/52) showed abnormal physical examination, and 48.8% (40/82) of the patient who had normal physical examination showed abnormal ENG results ( P = .46). Among patients with severe disability by DHI, 46.4% (13/28) had an abnormal ENG, and 42.9% (12/28) had a normal ENG ( P = .39). This study did not demonstrate association between vestibular physical examination, vestibular questionnaires, and ENG results. Although history (augmented by questionnaires) and physical examination are the initial steps in the evaluation of vertigo, the current study suggests that they should be complemented by objective testing for evaluation of inner ear origin of vertigo.

The "Physically Educated" Person: Physical Education in the Philosophy of Reid, Peters and Aristotle

ERIC Educational Resources Information Center

MacAllister, James

2013-01-01

This article will derive a definition and account of the physically educated person, through an examination of the philosophy of Andrew Reid, Richard Peters and Aristotle. Initially, Reid's interpretation of Peters' views about the educational significance of practical knowledge (and physical education) will be considered. While it will…

Teacher-Led Change in Secondary School Physical Education

ERIC Educational Resources Information Center

Cameron, Jay; Mercier, Kevin; Doolittle, Sarah

2016-01-01

How and why meaningful curriculum or program changes happen in physical education is important, but not well understood, especially at the secondary school level. In this longitudinal case study, we examined teacher-initiated changes in a high school physical education program. Data were collected through prolonged engagement over 5 years and…

Integration and Physical Education: A Review of Research

ERIC Educational Resources Information Center

Marttinen, Risto Harri Juhani; McLoughlin, Gabriella; Fredrick, Ray, III; Novak, Dario

2017-01-01

The Common Core State Standards Initiative has placed an increased focus on mathematics and English language arts. A relationship between physical activity and academic achievement is evident, but research on integration of academic subjects with physical education is still unclear. This literature review examined databases for the years…

A GUIDE FOR PLANNING PHYSICAL EDUCATION AND ATHLETIC FACILITIES.

ERIC Educational Resources Information Center

New Jersey State Dept. of Education, Trenton.

THIS STUDY EXAMINES PHYSICAL EDUCATION FACILITIES, THEIR PHYSICAL NEEDS, AND RELATED DESIGN CONSIDERATIONS. A SYSTEM OF DETERMINING THE TOTAL NUMBER OF TEACHING STATIONS NEEDED IS GIVEN TO AID INITIAL REQUIREMENT ANALYSIS. INDOOR FACILITIES ANALYZED INCLUDE--(1) THE GYMNASIUM, IN TERMS OF LOCATION, SIZE, DESIGN FEATURES, AND RELATED COMPONENTS,…

Physical Activity Level and Symptom Duration Are Not Associated After Concussion.

PubMed

Howell, David R; Mannix, Rebekah C; Quinn, Bridget; Taylor, J Andrew; Tan, Can Ozan; Meehan, William P

2016-04-01

Physical rest after a concussion has been described as a key component in the management of the injury. Evidence supporting this recommendation, however, is limited. To examine the association between physical activity and symptom duration in a cohort of patients after a concussion. Cohort study; Level of evidence, 2. This study included 364 patients who were diagnosed with a concussion, were seen by a physician within 3 weeks of injury, and completed a questionnaire at the initial clinic visit. The questionnaire assessed the postconcussion symptom scale (PCSS) score, previous number of concussions, presence of the loss of consciousness or amnesia at the time of injury, and prior treatment for headaches. During each follow-up clinic visit, physical activity level was self-reported. A Cox proportional hazard model was constructed to determine the association between symptom duration, initial clinic visit responses, and self-reported physical activity level after the injury. Study participants ranged in age from 8 to 27 years (mean age, 15.0 years) and had sustained a mean of 0.8 prior concussions; 222 patients (61%) were male. On initial examination, the mean PCSS score was 34.7. The mean symptom duration was 48.9 days after the injury. Among the variables included in the model, initial PCSS score and female sex were independently associated with symptom duration, while physical activity level after the injury was not. For participants aged between 13 and 18 years, however, higher levels of physical activity after the injury were associated with a shorter symptom duration. Results from this study indicate that physical activity after the injury may not be universally detrimental to the recovery of concussion symptoms. © 2016 The Author(s).

Examining Physical Activity Service Provision to Culturally and Linguistically Diverse (CALD) Communities in Australia: A Qualitative Evaluation

PubMed Central

Caperchione, Cristina M.; Kolt, Gregory S.; Mummery, W. Kerry

2013-01-01

Strong evidence exists for the role of physical activity in preventing and managing a range of chronic health conditions. A particular challenge in promoting physical activity as a health strategy exists in culturally and linguistically diverse (CALD) groups, as such groups demonstrate high risk for a range of non-communicable diseases. The aim of this research was to examine the perspective of multicultural health service providers for CALD groups with respect to the physical activity services/initiatives on offer, access barriers to these services, and ideas for future service delivery in this area. Semi-structured interviews were conducted with 15 multicultural health service providers across the capital cities of the three most populous states in Australia (New South Wales, Queensland, and Victoria), and thematic content analysis was used to examine the data. Findings indicated that the majority of physical activity initiatives were associated with organizations offering other social services for CALD communities but were greatly restrained by resources. As well, it was found that most services were not designed by taking into account specific cultural requirements for CALD communities or their cultural expectations. Common barriers identified to service uptake were classified as socio-cultural (e.g., gender, language, context of health) and environmental (e.g., transportation) in nature. These findings should be utilized when planning future physical activity and health promotion initiatives for increasing CALD participation. In particular, programs need to be culturally tailored to the specific expectations of CALD groups, addressing cultural safety and sensitivity, and should be in partnership with other organizations to extend the reach and capacity. PMID:23638145

Managing acute abdominal pain in pediatric patients: current perspectives

PubMed Central

Hijaz, Nadia M; Friesen, Craig A

2017-01-01

Acute abdominal pain in pediatric patients has been a challenge for providers because of the nonspecific nature of symptoms and difficulty in the assessment and physical examination in children. Although most children with acute abdominal pain have self-limited benign conditions, pain may be a manifestation of an urgent surgical or medical condition where the biggest challenge is making a timely diagnosis so that appropriate treatment can be initiated without any diagnostic delays that increase morbidity. This is weighed against the need to decrease radiation exposure and avoid unnecessary operations. Across all age groups, there are numerous conditions that present with abdominal pain ranging from a very simple viral illness to a life-threatening surgical condition. It is proposed that the history, physical examination, laboratory tests, and imaging studies should initially be directed at differentiating surgical versus nonsurgical conditions both categorized as urgent versus nonurgent. The features of the history including patient’s age, physical examination focused toward serious conditions, and appropriate tests are highlighted in the context of making these differentiations. Initial testing and management is also discussed with an emphasis on making use of surgeon and radiologist consultation and the need for adequate follow-up and reevaluation of the patient. PMID:29388612

Evaluation of the first seizure patient: Key points in the history and physical examination.

PubMed

Nowacki, Tomasz A; Jirsch, Jeffrey D

2017-07-01

This review will present the history and physical examination as the launching point of the first seizure evaluation, from the initial characterization of the event, to the exclusion of alternative diagnoses, and then to the determination of specific acute or remote causes. Clinical features that may distinguish seizures from alternative diagnoses are discussed in detail, followed by a discussion of acute and remote first seizure etiologies. This review article is based on a discretionary selection of English language articles retrieved by a literature search in the PubMed database, and the authors' clinical experience. The first seizure is a dramatic event with often profound implications for patients and family members. The initial clinical evaluation focuses on an accurate description of the spell to confirm the diagnosis, along with careful scrutiny for previously unrecognized seizures that would change the diagnosis more definitively to one of epilepsy. The first seizure evaluation rests primarily on the clinical history, and to a lesser extent, the physical examination. Even in the era of digital EEG recording and neuroimaging, the initial clinical evaluation remains essential for the diagnosis, treatment, and prognostication of the first seizure. Copyright © 2016. Published by Elsevier Ltd.

Development of a Scale Measuring Trait Anxiety in Physical Education

ERIC Educational Resources Information Center

Barkoukis, Vassilis; Rodafinos, Angelos; Koidou, Eirini; Tsorbatzoudis, Haralambos

2012-01-01

The aim of the present study was to examine the validity and reliability of a multi-dimensional measure of trait anxiety specifically designed for the physical education lesson. The Physical Education Trait Anxiety Scale was initially completed by 774 high school students during regular school classes. A confirmatory factor analysis supported the…

Changes in physical activity, self-efficacy and depressive symptoms in adolescent girls.

PubMed

Neissaar, Inga; Raudsepp, Lennart

2011-08-01

The purpose of this study was to examine the longitudinal relationships between naturally occurring changes in leisure-time physical activity, depressive symptoms and self-efficacy in adolescent girls. We also aimed to test whether depressive symptoms would moderate the self-efficacy-physical activity relationship. Participants were 181 urban adolescent girls. Physical activity was measured using the 3-Day Physical Activity Recall. Self-efficacy and depressive symptoms were assessed using questionnaires. Body height and body mass were measured and body mass index (BMI) was calculated. Data were collected on three occasions over a 2-year period. There was a decrease in physical activity and self-efficacy and increase in depressive symptoms across three measurement occasions. There were statistically significant and negative relationships between initial level and change for physical activity and depressive symptoms. Initially higher levels of physical activity were related with initially lower levels of depressive symptoms, and change in physical activity across time was inversely associated with change in levels of depressive symptoms across measurements. There were statistically significant and positive relationships between initial level and change for physical activity and self-efficacy after controlling effect of BMI. Latent growth modeling (LGM) also indicated a moderating effect of depressive symptoms on the self-efficacy-physical activity relationship. Girls who had high initial levels of self-efficacy and smaller increases in depressive symptoms had the lowest decline in physical activity participation. Our results encourage the design of interventions that reduce depressive symptoms and increase self-efficacy as a possible of means of increasing adolescent girls' physical activity.

Emotional outlook on life predicts increases in physical activity among initially inactive men.

PubMed

Baruth, Meghan; Lee, Duck-Chul; Sui, Xuemei; Church, Timothy S; Marcus, Bess H; Wilcox, Sara; Blair, Steven N

2011-04-01

This study examined the relationship between emotional outlook on life and change in physical activity among inactive adults in the Aerobics Center Longitudinal Study. A total of 2,132 sedentary adults completed a baseline medical examination and returned for a follow-up examination at least 6 months later. Participants self-reported physical activity level and emotional outlook on life. Emotional outlook on life was significantly and positively related to physical activity participation at the follow-up visit in men but not women. Men who were usually very happy and optimistic at baseline had significantly greater increases in physical activity compared to men who were not happy. Men with a more positive outlook on life (e.g., happier) may be more likely to increase physical activity levels. Physical activity interventions targeting men may be more successful if they first increase happiness.

History and physical examination of hip injuries in elderly adults.

PubMed

Hamedan Al Maqbali, Mohammed Abdullah

2014-01-01

Hip fracture is the most common injury occurring to elderly people and is associated with restrictions of the activities of the patients themselves. The discovery of a hip fracture can be the beginning of a complex journey of care, from initial diagnosis, through operational procedures to rehabilitation. The patient's history and physical examination form the basis of the diagnosis and monitoring of elderly patients with hip problems and dictate the appropriate treatment strategy to be implemented. The aim of this study is to discuss the different diagnoses of hip pain in a case study of an elderly woman who initially complained of pain in her right knee following a fall at home. It shows that musculoskeletal physical examination determined the management of the hip fracture that was found to be present. In addition, the aim of this article is to review diagnostic tests such as radiographs and recommend appropriate management and treatment of hip fractures in elderly patients.

Achievement Motivation, Coping Processes, and Sports Participation of Athletes with Physical Handicaps: A Student-Initiated Project. Final Report, July 1, 1985 to September 15, 1986.

ERIC Educational Resources Information Center

Overton, Sara R.; And Others

The study examined how the coping behaviors and achievement motivation of 181 athletes (aged 18-66) with cerebral palsy or other physical disabilities influence participation in the normalized activity of competitive sport. The project examined the following cognitive aspects of performance: (1) reasons for becoming involved in sports; (2) how the…

Taking the History and Performing the Physical Examination in a Child with Hearing Loss.

PubMed

Cushing, Sharon L; Papsin, Blake C

2015-12-01

Hearing loss is one of the most common childhood disorders and has far reaching effects on communication and socialization in children. Language acquisition, the most commonly sought and measured outcome, is tightly linked to age at diagnosis of the hearing loss and the speed with which rehabilitation is instituted. Treatment is often not affected by the underlying cause of the hearing loss and should be initiated at the time of initial identification. History-taking and physical examination in the setting of pediatric hearing loss are straightforward and should include an assessment of motor milestones, balance, and vestibular function. Copyright © 2015 Elsevier Inc. All rights reserved.

Initialization and assimilation of cloud and rainwater in a regional model

NASA Technical Reports Server (NTRS)

Raymond, William H.; Olson, William S.

1990-01-01

The initialization and assimilation of cloud and rainwater quantities in a mesoscale regional model was examined. Forecasts of explicit cloud and rainwater are made using conservation equations. The physical processes include condensation, evaporation, autoconversion, accretion, and the removal of rainwater by fallout. These physical processes, some of which are parameterized, represent source and sink in terms in the conservation equations. The question of how to initialize the explicit liquid water calculations in numerical models and how to retain information about precipitation processes during the 4-D assimilation cycle are important issues that are addressed.

Sharing Good Practices: Teenage Girls, Sport, and Physical Activities.

ERIC Educational Resources Information Center

Vescio, Johanna A.; Crosswhite, Janice J.

2002-01-01

Investigated initiatives to increase teenage girls' participation in sport and physical activities, examining good practice case studies from Australia. Surveys of national, state, and regional sporting organizations and various community and school organizations (including culturally diverse girls and girls with disabilities) highlighted three…

The association of cardiorespiratory fitness and physical activity with incidence of hypertension in men.

PubMed

Chase, Nancy L; Sui, Xuemei; Lee, Duck-chul; Blair, Steven N

2009-04-01

Few prospective studies have simultaneously investigated the relationship between physical activity, cardiorespiratory fitness (CRF), and the development of hypertension in initially normotensive individuals. In the Aerobics Center Longitudinal Study (ACLS), we examined this association among initially healthy normotensive men. Participants were 16,601 men aged 20-82 years who completed a baseline examination during 1970-2002 and were followed for hypertension incidence. Physical activity was self-reported and CRF was quantified from the duration of a maximal treadmill test. A total of 2,346 men reported hypertension during a mean 18 years of follow-up. Event rates per 10,000 man-years adjusted for age and examination year were 86.2, 76.6, and 66.7 across physical activity groups of sedentary, walker/jogger/runner (WJR), and sport/fitness, respectively, and 89.8, 78.4, and 64.6 for low, middle, and high CRF, respectively (trend P < 0.0001). These associations persisted after further adjustment for body mass index (BMI), smoking, alcohol intake, resting systolic blood pressure, baseline health status, family history of diseases, and survey response patterns. Both physical activity and CRF are associated with lower risk of developing hypertension in a graded fashion. These findings provide a basis for health professionals to emphasize the importance of participating in regular physical activity to improve fitness for the primary prevention of hypertension in men.

Impact of National Physical Activity and Health Guidelines and Documents on Research on Teaching K-12 Physical Education in U.S.A.

ERIC Educational Resources Information Center

Li, Weidong; Xiang, Ping; Gao, Zan; Shen, Bo; Yin, Zhihua; Kong, Qingtao

2016-01-01

Purpose: This study examined the impact of published national physical activity (PA) and health guidelines, documents, and initiatives on the evolution of research on teaching K-12 physical education (PE) in U.S.A. from 1996 to October 2013. Methods: A total of 262 peer-reviewed, data-based journal articles meeting our inclusion and exclusion…

Informal Science: Family Education, Experiences, and Initial Interest in Science

ERIC Educational Resources Information Center

Dabney, Katherine P.; Tai, Robert H.; Scott, Michael R.

2016-01-01

Recent research and public policy have indicated the need for increasing the physical science workforce through development of interest and engagement with informal and formal science, technology, engineering, and mathematics experiences. This study examines the association of family education and physical scientists' informal experiences in…

The value of physical examination in mental health nursing.

PubMed

Martin, Carolyn T

2016-03-01

This article explores the use of a physical examination assignment in a mental health general nursing clinical placement course that addresses the poor physical health of people with mental illness and the barriers traditionally impeding health care provision for this population. A descriptive qualitative approach utilizes inductive content analysis to investigate 145 student survey responses. The assignment assists student nurses in understanding that physical and mental well-being are intrinsically linked. Students report increased comfort performing a physical examination on patients with mental illness post assignment. Students' initial bias towards this population was minimized post the clinical assignment. Poor physical health is common among people with mental health problems. Many view the provision of care as a major public health issue. Nurses are the front line caregivers of mental health service consumers and are well positioned to assess their physical needs. Their assessment may be the first step in recognizing health care issues in this population. Copyright © 2015 Elsevier Ltd. All rights reserved.

Effects of Attractiveness and Gender on the Perception of Achievement-Related Variables.

ERIC Educational Resources Information Center

Chia, R. C.; Allred, L. J.; Grossnickle, W. F.; Lee, G. W.

1998-01-01

Examines the effects of physical attractiveness and gender on perceptions of academic success, achievement-related traits, intelligence, initiative, and attributions of ability and effort in relation to academic success. Finds that being perceived as physically attractive created positive impressions of achievement-related traits for men but…

MoveU? Assessing a Social Marketing Campaign to Promote Physical Activity

ERIC Educational Resources Information Center

Scarapicchia, Tanya M. F.; Sabiston, Catherine M. F.; Brownrigg, Michelle; Blackburn-Evans, Althea; Cressy, Jill; Robb, Janine; Faulkner, Guy E. J.

2015-01-01

Objective: MoveU is a social marketing initiative aimed at increasing moderate-to-vigorous physical activity (MVPA) among undergraduate students. Using the Hierarchy of Effects model (HOEM), this study identified awareness of MoveU and examined associations between awareness, outcome expectations, self-efficacy, intentions, and MVPA. Participants:…

Sensitivity of a Simulated Derecho Event to Model Initial Conditions

NASA Astrophysics Data System (ADS)

Wang, Wei

2014-05-01

Since 2003, the MMM division at NCAR has been experimenting cloud-permitting scale weather forecasting using Weather Research and Forecasting (WRF) model. Over the years, we've tested different model physics, and tried different initial and boundary conditions. Not surprisingly, we found that the model's forecasts are more sensitive to the initial conditions than model physics. In 2012 real-time experiment, WRF-DART (Data Assimilation Research Testbed) at 15 km was employed to produce initial conditions for twice-a-day forecast at 3 km. On June 29, this forecast system captured one of the most destructive derecho event on record. In this presentation, we will examine forecast sensitivity to different model initial conditions, and try to understand the important features that may contribute to the success of the forecast.

Microenergetic Shock Initiation Studies on Deposited Films of Petn

NASA Astrophysics Data System (ADS)

Tappan, Alexander S.; Wixom, Ryan R.; Trott, Wayne M.; Long, Gregory T.; Knepper, Robert; Brundage, Aaron L.; Jones, David A.

2009-12-01

Films of the high explosive PETN (pentaerythritol tetranitrate) up to 500-μm thick have been deposited through physical vapor deposition, with the intent of creating well-defined samples for shock-initiation studies. PETN films were characterized with microscopy, x-ray diffraction, and focused ion beam nanotomography. These high-density films were subjected to strong shocks in both the out-of-plane and in-plane orientations. Initiation behavior was monitored with high-speed framing and streak camera photography. Direct initiation with a donor explosive (either RDX with binder, or CL-20 with binder) was possible in both orientations, but with the addition of a thin aluminum buffer plate (in-plane configuration only), initiation proved to be difficult. Initiation was possible with an explosively-driven 0.13-mm thick Kapton flyer and direct observation of initiation behavior was examined using streak camera photography at different flyer velocities. Models of this configuration were created using the shock physics code CTH.

Annual physical examination reports vary by gender once teenagers become sexually active.

PubMed

Marcell, Arik V; Matson, Pam; Ellen, Jonathan M; Ford, Carol A

2011-07-01

Few sexually active male adolescents receive sexual and reproductive health (SRH) services. To understand this, we examined the association between sexual behavior status and physical examination of the adolescents over time. We conducted longitudinal cohort analysis of the National Longitudinal Study of Adolescent Health with 9,239 adolescents who completed the baseline school (1994/1995) and wave 2 (1996) follow-up surveys approximately 1.5 years later (retention rate = 71%). The logistic regression models were fitted with random effects to estimate individual odds of reporting a physical examination in the past 12 months at follow-up, compared with baseline, stratified by sexual behavior status and gender, and adjusting for sociodemographic and healthcare access factors. In all, 34.5% of male and 38.2% of female adolescents reported experiencing vaginal intercourse by follow-up, and 22.4% of male and 24.7% of female adolescents reported first experiencing intercourse during the study period. Among sexually active adolescents, about half reported having annual physical examinations and one-fifth reported not having any physical examinations. Among female adolescents, baseline to follow-up examination reports significantly increased in the following: sex initiators (adjusted odds ratio [OR] = 2.09, 95% confidence interval [CI] = 1.66-2.64); those reporting sex at both times (OR = 2.16, CI = 1.51-3.09); and those reporting no sex either time (OR = 2.47, CI = 2.00-3.04). Among male adolescents, baseline to follow-up examination reports significantly increased in those reporting no sex either time (OR = 1.57, CI = 1.26-1.96) and showed increasing trends in sex initiators (OR = 1.27, CI = .92-1.76). A majority of sexually active adolescents report annual physical examinations over time. Providers should not miss opportunities to deliver evidence-based SRH to sexually active adolescents. Future efforts are needed to increase access of all adolescents to SRH services. MESH TERMS: Health Services Accessibility, Male, Female. Copyright © 2011 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

The Association of Family Influence and Initial Interest in Science

ERIC Educational Resources Information Center

Dabney, Katherine P.; Chakraverty, Devasmita; Tai, Robert H.

2013-01-01

With recent attention to improving scientific workforce development and student achievement, there has been a rise in effort to understand and encourage student engagement in physical science. This study examines the association of family influence and initial interest in science through multiple and logistic regression models. Research questions…

Evaluation of common elbow pathologies: a focus on physical examination.

PubMed

Laratta, Joseph; Caldwell, Jon-Michael; Lombardi, Joseph; Levine, William; Ahmad, Christopher

2017-05-01

Elbow tendinopathy accounts for the majority of elbow pathology in patients presenting to upper extremity and sports medicine surgeons. With increased participation in overhead sports in an aging population, the incidence of elbow injuries has risen. A comprehensive knowledge of elbow anatomy and biomechanical function of the elbow complex is prerequisite in the assessment of patients with elbow injuries; however, a thorough understanding of alternative and confounding pathologies is essential for accurate diagnosis. Because tendinopathy, tendonitis, and tendon tears have an anatomic basis for their pathology, a targeted history and meticulous physical examination often yields an accurate clinical diagnosis. The importance of physical examination and provocative examination maneuvers must be stressed in a technologically advanced era where clinical diagnosis is too commonly attained solely by advanced imaging modalities. A revived dedication to the physical examination may enhance our ability to correctly diagnose various pathologies about the elbow. Early and accurate clinical diagnosis is the first step in the proper initiation of treatment modalities and improvement in overall patient outcome.

Social Processes of Health and Physical Education Teachers' Identity Formation: Reproducing and Changing Culture

ERIC Educational Resources Information Center

Sirna, K.; Tinning, R.; Rossi, T.

2010-01-01

This paper examines Initial Teacher Education students' experiences of participation in health and physical education (HPE) subject department offices and the impact on their understandings and identity formation. Pierre Bourdieu's concepts of habitus, field, and practice along with Wenger's communities of practice form the theoretical frame used…

Empowering Teachers to Implement Innovative Content in Physical Education through Continuous Professional Development

ERIC Educational Resources Information Center

Braga, Luciana; Jones, Emily; Bulger, Sean; Elliott, Eloise

2017-01-01

The purpose of this study was to examine teacher perceptions regarding their experiences in a research-informed continuous professional development (CPD) initiative and its influence on their professional readiness to implement innovative content in physical education (PE). Participants included four PE teachers who engaged in a series of hands-on…

An Examination of Learning Profiles in Physical Education

ERIC Educational Resources Information Center

Shen, Bo; Chen, Ang

2007-01-01

Using the model of domain learning as a theoretical framework, the study was designed to examine the extent to which learners' initial learning profiles based on previously acquired knowledge, learning strategy application, and interest-based motivation were distinctive in learning softball. Participants were 177 sixth-graders from three middle…

Short-term functional health and well-being after marital separation: does initiator status make a difference?

PubMed

Hewitt, Belinda; Turrell, Gavin

2011-06-01

The authors investigated the health consequences of marital separation and whether the partners who initiated the separation had better health than those who did not. The data came from the Households, Income and Labour Dynamics in Australia (HILDA) panel study (2001-2007), comprising an analytic sample of 1,786 men and 2,068 women who were in their first marriages in 2001. For participants who separated, the authors distinguished between self-initiated, partner-initiated, and jointly initiated separations. Using linear random-intercept models, they examined scores on the 8 physical and mental health dimensions of Short Form 36, with scale scores ranging from 0 to 100. The results indicated that in general, men who separated had a decline in health, although this was more pronounced for mental dimensions than for physical dimensions. Among separated men, those whose partner initiated the separation had poorer mental health than those for whom the separation was self-initiated or jointly initiated (-4.61). Women's physical health improved with separation, but their mental health declined. For separated women, those whose partner initiated the separation had lower scores on the general health (-5.39), role-emotional (-11.08), and mental health (-7.18) scales than women who self-initiated separation. The health consequences of separation were less severe for self- or jointly initiated separations, suggesting that not all marital dissolutions are equally bad for health.

The epidemiology of physical attack and rape among crack-using women.

PubMed

Falck, R S; Wang, J; Carlson, R G; Siegal, H A

2001-02-01

This prospective study examines the epidemiology of physical attack and rape among a sample of 171 not-in-treatment, crack-cocaine using women. Since initiating crack use, 62% of the women reported suffering a physical attack. The annual rate of victimization by physical attack was 45%. Overall, more than half of the victims sought medical care subsequent to an attack. The prevalence of rape since crack use was initiated was 32%, and the annual rate was 11%. Among those women having been raped since they initiated crack use, 83% reported they were high on crack when the crime occurred as were an estimated 57% of the perpetrators. Logistic regression analyses showed that duration of crack use, arrest for prostitution, and some college education were predictors of having experienced a physical attack. Duration of crack use and a history of prostitution were predictors of suffering a rape. Drug abuse treatment programs must be sensitive to high levels of violence victimization experienced by crack-cocaine using women. Screening women for victimization, and treating the problems that emanate from it, may help make drug abuse treatment more effective.

Undergraduate Students' Perceptions of an Inquiry-Based Physics Course

NASA Astrophysics Data System (ADS)

Ballone Duran, Lena; McArthur, Julia; van Hook, Stephen

2004-04-01

The purpose of this study was to examine middle childhood students'' perceptions of the learning environment in a reform-based physics course. A lecture-style, introductory physics course was modified into an inquiry-based course designed for preservice middle childhood teachers through the collaborative efforts of faculty in the Colleges of Education and Arts and Sciences. Focus group interviews were conducted to examine students'' perceptions. The results suggested that the students initially felt a level of frustration with a new constructivist experience; however, they were able to embrace the inquiry method and expressed a desire for additional specialized content courses for preservice teachers.

Urban environment interventions linked to the promotion of physical activity. A mixed methods study applied to the urban context of Latin America

PubMed Central

Gomez, Luis F; Sarmiento, Rodrigo; Ordoñez, Maria Fernanda; Pardo, Carlos Felipe; de Sá, Thiago Hérick; Mallarino, Christina H; Miranda, J Jaime; Mosquera, Janeth; Parra, Diana Celmira; Reis, Rodrigo; Quistberg, Alex

2015-01-01

This study summarizes the evidence from quantitative systematic reviews that assessed the association between urban environment attributes and physical activity. It also documents sociopolitical barriers and facilitators involved in urban interventions linked with active living in the ten most populated urban settings of Latin America. The synthesis of evidence indicates that several attributes of urban environments are associated with physical activity, including land-use mix and cycling infrastructure. The documentary analysis indicated that despite the benefits and opportunities provided by the programs and existing infrastructure in the examined cities, an overall concern is the rising inequality in the coverage and distribution of the initiatives in the region. If these programs and initiatives are to achieve a real population level effect that helps to reduce health disparities, they need to examine their social and spatial distribution within the cities so they can reach underserved populations and develop to their full potential. PMID:25748111

Urban environment interventions linked to the promotion of physical activity: a mixed methods study applied to the urban context of Latin America.

PubMed

Gomez, Luis F; Sarmiento, Rodrigo; Ordoñez, Maria Fernanda; Pardo, Carlos Felipe; de Sá, Thiago Hérick; Mallarino, Christina H; Miranda, J Jaime; Mosquera, Janeth; Parra, Diana C; Reis, Rodrigo; Quistberg, D Alex

2015-04-01

This study summarizes the evidence from quantitative systematic reviews that assessed the association between urban environment attributes and physical activity. It also documents sociopolitical barriers and facilitators involved in urban interventions linked with active living in the ten most populated urban settings of Latin America. The synthesis of evidence indicates that several attributes of urban environments are associated with physical activity, including land-use mix and cycling infrastructure. The documentary analysis indicated that despite the benefits and opportunities provided by the programs and existing infrastructure in the examined cities, an overall concern is the rising inequality in the coverage and distribution of the initiatives in the region. If these programs and initiatives are to achieve a real population level effect that helps to reduce health disparities, they need to examine their social and spatial distribution within the cities so they can reach underserved populations and develop to their full potential. Copyright © 2015 Elsevier Ltd. All rights reserved.

The American Society for Radiation Oncology's 2015 Core Physics Curriculum for Radiation Oncology Residents

DOE Office of Scientific and Technical Information (OSTI.GOV)

Burmeister, Jay, E-mail: burmeist@karmanos.org; Chen, Zhe; Chetty, Indrin J.

Purpose: The American Society for Radiation Oncology (ASTRO) Physics Core Curriculum Subcommittee (PCCSC) has updated the recommended physics curriculum for radiation oncology resident education to improve consistency in teaching, intensity, and subject matter. Methods and Materials: The ASTRO PCCSC is composed of physicists and physicians involved in radiation oncology residency education. The PCCSC updated existing sections within the curriculum, created new sections, and attempted to provide additional clinical context to the curricular material through creation of practical clinical experiences. Finally, we reviewed the American Board of Radiology (ABR) blueprint of examination topics for correlation with this curriculum. Results: The newmore » curriculum represents 56 hours of resident physics didactic education, including a 4-hour initial orientation. The committee recommends completion of this curriculum at least twice to assure both timely presentation of material and re-emphasis after clinical experience. In addition, practical clinical physics and treatment planning modules were created as a supplement to the didactic training. Major changes to the curriculum include addition of Fundamental Physics, Stereotactic Radiosurgery/Stereotactic Body Radiation Therapy, and Safety and Incidents sections, and elimination of the Radiopharmaceutical Physics and Dosimetry and Hyperthermia sections. Simulation and Treatment Verification and optional Research and Development in Radiation Oncology sections were also added. A feedback loop was established with the ABR to help assure that the physics component of the ABR radiation oncology initial certification examination remains consistent with this curriculum. Conclusions: The ASTRO physics core curriculum for radiation oncology residents has been updated in an effort to identify the most important physics topics for preparing residents for careers in radiation oncology, to reflect changes in technology and practice since the publication of previous recommended curricula, and to provide practical training modules in clinical radiation oncology physics and treatment planning. The PCCSC is committed to keeping the curriculum current and consistent with the ABR examination blueprint.« less

The American Society for Radiation Oncology's 2015 Core Physics Curriculum for Radiation Oncology Residents.

PubMed

Burmeister, Jay; Chen, Zhe; Chetty, Indrin J; Dieterich, Sonja; Doemer, Anthony; Dominello, Michael M; Howell, Rebecca M; McDermott, Patrick; Nalichowski, Adrian; Prisciandaro, Joann; Ritter, Tim; Smith, Chadd; Schreiber, Eric; Shafman, Timothy; Sutlief, Steven; Xiao, Ying

2016-07-15

The American Society for Radiation Oncology (ASTRO) Physics Core Curriculum Subcommittee (PCCSC) has updated the recommended physics curriculum for radiation oncology resident education to improve consistency in teaching, intensity, and subject matter. The ASTRO PCCSC is composed of physicists and physicians involved in radiation oncology residency education. The PCCSC updated existing sections within the curriculum, created new sections, and attempted to provide additional clinical context to the curricular material through creation of practical clinical experiences. Finally, we reviewed the American Board of Radiology (ABR) blueprint of examination topics for correlation with this curriculum. The new curriculum represents 56 hours of resident physics didactic education, including a 4-hour initial orientation. The committee recommends completion of this curriculum at least twice to assure both timely presentation of material and re-emphasis after clinical experience. In addition, practical clinical physics and treatment planning modules were created as a supplement to the didactic training. Major changes to the curriculum include addition of Fundamental Physics, Stereotactic Radiosurgery/Stereotactic Body Radiation Therapy, and Safety and Incidents sections, and elimination of the Radiopharmaceutical Physics and Dosimetry and Hyperthermia sections. Simulation and Treatment Verification and optional Research and Development in Radiation Oncology sections were also added. A feedback loop was established with the ABR to help assure that the physics component of the ABR radiation oncology initial certification examination remains consistent with this curriculum. The ASTRO physics core curriculum for radiation oncology residents has been updated in an effort to identify the most important physics topics for preparing residents for careers in radiation oncology, to reflect changes in technology and practice since the publication of previous recommended curricula, and to provide practical training modules in clinical radiation oncology physics and treatment planning. The PCCSC is committed to keeping the curriculum current and consistent with the ABR examination blueprint. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Age of Sexual Debut and Physical Dating Violence Victimization: Sex Differences among US High School Students

ERIC Educational Resources Information Center

Ihongbe, Timothy O.; Cha, Susan; Masho, Saba W.

2017-01-01

Background: Research has shown that early age of sexual debut is associated with physical dating violence (PDV), but sex-specific associations are sparse. We estimated the prevalence of PDV victimization in high school students who have initiated sexual intercourse and examined sex-specific association between age of sexual debut and PDV…

Effectiveness of physical therapy for patients with neck pain: an individualized approach using a clinical decision-making algorithm.

PubMed

Wang, Wendy T J; Olson, Sharon L; Campbell, Anne H; Hanten, William P; Gleeson, Peggy B

2003-03-01

The purpose of this study was to determine the effectiveness of an individualized physical therapy intervention in treating neck pain based on a clinical reasoning algorithm. Treatment effectiveness was examined by assessing changes in impairment, physical performance, and disability in response to intervention. One treatment group of 30 patients with neck pain completed physical therapy treatment. The control group of convenience was formed by a cohort group of 27 subjects who also had neck pain but did not receive treatment for various reasons. There were no significant differences between groups in demographic data and the initial test scores of the outcome measures. A quasi-experimental, nonequivalent, pretest-posttest control group design was used. A physical therapist rendered an eclectic intervention to the treatment group based on a clinical decision-making algorithm. Treatment outcome measures included the following five dependent variables: cervical range of motion, numeric pain rating, timed weighted overhead endurance, the supine capital flexion endurance test, and the Patient Specific Functional Scale. Both the treatment and control groups completed the initial and follow-up examinations, with an average duration of 4 wk between tests. Five mixed analyses of variance with follow-up tests showed a significant difference for all outcome measures in the treatment group compared with the control group. After an average 4 wk of physical therapy intervention, patients in the treatment group demonstrated statistically significant increases of cervical range of motion, decrease of pain, increases of physical performance measures, and decreases in the level of disability. The control group showed no differences in all five outcome variables between the initial and follow-up test scores. This study delineated algorithm-based clinical reasoning strategies for evaluating and treating patients with cervical pain. The algorithm can help clinicians classify patients with cervical pain into clinical patterns and provides pattern-specific guidelines for physical therapy interventions. An organized and specific physical therapy program was effective in improving the status of patients with neck pain.

42 CFR 410.16 - Initial preventive physical examination: Conditions for and limitations on coverage.

Code of Federal Regulations, 2010 CFR

2010-10-01

... preventive examination not more than 1 year after the effective date of his or her first Medicare Part B... potential (risk factors) for depression, including current or past experiences with depression or other mood... use of appropriate screening questions or a screening questionnaire, which the physician or other...

Preschoolers who refuse to be examined. Fearful or spoiled?

PubMed

Schmitt, B D

1984-05-01

Twenty-two children (aged 2 to 5 years) who cried excessively or resisted physical examination during routine office visits initially seemed to be afraid of physicians, but eight were afraid of medical procedures, five had prolonged separation anxiety, six were manipulative, and three were afraid of men because of previous physical abuse by their fathers. Management plans were initiated for each etiological subtype. Five of eight parents whose children were afraid of medical procedures and five of six parents whose children were manipulative returned for counseling. In these cases, 100% (8/8) and 80% (4/5) of the children, respectively, made major improvement. Abused children required referral to mental health centers. Most parents of children with prolonged separation anxiety (three of five) did not consider the overdependent behavior to be a problem and therefore did not comply with treatment recommendations.

Musculoskeletal education in physical medicine and rehabilitation residency programs.

PubMed

Smith, Jay; Krabak, Brian J; Malanga, Gerard A; Moutvic, Margaret A

2004-10-01

To characterize current musculoskeletal (MSK) education experiences in physical medicine and rehabilitation residency programs and to identify perceived barriers to providing more extensive MSK education experiences. In addition, to establish utilization patterns for the PASSOR Physical Examination Core Competencies List. Between March and November 2003, all 81 physical medicine and rehabilitation residency program directors were asked to complete an MSK education survey developed by the authors. A total of 69 of 81 program directors (86%) responded after multiple contacts. The most frequently utilized MSK education formats were MSK lecture series, MSK departmental conferences, and physical examination workshops. Potential barriers to expanded MSK education included money, time, and staff number. Given unlimited resources, most residency programs would greatly increase utilization of visiting lecturers, CD-ROMs/DVDs, objective structured clinical examinations, and physical examination videos. Of the 30 program directors who recalled receiving the Core Competencies List, only 40% (12 of 30) have formally integrated the list into their residency training. Barriers to implementation included logistical challenges and lack of direction regarding implementation. Residency program directors indicate a strong interest in expanding resident MSK education through the use of CD-ROMs/DVDs, physical examination videos, objective structured clinical examinations, and visiting lecturer programs. CD-ROMs/DVDs and videos represent particularly attractive educational formats for supplementing resident MSK education due to the advantages of central production, nominal costs, widespread distribution, multimedia capabilities, and accessibility. These educational formats should be considered for targeted educational initiatives to enhance resident MSK education, regardless of residency program size or resources.

Factors associated with breastfeeding initiation time in a baby-friendly hospital in Istanbul.

PubMed

İnal, Sevil; Aydin, Yasemin; Canbulat, Nejla

2016-11-01

To investigate perinatal factors that affect breastfeeding of newborns delivered at a baby-friendly public hospital in Turkey, including the time of the first physical examination by a pediatrician, the first union with their mothers, and the first breastfeeding time after delivery. The research was conducted from May 2nd through June 30th, 2011, in a baby-friendly public hospital in Istanbul. The sample consisted of 194 mothers and their full-term newborns. The data were collected via an observation form developed by the researchers. In analyzing the data, the average, standard deviation, minimum, maximum values, Chi-square, and percentages were used. The results revealed that the first physical examinations of the newborns were performed approximately 53.02±39min (range, 1-180 min) after birth. The newborns were given to their mothers approximately 69.75±41min (range, 3-190 min) after birth. Consequently, the first initiated breastfeeding took place approximately 78.58±44min following birth, and active sucking was initiated after approximately 85.90±54min. A large percentage of the newborns (64.4%) were not examined by a specialist pediatrician within half an hour of birth, and 74.7% were not united with their mothers within the same period. Also, the newborns who initiated breastfeeding within the first half hour had significantly earlier success with active sucking and required significantly less assistance to achieve successful breastfeeding. The newborns in our study met with their mothers late in the birth ward because examinations of the newborns were delayed. The newborns began initial sucking later, and this chain reaction negatively impacted the breastfeeding success of the newborns. Copyright © 2016 Elsevier Inc. All rights reserved.

Quality of Life Assessment for Physical Activity and Health Promotion: Further Psychometrics and Comparison of Measures

ERIC Educational Resources Information Center

Gill, Diane L.; Reifsteck, Erin J.; Adams, Melanie M.; Shang, Ya-Ting

2015-01-01

Despite the clear relationship between physical activity and quality of life, few sound, relevant quality of life measures exist. Gill and colleagues developed a 32-item quality of life survey, and provided initial psychometric evidence. This study further examined that quality of life survey in comparison with the widely used short form (SF-36)…

THE DEVELOPMENT AND EVALUATION OF THREE TYPES OF PHYSICAL EDUCATION PROGRAMS FOR EDUCABLE MENTALLY RETARDED BOYS. FINAL REPORT.

ERIC Educational Resources Information Center

GOHEEN, ROYAL L.

THREE PHYSICAL EDUCATION PROGRAMS, SKILL-ORIENTED, PLAY- ORIENTED, AND FREE-PLAY ORIENTED WERE DEVELOPED. THESE PROGRAMS WERE EXAMINED, INITIALLY, BY SEVEN EXPERTS AND THEN SUBJECTED TO A PILOT STUDY. THE REVISED PROGRAMS WERE TAUGHT BY RESEARCH ASSISTANTS TO SIX EXPERIMENTAL GROUPS WHICH INCLUDED 82 BOYS AT TWO STATE SCHOOLS FOR THE MENTALLY…

Gender Differences in College Students' Perceptions of Same-Sex Sexual Harassment: The Influence of Physical Attractiveness and Attitudes toward Lesbians and Gay Men

ERIC Educational Resources Information Center

Castillo, Yenys; Muscarella, Frank; Szuchman, Lenore T.

2011-01-01

This study examined college students' perceptions of same-sex harassment as a function of the observer's gender, the initiator's physical attractiveness, and observers' attitudes toward lesbians and gay men. Ninety-six college students read a scenario portraying a professor's sexual advances toward a student. The Perception of Harassment…

An Evaluation of the Navy Family Advocacy Program at Naval Regional Medical Center, Camp Pendleton, California.

DTIC Science & Technology

1982-08-01

to d suggest that health system intervention varies from simply providing initial physical examination to coordinating long term care and follow-up...developed with item numbers 3, 4, and 6 utilized to score the local program in terms of professional awareness. The cover 1 49 letter and questionnaire...Congress. HARM: Includes, but not limited to: ( 1 ) Physical , emo- tional, or mental injury, including physical injury resulting from otherwise lawful

Body temperature rhythm and control of the time of the best physical condition by performing physical labor.

PubMed

Imafuku, Michio

2016-01-01

The initial examination of a male subject's body temperature revealed that it was highest during the evening. Based on this observation, I measured grasping power, calculation speed, performance time on a light sensory task and body temperature, all of which were highest or best during the evening. The time of this subject's best physical condition shifted from the evening to morning hours when the subject executed hard physical labor in the morning, and the shifted phase was maintained after the termination of the labor period.

Reliability of the OSCE for Physical and Occupational Therapists

PubMed Central

Sakurai, Hiroaki; Kanada, Yoshikiyo; Sugiura, Yoshito; Motoya, Ikuo; Wada, Yosuke; Yamada, Masayuki; Tomita, Masao; Tanabe, Shigeo; Teranishi, Toshio; Tsujimura, Toru; Sawa, Syunji; Okanishi, Tetsuo

2014-01-01

[Purpose] To examine agreement rates between faculty members and clinical supervisors as OSCE examiners. [Subjects] The study subjects were involved physical and occupational therapists working in clinical environments for 1 to 5 years after graduating from training schools as OSCE examinees, and a physical or occupational therapy faculty member and a clinical supervisor as examiners. Another clinical supervisor acted as a simulated patient. [Methods] The agreement rate between the examiners for each OSCE item was calculated based on Cohen’s kappa coefficient to confirm inter-rater reliability. [Results] The agreement rates for the behavioral aspects of the items were higher in the second than in the first examination. Similar increases were also observed in the agreement rates for the technical aspects until the initiation of each activity; however, the rates decreased during the middle to terminal stages of continuous movements. [Conclusion] The results may reflect the recent implementation of measures for the integration of therapist education in training schools and clinical training facilities. PMID:25202170

42 CFR 410.16 - Initial preventive physical examination: Conditions for and limitations on coverage.

Code of Federal Regulations, 2013 CFR

2013-10-01

... potential (risk factors) for depression, including current or past experiences with depression or other mood... of depression, which the physician or other qualified nonphysician practitioner may select from...

42 CFR 410.16 - Initial preventive physical examination: Conditions for and limitations on coverage.

Code of Federal Regulations, 2014 CFR

2014-10-01

... potential (risk factors) for depression, including current or past experiences with depression or other mood... of depression, which the physician or other qualified nonphysician practitioner may select from...

42 CFR 410.16 - Initial preventive physical examination: Conditions for and limitations on coverage.

Code of Federal Regulations, 2012 CFR

2012-10-01

... potential (risk factors) for depression, including current or past experiences with depression or other mood... of depression, which the physician or other qualified nonphysician practitioner may select from...

The Correlation between Physical Environment and Student Engagement

NASA Astrophysics Data System (ADS)

Carmona-Reyes, Jorge; Wang, Li; Matthews, Lorin; Cook, Mike; Hyde, Truell

2016-10-01

In its second year of an educational research collaboration on the convergence between physical environment, pedagogical methods, student attainment and academic performance, CASPER along with the Region 12 Education Service Center and Huckabee Inc. have completed their initial quantitative study. This project examined the impact of the physical environment on student engagement, employing a flexibility construct and examination of teacher mobility and places of centeredness. Data analysis showed a positive correlation between student engagement and classroom flexibility for two locations having statistically significant differences in flexibility scores. The research is now being extended to examine a laboratory setting (in this case, a complex plasma lab) where the results will be used to enhance student work efficiency while also increasing safety within the lab. Details will be discussed in this presentation. Region 12 and Huckabee funding is gratefully acknowledged.

[How to Interpret and Use Routine Laboratory Data--Our Methods to Interpret Routine Laboratory Data--Chairmen's Introductory Remarks].

PubMed

Honda, Takayuki; Tozuka, Minoru

2015-09-01

In the reversed clinicopathological conference (R-CPC), three specialists in laboratory medicine interpreted routine laboratory data independently in order to understand the detailed state of a patient. R-CPC is an educational method to use laboratory data appropriately, and it is also important to select differential diagnoses in a process of clinical reasoning in addition to the present illness and physical examination. Routine laboratory tests can be performed repeatedly at a relatively low cost, and their time-series analysis can be performed. Interpretation of routine laboratory data is almost the same as taking physical findings. General findings are initially checked and then the state of each organ is examined. Although routine laboratory tests cost little, we can gain much more information from them about the patient than physical examinations.

Distance Learning Courses and Master of Arts in Physics Education

NASA Astrophysics Data System (ADS)

Lindgren, Richard; Thornton, Stephen

2006-11-01

More than twenty distance learning courses in physics have been taken by hundreds of High School Physics Teachers over the past 7 years. The success of these courses helped initiate our 30 credit Master of Arts in Physics Education degree program. We have graduated 28 teachers over the last 6 years and expect 13 more to graduate in 2006. The candidates earn 14 credits in residence at the University of Virginia and 16 credits online. This allows teachers to matriculate, while earning more than half the credits at home. Presently, there are over 50 Master degree candidates. Three of the five online courses utilize CD-ROMS with edited lectures of live Physics courses taught at the University of Virginia by Physics Professors recognized for their teaching. Homework and examinations are submitted using WebAssign. Local high school teachers and administrators proctor the examinations. General communication and pedagogical feedback on homework assignments and exams are submitted through Blackboard as well as email. Screen captured video shots of physics demonstrations are widely used in the audio chat room to facilitate discussion and also used on examinations. We will discuss the changes of our distance-learning model based on what has worked (or not) and new technology.

Three-Year Study of Students' Attitudes Toward Physical Education: Grades 4-8.

PubMed

Mercier, Kevin; Donovan, Corinne; Gibbone, Anne; Rozga, Kimberly

2017-09-01

A relationship exists between attitudes toward physical education and future physical activity. The purpose of this study was to examine changes in attitude toward physical education as students progressed from upper elementary school (Grade 4) through middle school (Grade 8). Three cohorts of students (Cohort 1, Grades 4-6, n = 96; Cohort 2, Grades 5-7, n = 71; and Cohort 3, Grades 6-8, n = 73) were each followed for 3 years to examine changes in attitudes toward physical education. After an initial increase from Grade 4 to Grade 5, a significant decrease was observed from Grades 5 to 8 in students' positive attitudes toward physical education, with a faster rate of change for girls than boys. This longitudinal study provides further insights regarding the attitudes of students as they progress from Grade 4 to Grade 8 and expands on previous findings identifying decreasing positive attitudes toward physical education as students age, particularly for girls. The results provide evidence to support targeted interventions.

The course of early disinhibited social engagement among post-institutionalized adopted children

PubMed Central

Lawler, Jamie M.; Koss, Kalsea J.; Doyle, Colleen M.; Gunnar, Megan R.

2016-01-01

Background Approximately 20% of post-institutionalized (PI) children exhibit disinhibited social engagement (DSE) or the propensity to approach and engage strangers. There is little longitudinal research examining changes in DSE after adoption, or methods of identifying children with persistent behaviors. Methods DSE was assessed observationally four times during the first two years post-adoption in PI children 16-36 months at adoption (n=68) relative to same-age non-adopted children (n=52). At age 5, a validated interview determined which PI children met criteria for Disinhibited Social Engagement Disorder (DSED). Results DSE trajectories initially increased and then stabilized. PIs had higher DSE levels initially and a steeper increase rate than NAs. When separated into physical and non-physical DSE components, group differences arose in initial physical DSE and the rate of change of non-physical DSE. DSE rate of increase predicted DSED diagnosis, as did longer institutional duration and poorer institutional care. Conclusions The rate of increase in DSE post-adoption, rather than the level observed at adoption, is predictive of disordered social engagement by age 5 years. PMID:27460336

Improving the Medical Assessment of Patients Before Electroconvulsive Therapy: An Audit Across Two Sites.

PubMed

Driver, Hannah R

2016-06-01

It is essential that a medical assessment is completed before commencing electroconvulsive therapy (ECT) to identify possible risk factors that may complicate anesthesia. This audit aimed to improve the physical examination and documented medical history of this assessment usually performed by referring psychiatrists. Patients from 2 sites (A and B) were retrospectively audited against standards from the Scottish ECT Accreditation Network. The timing and systems examined for the physical examination were noted. Site A used an examination sheet; at site B there was no standard way of recording examination. Documented medical histories were compared with comprehensive histories obtained using multiple sources. Discrepancies were noted. Site A was reaudited after amending the examination sheet and adding prompts to use multiple sources when gathering histories. There were repeat examinations for ECT in 30 patients (100%) at site A and 6 (23%) of 26 at site B. Physical examinations were incomplete in 47% of patients at A and 100% at B. Oral examination was frequently missed at both sites. Medical histories were accurate in 20% at A and 38% at B. In the reaudit of site A, all 12 patients had a complete repeat examination; histories were accurate in 8 (67%), with multiple sources used in 11 (92%). Incomplete or inaccurate assessments put patients at risk. Oral examinations should be part of initial medical assessments. This audit shows the benefits of using a physical examination sheet to ensure a repeat complete examination. Using multiple sources to gather medical histories is encouraged.

Evolution of solar magnetic fields - A new approach to MHD initial-boundary value problems by the method of nearcharacteristics

NASA Technical Reports Server (NTRS)

Nakagawa, Y.

1980-01-01

A method of analysis for the MHD initial-boundary problem is presented in which the model's formulation is based on the method of nearcharacteristics developed by Werner (1968) and modified by Shin and Kot (1978). With this method, the physical causality relationship can be traced from the perturbation to the response as in the method of characteristics, while achieving the advantage of a considerable reduction in mathematical procedures. The method offers the advantage of examining not only the evolution of nonforce free fields, but also the changes of physical conditions in the atmosphere accompanying the evolution of magnetic fields. The physical validity of the method is demonstrated with examples, and their significance in interpreting observations is discussed.

The physical examination in pediatric and adolescent patients.

PubMed

Lara-Torre, Eduardo

2008-06-01

The initial evaluation and examination of both the pediatric and adolescent patients provides the opportunity for the clinician to establish a relationship that will ensure the successful outcome of the visit. In the younger age group, cooperation of the child before performing an examination should be the focus at the first encounter. This cooperation will enable proper positioning and a systematic approach to examination and documentation of findings. Although the adolescent patients may be older and better able to understand the specifics of the examination, these patients present additional challenges for the examining practitioner.

Clinical examination and physical assessment of hip joint-related pain in athletes.

PubMed

Reiman, Michael P; Thorborg, Kristian

2014-11-01

Evidence-based clinical examination and assessment of the athlete with hip joint related pain is complex. It requires a systematic approach to properly differentially diagnose competing potential causes of athletic pain generation. An approach with an initial broad focus (and hence use of highly sensitive tests/measures) that then is followed by utilizing more specific tests/measures to pare down this imprecise differential diagnosis list is suggested. Physical assessment measures are then suggested to discern impairments, activity and participation restrictions for athletes with hip-join related pain, hence guiding the proper treatment approach. 5.

Pediatric Evaluation of Disability Inventory Computer Adaptive Test (PEDI-CAT) and Alberta Infant Motor Scale (AIMS): Validity and Responsiveness.

PubMed

Dumas, Helene M; Fragala-Pinkham, Maria A; Rosen, Elaine L; Lombard, Kelly A; Farrell, Colleen

2015-11-01

Although preliminary studies have established a good psychometric foundation for the Pediatric Evaluation of Disability Inventory Computer Adaptive Test (PEDI-CAT) for a broad population of youth with disabilities, additional validation is warranted for young children. The study objective was to (1) examine concurrent validity, (2) evaluate the ability to identify motor delay, and (3) assess responsiveness of the PEDI-CAT Mobility domain and the Alberta Infant Motor Scale (AIMS). Fifty-three infants and young children (<18 months of age) admitted to a pediatric postacute care hospital and referred for a physical therapist examination were included. The PEDI-CAT Mobility domain and the AIMS were completed during the initial physical therapist examination, at 3-month intervals, and at discharge. A Spearman rank correlation coefficient was used to examine concurrent validity. A chi-square analysis of age percentile scores was used to examine the identification of motor delay. Mean score differences from initial assessment to final assessment were analyzed to evaluate responsiveness. A statistically significant, fair association (rs=.313) was found for the 2 assessments. There was no significant difference in motor delay identification between tests; however, the AIMS had a higher percentage of infants with scores at or below the fifth percentile. Participants showed significant changes from initial testing to final testing on the PEDI-CAT Mobility domain and the AIMS. This study included only young patients (<18 months of age) in a pediatric postacute hospital; therefore, the generalizability is limited to this population. The PEDI-CAT Mobility domain is a valid measure for young children admitted to postacute care and is responsive to changes in motor skills. However, further item and standardization development is needed before the PEDI-CAT is used confidently to identify motor delay in children <18 months of age. © 2015 American Physical Therapy Association.

Social cognitive mediators of the effect of the MobileMums intervention on physical activity.

PubMed

Fjeldsoe, Brianna S; Miller, Yvette D; Marshall, Alison L

2013-07-01

To explore whether improvements in physical activity following the MobileMums intervention were mediated by changes in Social Cognitive Theory (SCT) constructs targeted in the intervention (barrier self efficacy, goal setting skills, outcome expectancy, social support, and perceived environmental opportunity for exercise). This paper also examined if the mediating constructs differed between initial (baseline to 6 weeks) and overall (baseline to 13 weeks) changes in physical activity. Secondary analysis of data from a randomized controlled trial involving 88 postnatal women (<12 months postpartum). Participants were randomized to receive either the 12-week MobileMums intervention or a minimal-contact control condition. Physical activity and proposed mediators were assessed by self-report at baseline, 6 weeks, and 13 weeks. Walking for Exercise frequency was assessed using the Australian Women's Activity Survey and frequency of moderate-to-vigorous physical activity (MVPA) was assessed using a single-item question. Initial improvements in goal-setting skills mediated the relationship between experimental condition and initial changes in MVPA, αβ (95% CI) = 0.23(0.01, 0.59), and Walking for Exercise, αβ (95% CI) = 0.34(0.06, 0.73). Initial improvements in barrier self efficacy mediated the relationship between experimental condition and initial change in MVPA, αβ (95% CI) = 0.36(0.12, 0.65), but not Walking for Exercise. None of the SCT outcomes significantly mediated the relationship between experimental condition and overall (baseline to 13 weeks) change in frequency of MVPA or Walking for Exercise. Future interventions with postnatal women using SCT should target barrier self-efficacy and goal setting skills in order to increase physical activity. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Who should swing the stethoscope? An audit of baseline physical examination and blood monitoring on new patients accepted by an early intervention in psychosis team.

PubMed

Crabb, Jim; McAllister, Mark; Blair, Alison

2009-11-01

It has been established that patients with severe mental illness are at increased risk of physical illness and that physical health screening should be performed when an individual experiences a first episode of psychosis. The aim of the audit was to examine how physical health screening was achieved in the real world of an early intervention in psychosis (EIP) service in Scotland. Of particular interest was considering if primary or secondary care were more effective in providing specific physical health assessment for those presenting to the service. A case note audit was performed. The audit shows that physical examination and blood tests were being completed in the majority of service users under the care of the Esteem service. However, an unacceptably high number were not undergoing sufficient initial screening for metabolic syndrome or having baseline monitoring prior to commencing antipsychotic medication. Our results suggest that relying on primary care to provide physical health screening was not an effective approach in a population experiencing first-episode psychosis. Having a psychiatrist motivated to perform physical health screening within the EIP team may help to improve the uptake of physical health screening. Strategies to improve physical health screening in EIP services are discussed. © 2009 The Authors. Journal compilation © 2009 Blackwell Publishing Asia Pty Ltd.

Hospice inpatients' views on physical examination by medical students: is it acceptable?

PubMed

Hayes, Jennifer

2012-12-01

Hospices are increasingly involved in medical student teaching, which the patients generally enjoy. No studies have specifically investigated how hospice patients view the prospect of physical examination by students. Previous evidence involves patients who have already seen students, while the views of other patients are unknown. This study aimed to provide an initial understanding of the views of a diverse group of hospice inpatients on the acceptability and perceived importance of students physically examining them. 42 hospice inpatients completed a short questionnaire focusing on their views of medical students examining them. Patients chose to do this alone or via a short interview. All inpatients at Exeter Hospice were considered eligible, including patients who were asked and those who may not have been asked to see students; all 42 patients completed the study. In accordance with existing evidence, patients generally held positive views about seeing students. However, many patients expressed concerns about being physically examined by students, specifically including that it might be painful, tiring or embarrassing. Most importantly, several patients who did not wish to be examined by medical students said they would feel obliged to accept it, or would find it difficult to decline. Hospice inpatients generally wish to be involved in medical student teaching, but many are concerned about being physically examined, and some feel a sense of obligation to participate. There are implications for hospices that teach students. Further research is necessary to investigate the frequency and severity of these concerns.

Does physical activity protect against drug abuse vulnerability?

PubMed

Bardo, Michael T; Compton, Wilson M

2015-08-01

The current review examined recent literature to determine our state of knowledge about the potential ability of physical activity serve as a protectant against drug abuse vulnerability. Both preclinical and clinical studies were examined using either associational or random assignment study designs. In addition to examining drug use as an outcome variable, the potential neural mediators linking physical activity and drug abuse vulnerability were examined. Several important conclusions may be drawn. First, the preclinical evidence is solid in showing that physical activity in various forms is able to serve as both a preventive and treatment intervention that reduces drug use, although voluntary alcohol drinking appears to be an exception to this conclusion. Second, the clinical evidence provides some evidence, albeit mixed, to suggest a beneficial effect of physical activity on tobacco dependent individuals. In contrast, there exists only circumstantial evidence that physical activity may reduce use of drugs other than nicotine, and there is essentially no solid information from random control studies to know if physical activity may prevent initiation of problem use. Finally, both preclinical and clinical evidence shows that various brain systems are altered by physical activity, with the medial prefrontal cortex (mPFC) serving as one potential node that may mediate the putative link between physical activity and drug abuse vulnerability. It is concluded that novel neurobehavioral approaches taking advantage of novel techniques for assessing the physiological impact of physical activity are needed and can be used to inform the longitudinal random control studies that will answer definitively the question posed. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

The FAMULATUR PLUS as an innovative approach for teaching physical examination skills.

PubMed

Jerg, Achim; Öchsner, Wolfgang; Wander, Henriette; Traue, Harald C; Jerg-Bretzke, Lucia

2016-01-01

The FAMULATUR PLUS is an innovative approach to teaching physical examination skills. The concept is aimed at medical students during the clinical part of their studies and includes a clinical traineeship (English for "Famulatur") extended to include various courses ("PLUS"). The courses are divided into clinical examination courses and problembased-learning (PBL) seminars. The concept's special feature is the full integration of these courses into a 30-day hospital traineeship. The aim is to facilitate the transfer of knowledge from the courses into daily practice. Each week of the FAMULATUR PLUS is structured in line with the courses and focuses on a particular part of the body (e.g., abdomen). A physical examination course under the supervision of a physician is offered at the beginning of the week. Here, medical students learn the relevant examination techniques by practicing on each other (partner exercises). Subsequently, the techniques taught are applied independently during everyday work on the ward, corrected by the supervisor, if necessary, and thereby reinforced. The final POL seminar takes place towards the end of the week. Possible differential diagnoses are developed based on a clinical case study. The goal is to check these by taking a fictitious medical history and performing a physical examination, as well as to make a preliminary diagnosis. Finally, during the PBL seminar, medical students will be shown how physical examination techniques can be efficiently applied in the diagnosis of common cardinal symptoms (e.g., abdominal pain). The initial implementation of the FAMULATUR PLUS proved the practical feasibility of the concept. In addition, the accompanying evaluation showed that the participants of the pilot project improved with regard to their practical physical examination skills.

The FAMULATUR PLUS as an innovative approach for teaching physical examination skills

PubMed Central

Jerg, Achim; Öchsner, Wolfgang; Wander, Henriette; Traue, Harald C.; Jerg-Bretzke, Lucia

2016-01-01

The FAMULATUR PLUS is an innovative approach to teaching physical examination skills. The concept is aimed at medical students during the clinical part of their studies and includes a clinical traineeship (English for “Famulatur”) extended to include various courses (“PLUS”). The courses are divided into clinical examination courses and problembased-learning (PBL) seminars. The concept’s special feature is the full integration of these courses into a 30-day hospital traineeship. The aim is to facilitate the transfer of knowledge from the courses into daily practice. Each week of the FAMULATUR PLUS is structured in line with the courses and focuses on a particular part of the body (e.g., abdomen). A physical examination course under the supervision of a physician is offered at the beginning of the week. Here, medical students learn the relevant examination techniques by practicing on each other (partner exercises). Subsequently, the techniques taught are applied independently during everyday work on the ward, corrected by the supervisor, if necessary, and thereby reinforced. The final POL seminar takes place towards the end of the week. Possible differential diagnoses are developed based on a clinical case study. The goal is to check these by taking a fictitious medical history and performing a physical examination, as well as to make a preliminary diagnosis. Finally, during the PBL seminar, medical students will be shown how physical examination techniques can be efficiently applied in the diagnosis of common cardinal symptoms (e.g., abdominal pain). The initial implementation of the FAMULATUR PLUS proved the practical feasibility of the concept. In addition, the accompanying evaluation showed that the participants of the pilot project improved with regard to their practical physical examination skills. PMID:26958652

"It's All about Developing the Whole Child": An Examination of the "Legacy" Benefits of Youth Sport Trust's School-Based Inclusion Initiatives

ERIC Educational Resources Information Center

Black, Alison; Costello, Rebecca; Craft, Anna; Katene, Will

2015-01-01

Between 2011 and 2013, the Department for Education (DfE) in England made £3.3 million available to support the development of opportunities for young disabled people to access high-quality physical education and school sport. The DfE with the Youth Sport Trust (YST) developed a range of initiatives to help meet this aim, including Project…

Associations of Dating Violence Victimization with Lifetime Participation, Co-Occurrence, and Early Initiation of Risk Behaviors among U.S. High School Students

ERIC Educational Resources Information Center

Eaton, Danice K.; Davis, Kristen S.; Barrios, Lisa; Brener, Nancy D.; Noonan, Rita K.

2007-01-01

This study examined the association of victimization in a physically violent dating relationship with risk behaviors, age of risk behavior initiation, and co-occurrence of risk behaviors among students in grades 9 through 12 in the United States. Data were from the 2003 national Youth Risk Behavior Survey (YRBS). Nearly 9% of students reported…

Annual physical examination reports vary by gender once teenagers become sexually active

PubMed Central

Marcell, Arik V.; Matson, Pam; Ellen, Jonathan M.; Ford, Carol A.

2010-01-01

Introduction Few sexually active male adolescents receive sexual/reproductive health (SRH) services. We examine whether the association between adolescents’ sexual behavior status and physical examination over time can help us understand why. Methods We conducted longitudinal cohort analysis of the National Longitudinal Study of Adolescent Health with 9239 adolescents who completed the baseline school (1994/95) and Wave 2 (1996) follow-up surveys approximately 1.5 years later (retention rate=71%). We fit logistic regression models with random effects to estimate individual odds of reporting a physical examination in the past 12 months at follow-up, as compared to baseline, stratified by sexual behavior status and gender, and adjusting for sociodemographic and healthcare access factors. Results 34.5% males and 38.2% females reported experiencing vaginal intercourse by follow-up, and 22.4% males and 24.7% females reported first experiencing intercourse during the study. Among sexually active adolescents, about half reported annual exams and one-fifth no exams. Among females, baseline to follow-up exam reports significantly increased in: sex initiators (adjusted Odds Ratio [95% confidence interval]=2.09 [1.66–2.64]); those reporting sex at both times (2.16 [1.51–3.09]); and those reporting no sex either time (2.47 [2.00–3.04]). Among males, baseline to follow-up exam reports significantly increased in those reporting no sex either time (1.57 [1.26–1.96]) and showed increasing trends in sex initiators (1.27 [0.92–1.76]). Discussion A majority of sexually active adolescents report annual physical exams over time. Providers should not miss opportunities to deliver evidence-based SRH to sexually active adolescents. Future efforts are needed to increase all adolescents’ access to SRH services. PMID:21700156

Initiation to street life: a qualitative examination of the physical, social, and psychological practices in becoming an accepted member of the street youth community in Western Kenya.

PubMed

Wachira, Juddy; Kamanda, Allan; Embleton, Lonnie; Naanyu, Violet; Winston, Susanna; Ayuku, David; Braitstein, Paula

2015-06-20

The objective of this study was to describe the physical, social, and psychological initiation practices of street connected children and youths, in Eldoret, western Kenya. This qualitative study was conducted from August 2013 to February 2014. A total of 65 SCCY aged 11-24 years were purposively sampled from the three referral points: 1) A dedicated study clinic for vulnerable children and youth at Moi Teaching and Referral Hospital (MTRH); 2) Primary locations in which street children reside "bases/barracks"; 3) Street youth community-based organizations. In-depth interviews and focus group discussions were used to collect data. All data were audio recorded, transcribed, translated to English, and a content analysis performed. The overall median age was 18 years (IQR 14-20.5 years) and 69.2% of participants were male. None had gone beyond primary level of education. The majority (81.5%) reported to be sexually active. The street community had well-defined structures and rules that were protective of members and ensured survival on the streets. To be fully accepted children had to go through an initiation ritual that had important gender differences. Common rituals between males and females included interrogation, smearing of black soot, and payment of tax. Ritual practices unique to boys were physical abuse, theft of personal possessions, volatile substance use, being forced to eat garbage, and sodomy among the physically weak. Rituals unique to girls were being forced to 'become a wife or sexual partner', rape, and gang rape. Physical and psychological abuse during initiation was normalized and there were no clear mechanisms of dealing with these forms of abuse. There were important gender differences in the initiation practices of SCCY. Normalization of physical and psychological abuse during initiation contributes to the high health risks faced by these SCCY. Appropriate interventions need to be developed in collaboration with SCCY.

An Examination of New York State's Integrated Primary and Mental Health Care Services for Adults with Serious Mental Illness.

PubMed

Scharf, Deborah M; Breslau, Joshua; Hackbarth, Nicole Schmidt; Kusuke, Daniela; Staplefoote, B Lynette; Pincus, Harold Alan

2014-12-30

The poor physical health of adults with serious mental illnesses is a public health crisis. Greater integration of mental health and primary medical care services at the clinic and system levels could address this need. In New York state, there are several ongoing initiatives that promote integrated care for adults with serious mental illness, provided or coordinated by community mental health center staff. This study examines three initiatives. Data were collected by RAND through site visits and surveys of mental health clinic administrators and associated professionals. Results showed that Primary and Behavioral Health Care Integration grantees developed infrastructure that supported a broad scope of primary and preventive health care services; these broad changes appeared to contribute to clinic-wide culture shifts toward integration and shared accountability for consumers' "whole person" health. Clinics participating in the Medicaid Incentive tended to implement only those services for which they could bill, which resulted in newly identified consumer physical health care needs but did not help consumers to connect to physical health care services. Finally, while administrators and providers were optimistic that Medicaid Health Homes have potential to improve access to care for adults with serious mental illness, the newness of the initiative made it difficult to assess the degree to which Health Home networks would meet these goals. We conclude with recommendations to state policymakers, clinical providers, and technical assistance providers and recommendations for future research, all designed to strengthen New York state's integrated care initiatives for adults with serious mental illness.

Depressive Symptoms Moderate Dating Violence Prevention Outcomes Among Adolescent Girls.

PubMed

Collibee, Charlene; Rizzo, Christie J; Kemp, Kathleen; Hood, Erik; Doucette, Hannah; Gittins Stone, Daniel I; DeJesus, Brett

2018-04-01

Few dating violence prevention programs assess how variations in initial violence risk affects responsiveness. This study examines the efficacy of Date SMART, a dating violence and sexual risk prevention program designed to target high-risk adolescent girls, in preventing dating violence in the context of varying initial levels of depressive symptoms. A diverse sample of N = 109 female adolescents with a history of physical dating violence participated in a randomized controlled trial of the Date SMART program and a knowledge only (KO) comparison. Using baseline depression level as a primary risk factor, a series of multilevel models revealed significant main effects of baseline depression such that higher baseline depression was associated with greater physical dating violence perpetration and victimization. Results also showed a three-way interaction for assessment point, depressive symptoms, and condition for physical dating violence perpetration. Specifically, those with higher baseline depression in Date SMART showed significantly less physical dating violence perpetration at follow-ups compared with those with higher baseline depression in the KO group. This difference in violence reduction between conditions was not observed for those with lower baseline depression. Date SMART appears to effectively reduce physical dating violence perpetration in those with higher levels of initial risk. Current findings support that adolescents with different risk profiles respond differently to violence prevention programs.

Associations of Neighborhood and Family Factors with Trajectories of Physical and Social Aggression During Adolescence

PubMed Central

Karriker-Jaffe, Katherine J.; Foshee, Vangie A.; Ennett, Susan T.; Suchindran, Chirayath

2013-01-01

Adolescents develop within multiple contexts that synergistically influence their behavior and health. To understand the simultaneous influence of neighborhood and family contexts on adolescents, this study examined relationships of neighborhood socioeconomic disadvantage, neighborhood social disorganization, family conflict, parent-child bonding and parental control with trajectories of physical and social aggression. The sample included 5,118 adolescents between ages 11 and 18 (50% female, 52% Caucasian) living in predominantly rural areas. Multilevel growth curve models showed an interaction between neighborhood disadvantage, family conflict and gender on the physical aggression trajectories. The interaction suggested more rapid processes of both increase in and desistance from physical aggression over time for boys with high neighborhood disadvantage and high family conflict, as well as a higher starting point, more gradual increase and slower process of desistance over time for girls in similar neighborhood and family contexts. Less parent-child bonding and less parental control also were associated with higher initial levels of physical aggression. For social aggression, an interaction between family conflict and gender showed girls with high family conflict had the highest initial levels of social aggression, with a more gradual increase over time for these girls compared to their male counterparts in high-conflict families or their female counterparts in low-conflict families. Less parent-child bonding was associated with higher initial levels and a faster increase over time of social aggression, and less parental control was associated with higher initial levels of social aggression. The findings suggest early family-based interventions may help prevent perpetration of both physical and social aggression during adolescence. PMID:23054352

Associations of neighborhood and family factors with trajectories of physical and social aggression during adolescence.

PubMed

Karriker-Jaffe, Katherine J; Foshee, Vangie A; Ennett, Susan T; Suchindran, Chirayath

2013-06-01

Adolescents develop within multiple contexts that synergistically influence their behavior and health. To understand the simultaneous influence of neighborhood and family contexts on adolescents, this study examined relationships of neighborhood socioeconomic disadvantage, neighborhood social disorganization, family conflict, parent-child bonding and parental control with trajectories of physical and social aggression. The sample included 5,118 adolescents between ages 11 and 18 (50% female, 52% Caucasian) living in predominantly rural areas. Multilevel growth curve models showed an interaction between neighborhood disadvantage, family conflict and gender on the physical aggression trajectories. The interaction suggested more rapid processes of both increase in and desistance from physical aggression over time for boys with high neighborhood disadvantage and high family conflict, as well as a higher starting point, more gradual increase and slower process of desistance over time for girls in similar neighborhood and family contexts. Less parent-child bonding and less parental control also were associated with higher initial levels of physical aggression. For social aggression, an interaction between family conflict and gender showed girls with high family conflict had the highest initial levels of social aggression, with a more gradual increase over time for these girls compared to their male counterparts in high-conflict families or their female counterparts in low-conflict families. Less parent-child bonding was associated with higher initial levels and a faster increase over time of social aggression, and less parental control was associated with higher initial levels of social aggression. The findings suggest early family-based interventions may help prevent perpetration of both physical and social aggression during adolescence.

Municipal Officials' Participation in Built Environment Policy Development in the United States.

PubMed

Lemon, Stephenie C; Goins, Karin Valentine; Schneider, Kristin L; Brownson, Ross C; Valko, Cheryl A; Evenson, Kelly R; Eyler, Amy A; Heinrich, Katie M; Litt, Jill; Lyn, Rodney; Reed, Hannah L; Tompkins, Nancy O'Hara; Maddock, Jay

2015-01-01

This study examined municipal officials' participation in built environment policy initiatives focused on land use design, transportation, and parks and recreation. Web-based cross-sectional survey. Eighty-three municipalities with 50,000 or more residents in eight states. Four hundred fifty-three elected and appointed municipal officials. Outcomes included self-reported participation in land use design, transportation, and parks and recreation policy to increase physical activity. Independent variables included respondent position; perceptions of importance, barriers, and beliefs regarding physical activity and community design and layout; and physical activity partnership participation. Multivariable logistic regression models. Compared to other positions, public health officials had lower participation in land use design (78.3% vs. 29.0%), transportation (78.1% vs. 42.1%), and parks and recreation (67.1% vs. 26.3%) policy. Perceived limited staff was negatively associated with participation in each policy initiative. Perceptions of the extent to which physical activity was considered in community design and physical activity partnership participation were positively associated with participation in each. Perceived lack of collaboration was associated with less land use design and transportation policy participation, and awareness that community design affects physical activity was associated with more participation. Perceived lack of political will was associated with less parks and recreation policy participation. Public health officials are underrepresented in built environment policy initiatives. Improving collaborations may improve municipal officials' policy participation.

Attitudes Toward Euthanasia for Patients Who Suffer From Physical or Mental Illness.

PubMed

Levin, Kfir; Bradley, Graham L; Duffy, Amanda

2018-01-01

This study examined whether attitudes toward euthanasia vary with type of illness and with the source of the desire to end the patient's life. The study used a 3 (illness type: cancer, schizophrenia, depression) × 2 (euthanasia type: patient-initiated, family-initiated) between-groups experimental design. An online questionnaire was administered to 324 employees and students from a Australian public university following random assignment of participants to one of the six vignette-based conditions. Attitudes toward euthanasia were more positive for patients with a physical illness than a mental illness. For a patient with cancer or depression, but not schizophrenia, approval was greater for patient-, than, family-, initiated euthanasia. Relationships between illness type and attitudes were mediated by perceptions of patient autonomy and illness controllability. Findings have implications for debate, practices, and legislation regarding euthanasia.

Depressive symptoms predict cancer caregivers' physical health decline.

PubMed

Shaffer, Kelly M; Kim, Youngmee; Carver, Charles S; Cannady, Rachel S

2017-11-01

Cancer caregiving has been associated with worsening health among caregivers themselves, yet demographic and psychosocial predictors of their long-term health decline are less known. This study examines changes in caregivers' physical health 2 to 8 years after their family members' cancer diagnosis and prospective predictors of that change. Caregivers (n = 664; mean age, 53.2 years) participated in a nationwide study at 2 (T1), 5 (T2), and 8 (T3) years after their family members' cancer diagnosis. Physical health (12-item Medical Outcomes Study Short Form Health Survey Physical Component Scale) was assessed T1 through T3 as outcome. Predictors were self-reported at T1, including caregiver demographics (age, sex, education, income, relationship to patient, and employment status), patient cancer severity (from medical records), and caregiver psychosocial factors (caregiving stress, caregiving esteem, social support, and depressive symptoms). Latent growth modeling tested predictors of caregivers' initial physical health and their physical health change across time. At T1, caregivers reported slightly better physical health than the US population (M = 51.22, P = .002), which declined over the following 6 years (M slope = -0.27, P < .001). All demographic factors, patient cancer severity, and T1 caregiving stress were related to caregivers' initial physical health (P ≤ .03). Higher depressive symptoms were unrelated to caregivers' initial physical health, but were the only significant predictor of caregivers' more rapid physical health decline (B = -0.02, P = .004). Findings highlight the unique contribution of caregivers' depressive symptoms to their physical health decline. Assessing and addressing depressive symptoms among caregivers early in the cancer survivorship trajectory may help to prevent premature health decline among this important yet vulnerable population. Cancer 2017;123:4277-4285. © 2017 American Cancer Society. © 2017 American Cancer Society.

Early Sex Work Initiation and Violence against Female Sex Workers in Mombasa, Kenya.

PubMed

Parcesepe, Angela M; L'Engle, Kelly L; Martin, Sandra L; Green, Sherri; Suchindran, Chirayath; Mwarogo, Peter

2016-12-01

Between 20 and 40 % of female sex workers (FSWs) began sex work before age 18. Little is known concerning whether early initiation of sex work impacts later experiences in adulthood, including violence victimization. This paper examines the relationship between early initiation of sex work and violence victimization during adulthood. The sample included 816 FSWs in Mombasa, Kenya, recruited from HIV prevention drop-in centers who were 18 years or older and moderate-risk drinkers. Early initiation was defined as beginning sex work at 17 or younger. Logistic regression modeled recent violence as a function of early initiation, adjusting for drop-in center, age, education, HIV status, supporting others, and childhood abuse. Twenty percent of the sample reported early initiation of sex work. Although both early initiators and other FSWs reported commonly experiencing recent violence, early initiators were significantly more likely to experience recent physical and sexual violence and verbal abuse from paying partners. Early initiation was not associated with physical or sexual violence from non-paying partners. Many FSWs begin sex work before age 18. Effective interventions focused on preventing this are needed. In addition, interventions are needed to prevent violence against all FSWs, in particular, those who initiated sex work during childhood or adolescence.

Extended physics as a theoretical framework for systems biology?

PubMed

Miquel, Paul-Antoine

2011-08-01

In this essay we examine whether a theoretical and conceptual framework for systems biology could be built from the Bailly and Longo (2008, 2009) proposal. These authors aim to understand life as a coherent critical structure, and propose to develop an extended physical approach of evolution, as a diffusion of biomass in a space of complexity. Their attempt leads to a simple mathematical reconstruction of Gould's assumption (1989) concerning the bacterial world as a "left wall of least complexity" that we will examine. Extended physical systems are characterized by their constructive properties. Time is acting and new properties emerge by their history that can open the list of their initial properties. This conceptual and theoretical framework is nothing more than a philosophical assumption, but as such it provides a new and exciting approach concerning the evolution of life, and the transition between physics and biology. Copyright © 2011 Elsevier Ltd. All rights reserved.

Evaluating average and atypical response in radiation effects simulations

NASA Astrophysics Data System (ADS)

Weller, R. A.; Sternberg, A. L.; Massengill, L. W.; Schrimpf, R. D.; Fleetwood, D. M.

2003-12-01

We examine the limits of performing single-event simulations using pre-averaged radiation events. Geant4 simulations show the necessity, for future devices, to supplement current methods with ensemble averaging of device-level responses to physically realistic radiation events. Initial Monte Carlo simulations have generated a significant number of extremal events in local energy deposition. These simulations strongly suggest that proton strikes of sufficient energy, even those that initiate purely electronic interactions, can initiate device response capable in principle of producing single event upset or microdose damage in highly scaled devices.

Examination of the Physical and Social Environments and Their Effect on Health Promotion Program Participation, Self Initiated Physical Activity and Nutrition Choices among University Employees

ERIC Educational Resources Information Center

Leininger, Lisa Janzen

2011-01-01

The worksite can be an effective arena to elicit health behavior change. Worksite health promotion programs now exist in 90% of all companies with more than 50 employees. These programs have become prevalent due to the high rates of obesity and lifestyle related diseases that are present in the United States. The purpose of this study was to…

Lumbar disc herniation in young children.

PubMed

Haidar, R; Ghanem, I; Saad, S; Uthman, I

2010-01-01

This article explores lumbar disc herniation in young children through focusing on matters relevant to patient presentation, physical examination, differential diagnosis, imaging and treatment. Major databases were searched for studies that addressed lumbar disc herniation in young children. Diagnosis of lumbar disc herniation in young children is usually delayed because of the rarity and lack of experience with this entity and the difficulty in extracting a reliable medical history. Nevertheless, lumbar disc herniation should be considered in the differential diagnosis of any young child presenting with a chief complaint of back pain and/or radiculopathy, especially in the setting of recent trauma. This should be coupled with a directed physical examination to elicit signs and narrow the differential diagnosis. Imaging studies, mainly magnetic resonance imaging, will help establish a diagnosis; yet radiographs are still required to exclude other spinal lesions. The initial management of lumbar disc herniation in children is the same as that in adults and consists of conservative treatment unless lumbar disc herniation affects the patient's motor and neurological functions in which case, early surgical treatment must be undertaken. Although the latter remains more difficult, current experience suggests a favourable outcome. Awareness of lumbar disc herniation will help the paediatrician extract a relevant medical history, perform a directed physical examination, and order appropriate imaging studies. This will aid in initiating early intervention, be it conservative or operative, and achieving a favourable outcome.

TH-E-201-01: Diagnostic Radiology Residents Physics Curriculum and Updates

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sensakovic, W.

The ABR Core Examination stresses integrating physics into real-world clinical practice and, accordingly, has shifted its focus from passive recall of facts to active application of physics principles. Physics education of radiology residents poses a challenge. The traditional method of didactic lectures alone is insufficient, yet it is difficult to incorporate physics teaching consistently into clinical rotations due to time constraints. Faced with this challenge, diagnostic medical physicists who teach radiology residents, have been thinking about how to adapt their teaching to the new paradigm, what to teach and meet expectation of the radiology resident and the radiology residency program.more » The proposed lecture attempts to discuss above questions. Newly developed diagnostic radiology residents physics curriculum by the AAPM Imaging Physics Curricula Subcommittee will be reviewed. Initial experience on hands-on physics teaching will be discussed. Radiology resident who will have taken the BAR Core Examination will share the expectation of physics teaching from a resident perspective. The lecture will help develop robust educational approaches to prepare radiology residents for safer and more effective lifelong practice. Learning Objectives: Learn updated physics requirements for radiology residents Pursue effective approaches to teach physics to radiology residents Learn expectation of physics teaching from resident perspective J. Zhang, This topic is partially supported by RSNA Education Scholar Grant.« less

Physics through the 1990s: Atomic, molecular and optical physics

NASA Technical Reports Server (NTRS)

1986-01-01

The volume presents a program of research initiatives in atomic, molecular, and optical physics. The current state of atomic, molecular, and optical physics in the US is examined with respect to demographics, education patterns, applications, and the US economy. Recommendations are made for each field, with discussions of their histories and the relevance of the research to government agencies. The section on atomic physics includes atomic theory, structure, and dynamics; accelerator-based atomic physics; and large facilities. The section on molecular physics includes spectroscopy, scattering theory and experiment, and the dynamics of chemical reactions. The section on optical physics discusses lasers, laser spectroscopy, and quantum optics and coherence. A section elucidates interfaces between the three fields and astrophysics, condensed matter physics, surface science, plasma physics, atmospheric physics, and nuclear physics. Another section shows applications of the three fields in ultra-precise measurements, fusion, national security, materials, medicine, and other topics.

Acute thoracolumbar pain due to cholecystitis: a case study.

PubMed

Carter, Chris T

2015-01-01

This article describes and discusses the case of an adult female with cholecystitis characterized on initial presentation as acute thoracolumbar pain. A 34-year-old female presented for care with a complaint of acute right sided lower thoracic and upper lumbar pain with associated significant hyperalgesia and muscular hypertonicity. The patient was examined, referred, and later diagnosed by use of ultrasound imaging. Despite many initial physical examination findings of musculoskeletal dysfunction, this case demonstrates the significance of visceral referred pain, viscerosomatic hyperalgesia & hypertonicity, and how these neurological processes can mimic mechanical pain syndromes. A clinical neurological discussion of cholecystitis visceral pain and referred viscerosomatic phenomena is included.

Documenting the Physical Universe:Preserving the Record of SLAC from 1962 to 2005

DOE Office of Scientific and Technical Information (OSTI.GOV)

Deken, Jean Marie; /SLAC

2006-03-10

Since 1905, Albert Einstein's ''miraculous year'', modern physics has advanced explosively. In 2005, the World Year of Physics, a session at the SAA Annual meeting discusses three institutional initiatives--Einstein's collected papers, an international geophysical program, and a research laboratory--to examine how physics and physicists are documented and how that documentation is being collected, preserved, and used. This paper provides a brief introduction to the research laboratory (SLAC), discusses the origins of the SLAC Archives and History Office, its present-day operations, and the present and future challenges it faces in attempting to preserve an accurate historical record of SLAC's activities.

Physical Examination of the Wrist: Useful Provocative Maneuvers.

PubMed

Kleinman, William B

2015-07-01

Chronic wrist pain resulting from partial interosseous ligament injury remains a diagnostic dilemma for many hand and orthopedic surgeons. Overuse of costly diagnostic studies including magnetic resonance imaging, computed tomography scans, and bone scans can be further frustrating to the clinician because of their inconsistent specificity and reliability in these cases. Physical diagnosis is an effective (and underused) means of establishing a working diagnosis of partial ligament injury to the wrist. Carefully performed provocative maneuvers can be used by the clinician to reproduce the precise character of a patient's problem, reliably establish a working diagnosis, and initiate a plan of treatment. Using precise physical examination techniques, the examiner introduces energy into the wrist in a manner that puts load on specific support ligaments of the carpus, leading to an accurate diagnosis. This article provides a broad spectrum of physical diagnostic tools to help the surgeon develop a working diagnosis of partial wrist ligament injuries in the face of chronic wrist pain and normal x-rays. Copyright © 2015 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Activity patterns of elderly men and women.

PubMed

Sidney, K H; Shephard, R J

1977-01-01

The activity patterns of elderly men and women (greater than 60 years) were examined by diaries, ECG taperecorders, and electro-chemical integrators. Although the subjects thought that they were active relative to others of their age, both activity measurements and initial assessments of fitness indicated an inactive life style. At different periods of the day, the heart rate averaged 70-90 beats per minute, and the physical training threshold was rarely approached. During the week, the women engaged in 90 min. more physical activity than the men. However, at the weekend the men added an average of 100 min. of physical activity, whereas the women carried out 30 min. less physical work. Introduction of a 1-hour physical activity class four times per week increased the average daily energy expenditure by 150-200 kCal, to 2500 kCal in the men and 2200 kCal in the women. The added activity was sufficient to augment aerobic power, to induce favorable changes in body composition and to initiate change in other areas of life style, including a diminished use of the car.

TH-E-201-00: Teaching Radiology Residents: What, How, and Expectation

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

The ABR Core Examination stresses integrating physics into real-world clinical practice and, accordingly, has shifted its focus from passive recall of facts to active application of physics principles. Physics education of radiology residents poses a challenge. The traditional method of didactic lectures alone is insufficient, yet it is difficult to incorporate physics teaching consistently into clinical rotations due to time constraints. Faced with this challenge, diagnostic medical physicists who teach radiology residents, have been thinking about how to adapt their teaching to the new paradigm, what to teach and meet expectation of the radiology resident and the radiology residency program.more » The proposed lecture attempts to discuss above questions. Newly developed diagnostic radiology residents physics curriculum by the AAPM Imaging Physics Curricula Subcommittee will be reviewed. Initial experience on hands-on physics teaching will be discussed. Radiology resident who will have taken the BAR Core Examination will share the expectation of physics teaching from a resident perspective. The lecture will help develop robust educational approaches to prepare radiology residents for safer and more effective lifelong practice. Learning Objectives: Learn updated physics requirements for radiology residents Pursue effective approaches to teach physics to radiology residents Learn expectation of physics teaching from resident perspective J. Zhang, This topic is partially supported by RSNA Education Scholar Grant.« less

Concern for privacy in relation to age during physical examination of children: an exploratory study.

PubMed

Hansson, Mats G; Kihlbom, Ulrik; Tuvemo, Torsten; Rodriguez, Alina

2009-08-01

To explore whether physicians behave differently regarding ethics and respect for privacy depending on children's age. We explored whether physician behaviours contributed to child uneasiness. Observational study of 21 children (0-12 years; 18 boys; mean age 3.2) undergoing evaluation for inguinal hernia. Specific physician-initiated verbal and nonverbal behaviours were coded from digital video discs of the consultations. Physician intrusiveness (i.e. approaching the child suddenly or in an uninvited way) during the physical examination was related to concurrent child uneasiness (r = 0.42, p < 0.06) and lasted through the postexamination phase of the consultation (r = 0.52, p < 0.01). Child mood during the examination strongly predicted postexamination mood (r = 0.69, p < 0.0001). Neither the total number of physician-initiated positive behaviours or privacy-related behaviours was associated with child age. Negative physician behaviours were strongly related to negative mood in the child (r = 0.72, p < 0.0001) at the close of the consultation. Although physicians were more likely to provide information to older than younger children, their behaviours regarding privacy did not differ by child age. We found that intrusiveness was rather common and related to child uneasiness that has implications for the ethical practice and a child's willingness to be examined.

Maintaining physical therapy standards in an emergency situation: solutions after the Bali bombing disaster.

PubMed

Edgar, D; Wood, F; Goodwin-Walters, A

2005-08-01

In a mass casualty event, treatment is traditionally provided in a 'best for the most' fashion. This paper examines the challenges encountered by physical therapists while providing rehabilitation to 28 survivors who suffered burns after the terrorist bombing in Bali, Indonesia. Individual patient input was achieved with routine outcome measures and workload statistics. Workforce expansion, maintenance of treatment quality, and other practical initiatives used in order to achieve this goal are discussed.

Physical Functioning among Women 80 Years of Age and Older With and Without a Cancer History.

PubMed

Weaver, Kathryn E; Leach, Corinne R; Leng, Xiaoyan; Danhauer, Suzanne C; Klepin, Heidi D; Vaughan, Leslie; Naughton, Michelle; Chlebowski, Rowan T; Vitolins, Mara Z; Paskett, Electra

2016-03-01

Females 80 years and older comprise 22% of the total U.S. survivor population, yet the impact of cancer on the physical well-being of women is this age group has not been well characterized. We compared women, 80 years of age and older in the Women's Health Initiative extension 2, who did (n = 2,270) and did not (n = 20,272) have an adjudicated history of cancer during Women's Health Initiative enrollment; analyses focused on women >2-years postcancer diagnosis. The physical functioning subscale of the RAND-36 was the primary outcome. Demographic, health-status, and psychosocial covariates were drawn from Women's Health Initiative assessments. Analysis of covariance was used to examine the effect of cancer history on physical function, with and without adjustment for covariates. In adjusted models, women with a history of cancer reported significantly lower mean physical functioning (56.6, standard error [SE] 0.4) than those without a cancer history (58.0, SE 0.1), p = .002. In these models, younger current age, lower body mass index, increased physical activity, higher self-rated health, increased reported happiness, and the absence of noncancer comorbid conditions were all associated with higher physical functioning in both women with and without a history of cancer. Women older than 80 years of age with a cancer history have only a moderately lower level of physical function than comparably aged women without a cancer history. Factors associated with higher levels of physical functioning were similar in both groups. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Hospital readmission risks in older adults following inpatient subacute care: A six-month follow-up study.

PubMed

Lee, Den-Ching A; Williams, Cylie; Lalor, Aislinn F; Brown, Ted; Haines, Terry P

2018-05-09

High rates of unplanned hospital readmissions are a burden on healthcare systems and individuals. This study examined factors at, and after initial hospital discharge and their associations with unplanned hospital readmission for older adults up to six months post-discharge from subacute care. Older subacute care patients were surveyed prior to discharge, and assessed monthly post-discharge for six months. Data included the Geriatric Depression Scale, Phone-Fitt sub-scales, Friendship Scale, modified Lubben Social Network Scale, unplanned hospital readmission, self-reported physical capacity and falls in the last month were collected. Regression analyses were used to examine relationships between unplanned hospital readmission and variables that may predispose this outcome. Participants (n = 311) completed the baseline assessment. N = 218 (70%) completed all at six-month post-discharge. Eighty-nine (29%) participants shared 143 readmissions. Those with cancer history (adjusted OR [95% CI]) (1.97 [1.15, 3.39]), neurological disease other than stroke (2.95 [1.32, 6.57]) and dependence on others to assist in bending tasks (1.94 [1.14, 3.29]) at initial discharge were associated with readmission within six months post-discharge. Those who fell in the last month (adjusted OR [robust 95% CI]) (2.28 [1.43, 3.64]), being less physical active (0.98 [0.96, 0.99]), and dependence on others in moving around residence (2.63 [1.37, 5.06]) after initial discharge were associated with a readmission in the next month within six months post-discharge. Trials investigating the effectiveness of strategies to reduce falls, build physical capacity, increase physical activity level, and connection with health care services after discharge to prevent readmission are warranted. Copyright © 2018 Elsevier B.V. All rights reserved.

Physical Activity Predicts Higher Physical Function in Older Adults: The Osteoarthritis Initiative.

PubMed

Batsis, John A; Germain, Cassandra M; Vásquez, Elizabeth; Zbehlik, Alicia J; Bartels, Stephen J

2016-01-01

Physical activity reduces mobility impairments in elders. We examined the association of physical activity on risk of subjective and objective physical function in adults with and at risk for osteoarthritis (OA). Adults aged ≥ 60 years from the longitudinal Osteoarthritis Initiative, a prospective observational study of knee OA, were classified by sex-specific quartiles of Physical Activity Score for the Elderly scores. Using linear mixed models, we assessed 6-year data on self-reported health, gait speed, Late-Life Function and Disability Index (LLFDI) and chair stand. Of 2252 subjects, mean age ranged from 66 to 70 years. Within each quartile, physical component (PCS) of the Short Form-12 and gait speed decreased from baseline to follow-up in both sexes (all P < .001), yet the overall changes across PASE quartiles between these 2 time points were no different (P = .40 and .69, males and females, respectively). Decline in PCS occurred in the younger age group, but rates of change between quartiles over time were no different in any outcomes in either sex. LLFDI scores declined in the 70+ age group. Adjusting for knee extensor strength reduced the strength of association. Higher physical activity is associated with maintained physical function and is mediated by muscle strength, highlighting the importance of encouraging physical activity in older adults with and at risk for OA.

Progress in defect quantification in multi-layered structures using ultrasonic inspection

NASA Astrophysics Data System (ADS)

Dierken, Josiah; Aldrin, John C.; Holec, Robert; LaCivita, Michael; Shearer, Joshua; Lindgren, Eric

2013-01-01

This study investigates the ability to resolve flaws in aluminum panel stackups representative of aircraft structural components. Using immersion ultrasound techniques, the specimens were examined for known fatigue cracks and electric discharge machined (EDM) notches at various fastener sites. Initial assessments suggested a possible trend between measured ultrasound parameters of flaw intensity and size, and known physical defect length. To improve analytical reliability and efficiency, development of automated data analysis (ADA) algorithms has been initiated.

Cauda Equina Compression in the Absence of Neurologic Signs.

PubMed

Buzzell, Bethany; Sheets, Charles; Bagley, Carlos A

2016-04-01

The patient was a 45-year-old man with a 4-year history of chronic low back pain, intensifying insidiously over the previous 8 months. On physical examination, generalized, severe low back pain was increased with all motions, with no abnormal neurologic signs. The initial physical therapy diagnosis was nonspecific low back pain; however, when the patient reported worsening symptoms at 2-week follow-up, he was advised to complete his previously scheduled magnetic resonance imaging and physician follow-up before further physical therapy. Magnetic resonance imaging revealed a mass at L5 consistent with benign nerve sheath tumor.

Can Vascular Injury be Appropriately Assessed With Physical Examination After Knee Dislocation?

PubMed

Weinberg, Douglas S; Scarcella, Nicholas R; Napora, Joshua K; Vallier, Heather A

2016-06-01

Knee dislocations are rare injuries with potentially devastating vascular complications. An expeditious and accurate diagnosis is necessary, as failing to diagnose vascular injury can result in amputation; however, the best diagnostic approach remains controversial. We asked: (1) What patient factors are predictors of vascular injury after knee dislocation? (2) What are the diagnostic utilities of palpable dorsalis pedis or posterior tibial pulses, and the presence of an ankle-brachial index (ABI) of 0.9 or greater? A database at a Level I trauma center was queried for patients with evidence of knee dislocation, demographic information (age at the time of injury, sex, Injury Severity Score, BMI, mechanism of injury), and the presence of open injury were recorded. One-hundred forty-one patients underwent screening at initial presentation, of whom 26 (24%) underwent early vascular exploration based on an abnormal physical examination. One-hundred five (91%) of the remaining 115 patients were available at a minimum followup of 6 months (mean, 19 ± 10 months). In total, 31 unique patients were excluded, including 10 patients (7%) who were lost to followup before 6 months. Among the 110 patients who met inclusion criteria, the mean age and SD was 37 ± 13 years, and the Injury Severity Score was 15 ± 9. There were 71 males (65%). Logistic regression was used to determine independent correlates of vascular injury. The vascular examination was reviewed for the presence of a palpable pulse in the dorsalis pedis artery, the presence of a palpable pulse in the posterior tibial artery, and whether the ABI in the dorsalis pedis was 0.9 or greater. Contingency tables were generated to assess the sensitivity, specificity, and accuracy of physical examination maneuvers. The physical examination was collectively regarded as "normal" when both pulses were palpable and the ABI was 0.9 or greater. The initial physical examination as just described was considered the diagnostic test being evaluated in this study; "positive" tests were evaluated by and confirmed at vascular surgery, and 6 months clinical followup without symptoms or progressive signs of vascular injury confirmed the absence of injury in the remainder of the patients. Contingency tables were generated again to assess the sensitivity, specificity, and accuracy of the combined physical examination. Increased BMI (odds ratio [OR], 1.077; 95% CI, 1.008-1.155; p = 0.033) and open injuries (OR, 3.366; 95% CI, 1.008-11.420; p = 0.048) were associated with vascular injury. No single physical examination maneuver had a 100% sensitivity for ruling out vascular injury. A normal physical examination (palpable pulses and ABI ≥ 0.9) had 100% sensitivity for ruling out vascular injury. Increased BMI and the presence of open dislocation are associated with a greater risk for vascular injury after knee dislocation. The combination of a palpable dorsalis pedis and posterior tibial pulse combined with an ABI of 0.9 or greater was 100% sensitive for the detection of vascular injury based on clinical followup at 6 months. Level III, diagnostic study.

Learning physical examination skills outside timetabled training sessions: what happens and why?

PubMed

Duvivier, Robbert J; van Geel, Koos; van Dalen, Jan; Scherpbier, Albert J J A; van der Vleuten, Cees P M

2012-08-01

Lack of published studies on students' practice behaviour of physical examination skills outside timetabled training sessions inspired this study into what activities medical students undertake to improve their skills and factors influencing this. Six focus groups of a total of 52 students from Years 1-3 using a pre-established interview guide. Interviews were recorded, transcribed and analyzed using qualitative methods. The interview guide was based on questionnaire results; overall response rate for Years 1-3 was 90% (n = 875). Students report a variety of activities to improve their physical examination skills. On average, students devote 20% of self-study time to skill training with Year 1 students practising significantly more than Year 3 students. Practice patterns shift from just-in-time learning to a longitudinal selfdirected approach. Factors influencing this change are assessment methods and simulated/real patients. Learning resources used include textbooks, examination guidelines, scientific articles, the Internet, videos/DVDs and scoring forms from previous OSCEs. Practising skills on fellow students happens at university rooms or at home. Also family and friends were mentioned to help. Simulated/real patients stimulated students to practise of physical examination skills, initially causing confusion and anxiety about skill performance but leading to increased feelings of competence. Difficult or enjoyable skills stimulate students to practise. The strategies students adopt to master physical examination skills outside timetabled training sessions are self-directed. OSCE assessment does have influence, but learning takes place also when there is no upcoming assessment. Simulated and real patients provide strong incentives to work on skills. Early patient contacts make students feel more prepared for clinical practice.

The Structure of Co-Occurring Bullying Experiences and Associations with Suicidal Behaviors in Korean Adolescents.

PubMed

Roh, Beop-Rae; Yoon, Yoewon; Kwon, Ahye; Oh, Seunga; Lee, Soyoung Irene; Ha, Kyunghee; Shin, Yun Mi; Song, Jungeun; Park, Eun Jin; Yoo, Heejung; Hong, Hyun Ju

2015-01-01

This study had two main goals: to examine the structure of co-occurring peer bullying experiences among adolescents in South Korea from the perspective of victims and to determine the effects of bullying on suicidal behavior, including suicidal ideation and suicide attempts, among adolescents. This study used data gathered from 4,410 treatment-seeking adolescents at their initial visits to 31 local mental health centers in Gyeonggi Province, South Korea. The structure of peer bullying was examined using latent class analysis (LCA) to classify participants' relevant experiences. Then, a binomial logistic regression adjusted by propensity scores was conducted to identify relationships between experiences of being bullied and suicidal behaviors. The LCA of experiences with bullying revealed two distinct classes of bullying: physical and non-physical. Adolescents who experienced physical bullying were 3.05 times more likely to attempt suicide than those who were not bullied. Victims of (non-physical) cyber bullying were 2.94 times more likely to attempt suicide than were those who were not bullied. Both physical and non-physical bullying were associated with suicide attempts, with similar effect sizes. Schools and mental health professionals should be more attentive than they currently are to non-physical bullying.

TH-E-201-02: Hands-On Physics Teaching of Residents in Diagnostic Radiology

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhang, J.

The ABR Core Examination stresses integrating physics into real-world clinical practice and, accordingly, has shifted its focus from passive recall of facts to active application of physics principles. Physics education of radiology residents poses a challenge. The traditional method of didactic lectures alone is insufficient, yet it is difficult to incorporate physics teaching consistently into clinical rotations due to time constraints. Faced with this challenge, diagnostic medical physicists who teach radiology residents, have been thinking about how to adapt their teaching to the new paradigm, what to teach and meet expectation of the radiology resident and the radiology residency program.more » The proposed lecture attempts to discuss above questions. Newly developed diagnostic radiology residents physics curriculum by the AAPM Imaging Physics Curricula Subcommittee will be reviewed. Initial experience on hands-on physics teaching will be discussed. Radiology resident who will have taken the BAR Core Examination will share the expectation of physics teaching from a resident perspective. The lecture will help develop robust educational approaches to prepare radiology residents for safer and more effective lifelong practice. Learning Objectives: Learn updated physics requirements for radiology residents Pursue effective approaches to teach physics to radiology residents Learn expectation of physics teaching from resident perspective J. Zhang, This topic is partially supported by RSNA Education Scholar Grant.« less

TH-E-201-03: A Radiology Resident’s Perspectives of Physics Teaching

DOE Office of Scientific and Technical Information (OSTI.GOV)

Key, A.

The ABR Core Examination stresses integrating physics into real-world clinical practice and, accordingly, has shifted its focus from passive recall of facts to active application of physics principles. Physics education of radiology residents poses a challenge. The traditional method of didactic lectures alone is insufficient, yet it is difficult to incorporate physics teaching consistently into clinical rotations due to time constraints. Faced with this challenge, diagnostic medical physicists who teach radiology residents, have been thinking about how to adapt their teaching to the new paradigm, what to teach and meet expectation of the radiology resident and the radiology residency program.more » The proposed lecture attempts to discuss above questions. Newly developed diagnostic radiology residents physics curriculum by the AAPM Imaging Physics Curricula Subcommittee will be reviewed. Initial experience on hands-on physics teaching will be discussed. Radiology resident who will have taken the BAR Core Examination will share the expectation of physics teaching from a resident perspective. The lecture will help develop robust educational approaches to prepare radiology residents for safer and more effective lifelong practice. Learning Objectives: Learn updated physics requirements for radiology residents Pursue effective approaches to teach physics to radiology residents Learn expectation of physics teaching from resident perspective J. Zhang, This topic is partially supported by RSNA Education Scholar Grant.« less

African-American Children's Representation of Personal and Social Responsibility

ERIC Educational Resources Information Center

Mowling, Claire M.; Brock, Sheri J.; Hastie, Peter A.

2011-01-01

This study examines 12 grade five elementary school students' attitudes and beliefs concerning personal and social responsibility in physical education. Factors used to identify students' attitudes and beliefs were initially divided into the six levels of Hellison's Taking Personal and Social Responsibility Model (TPSR), namely: irresponsibility,…

When Legitimacy Shapes Environmentally Responsible Behaviors: Considering Exposure to University Sustainability Initiatives

ERIC Educational Resources Information Center

Watson, Lesley; Hegtvedt, Karen A.; Johnson, Cathryn; Parris, Christie L.; Subramanyam, Shruthi

2017-01-01

This study examines how perceptions of the legitimacy of university sustainability efforts--support by the administration (authorization) or from students' peers (endorsement)--as well as the physical context in which students live, matter in shaping students' environmentally responsible behaviors (ERBs). Using survey data collected from…

Utilizing the Bicycle for Non-Traditional Activities

ERIC Educational Resources Information Center

Maina, Michael P.; Maina, Julie Schlegel; Sebek, Ludek; Hoffmanova, Jana; Kane, Jennifer Jackson

2012-01-01

This article examines the bicycle as not simply a means of transportation or as an exercise device, but rather as a vehicle for teambuilding and problem solving activities within a physical education curriculum. The activities described in this article focus on bike-centered initiatives that foster creative problem solving. They have universal…

Student Characteristics Mediating Engagement-Outcome Relationships in Physical Education.

ERIC Educational Resources Information Center

Silverman, Stephen

This study investigated the relationship between engagement and achievement for college students in an intermediate swimming class. It also examined this relationship for students who entered the class with different initial skill levels, different previous experience with the subject matter, and for students of different gender. The methodology…

ParticipACTION after 5 years of relaunch: a quantitative survey of Canadian organizational awareness and capacity regarding physical activity initiatives.

PubMed

Faulkner, Guy; Ramanathan, Subha; Plotnikoff, Ronald C; Berry, Tanya; Deshpande, Sameer; Latimer-Cheung, Amy E; Rhodes, Ryan E; Tremblay, Mark S; Spence, John C

2018-04-01

ParticipACTION is a Canadian physical activity communications and social marketing organization relaunched in 2007. This study assesses the capacity of Canadian organizations to adopt, implement, and promote physical activity initiatives. The four objectives were to compare findings from baseline (2008) and follow-up (2013) with respect to: (1) awareness of ParticipACTION; (2) organizational capacity to adopt, implement and promote physical activity initiatives; (3) potential differences in capacity based on organizational size, sector, and mandate; and (4) assess perceptions of ParticipACTION five years after relaunch. In this cross-sectional study, representatives from local, provincial/territorial, and national organizations completed an online survey assessing capacity to adopt, implement, and promote physical activity. Descriptive statistics and one-way analyses of variance were conducted to examine the objectives. Response rate for opening an email survey invitation and consenting to participate was 40.6% (685/1688) and 540 surveys were completed. Awareness of ParticipACTION increased from 54.6% at baseline to 93.9% at follow-up (Objective 1). Findings at both baseline and follow-up reflected good organizational capacity to adopt, implement and promote physical activity (Objective 2) although some varied by organizational sector and mandate (Objective 3). Most respondents reported that ParticipACTION provided positive leadership (65.3%), but there was less agreement regarding ParticipACTION's facilitation of infrastructure (44.0%) or organizational will/motivation (47.1%)(Objective 4). Canadian organizations continue to report having good capacity to adopt, implement, and promote physical activity. There was no discernible change in capacity indicators five years after ParticipACTION's relaunch although its broader contribution to the physical activity sector was endorsed.

Design and protocol of a randomized multiple behavior change trial: Make Better Choices 2 (MBC2).

PubMed

Pellegrini, Christine A; Steglitz, Jeremy; Johnston, Winter; Warnick, Jennifer; Adams, Tiara; McFadden, H G; Siddique, Juned; Hedeker, Donald; Spring, Bonnie

2015-03-01

Suboptimal diet and inactive lifestyle are among the most prevalent preventable causes of premature death. Interventions that target multiple behaviors are potentially efficient; however the optimal way to initiate and maintain multiple health behavior changes is unknown. The Make Better Choices 2 (MBC2) trial aims to examine whether sustained healthful diet and activity change are best achieved by targeting diet and activity behaviors simultaneously or sequentially. Study design approximately 250 inactive adults with poor quality diet will be randomized to 3 conditions examining the best way to prescribe healthy diet and activity change. The 3 intervention conditions prescribe: 1) an increase in fruit and vegetable consumption (F/V+), decrease in sedentary leisure screen time (Sed-), and increase in physical activity (PA+) simultaneously (Simultaneous); 2) F/V+ and Sed- first, and then sequentially add PA+ (Sequential); or 3) Stress Management Control that addresses stress, relaxation, and sleep. All participants will receive a smartphone application to self-monitor behaviors and regular coaching calls to help facilitate behavior change during the 9 month intervention. Healthy lifestyle change in fruit/vegetable and saturated fat intakes, sedentary leisure screen time, and physical activity will be assessed at 3, 6, and 9 months. MBC2 is a randomized m-Health intervention examining methods to maximize initiation and maintenance of multiple healthful behavior changes. Results from this trial will provide insight about an optimal technology supported approach to promote improvement in diet and physical activity. Copyright © 2015 Elsevier Inc. All rights reserved.

Changes in physical functioning in the Active Living Every Day program of the Active for Life Initiative®.

PubMed

Baruth, Meghan; Wilcox, Sara; Wegley, Stacy; Buchner, David M; Ory, Marcia G; Phillips, Alisa; Schwamberger, Karen; Bazzarre, Terry L

2011-09-01

Physical activity can prevent or delay the onset of physical functional limitations in older adults. There are limited data that evidence-based physical activity interventions can be successfully translated into community programs and result in similar benefits for physical functioning. The purpose of this study is to measure the effects of the Active Living Every Day program on physical functioning and physical functional limitations in a diverse sample of older adults. As a part of the Active for Life initiative, the Council on Aging of Southwestern Ohio implemented Active Living Every Day (ALED), a group-based lifestyle behavior change program designed to increase physical activity. Performance-based physical functioning tests (30-s Chair Stand Test, eight Foot Up-and-Go Test, Chair Sit-and-Reach Test, 30-Foot Walk Test) were administered to participants at baseline and posttest. Baseline to post-program changes in physical functioning and impairment status were examined with repeated measures analysis of covariance. Interactions tested whether change over time differed according to race/ethnicity, body mass index (BMI), and baseline impairment status. Participants significantly increased their performance in all four physical functioning tests. The percentage of participants classified as "impaired" according to normative data significantly decreased over time. Physical functioning improved regardless of BMI, race/ethnicity, or baseline impairment status. ALED is an example of an evidenced-based physical activity program that can be successfully translated into community programs and result in significant and clinically meaningful improvements in performance-based measures of physical functioning.

Posts, pics, or polls? Which post type generates the greatest engagement in a Facebook physical activity intervention?

PubMed

Edney, Sarah; Looyestyn, Jemma; Ryan, Jillian; Kernot, Jocelyn; Maher, Carol

2018-04-05

Social networking websites have attracted considerable attention as a delivery platform for physical activity interventions. Current evidence highlights a need to enhance user engagement with these interventions to actualize their potential. The purpose of this study was to determine which post type generates the most engagement from participants and whether engagement was related to change in physical activity in an intervention delivered via Facebook. Subgroup analysis of the intervention condition of a randomized controlled trial was conducted. The group moderator posted a new message to the private Facebook group each day of the program. The Facebook posts (n = 118) were categorized into the following types: moderator-initiated running program, multimedia, motivational, opinion polls, or discussion question and participant-initiated experience shares, or questions. Four metrics were used to measure volume of engagement with each post type, "likes," "comments," "poll votes," and "photo uploads." One-way ANOVA was used to determine whether engagement differed by post type and an independent samples t-test to determine differences in engagement between moderator and participant-initiated posts. Pearson correlation was used to examine associations between total engagement and change in physical activity. Engagement varied by post type. Polls elicited the greatest engagement (p ≤ .01). The most common form of engagement was "likes," and engagement was higher for moderator-initiated rather than participant-initiated posts (mean = 8.0 [SD 6.8] vs. 5.3 [SD 3.2]; p ≤ .01). Total engagement with the Facebook group was not directly associated with change in physical activity (r = -.13, p = .47). However, engagement was associated with compliance with the running program (r = .37, p = .04) and there was a nonsignificant positive association between compliance and change in physical activity (r = .32, p = .08). Posts requiring a simple response generated the most engagement. Intervention moderators should facilitate familiarity between participants at the intervention outset, to encourage engagement between participants. Engagement was related to change in physical activity, and these recommendations should be incorporated to enhance engagement and efficacy of interventions.

The influence of mastery on mother's health in middle years: Moderating role of stressful life context.

PubMed

King, Victoria; Wickrama, K A S; Klopack, Erick; Lorenz, Frederick O

2018-06-07

Using data from 416 middle-aged mothers gathered over the course of a decade, this study examined the influence of mastery trajectories (the initial level and change), on change in physical health. Mastery is defined as one's ability to control and influence his/her life and environment to reach a desired outcome or goal. Both the initial level and change in mastery from 1991 to 1994 were associated with decreased physical health problems over the middle years (1991-2001). Contextual moderation of this association by stressful life contexts including negative life events and work-family conflict was investigated. Moderation analysis showed that under conditions of low contextual life stressors, the level and increase in mastery significantly contributed to decreases in physical health problems in middle-aged mothers. Alternatively, conditions of high contextual life stressors inhibited the ability of mastery to influence physical health of mothers, suggesting that the positive health impact of mastery on physical health is mitigated by stressful life experiences. Implications for the need to maintain important personal resources, such as mastery, during times of stress are discussed. Copyright © 2018 John Wiley & Sons, Ltd.

ACOG Committee Opinion no. 598: Committee on Adolescent Health Care: The initial reproductive health visit.

PubMed

2014-05-01

: The initial visit for screening and the provision of reproductive preventive health care services and guidance should take place between the ages of 13 years and 15 years. The initial reproductive health visit provides an excellent opportunity for the obstetrician-gynecologist to start a patient-physician relationship, build trust, and counsel patients and parents regarding healthy behavior while dispelling myths and fears. The scope of the initial reproductive health visit will depend on the individual's need, medical history, physical and emotional development, and the level of care she is receiving from other health care providers. A general exam, a visual breast exam, and external pelvic examination may be indicated. However, an internal pelvic examination generally is unnecessary during the initial reproductive health visit, but may be appropriate if issues or problems are discovered in the medical history. Health care providers and office staff should be familiar with state and local statutes regarding the rights of minors to consent to health care services and the federal and state laws that affect confidentiality.

Review of systems, physical examination, and routine tests for case-finding in ambulatory patients.

PubMed

Boland, B J; Wollan, P C; Silverstein, M D

1995-04-01

The screening value of the comprehensive review of systems and the complete physical examination in detecting unsuspected diseases for which therapeutic interventions are initiated has not been formally studied in ambulatory patients. The medical records of 100 randomly selected adult patients who had an ambulatory general medical evaluation at the Mayo Clinic in 1990-1991 were surveyed to compare review of systems and physical examination with routine laboratory tests, chest radiography, and electrocardiography as case-finding maneuvers. The main outcome measure was the therapeutic yield of each case-finding maneuver, defined as the proportion of maneuvers leading to a new therapy for a new clinically important diagnosis. The utilization rate of routine tests in the 100 patients (mean age: 59 +/- 16 years; 58% women) was high, ranging from 77 to 98%. Overall, the case-finding maneuvers led to 36 unsuspected clinically important diagnoses and resulted in 25 new therapeutic interventions. Higher therapeutic yield was observed for review of systems (7%), physical examination (5%), and lipid screening (9.2%) than for chemistry group (2.2%), complete blood count (1.8%), thyroid tests (1.5%), urinalysis (1.1%), electrocardiography (0%), or chest radiography (0%). The number of therapeutic interventions was not associated with patient's age (P = 0.55), sex (P = 0.88), comorbidity (P = 0.30) or with the time interval since the last general medical evaluation (P = 0.12). Based on therapeutic yield, these data suggest that review of systems and physical examination are valuable case-finding maneuvers in the periodic medical evaluation of ambulatory patients.

Cost-effectiveness of preparticipation screening for prevention of sudden cardiac death in young athletes.

PubMed

Wheeler, Matthew T; Heidenreich, Paul A; Froelicher, Victor F; Hlatky, Mark A; Ashley, Euan A

2010-03-02

Inclusion of 12-lead electrocardiography (ECG) in preparticipation screening of young athletes is controversial because of concerns about cost-effectiveness. To evaluate the cost-effectiveness of ECG plus cardiovascular-focused history and physical examination compared with cardiovascular-focused history and physical examination alone for preparticipation screening. Decision-analysis, cost-effectiveness model. Published epidemiologic and preparticipation screening data, vital statistics, and other publicly available data. Competitive athletes in high school and college aged 14 to 22 years. Lifetime. Societal. Nonparticipation in competitive athletic activity and disease-specific treatment for identified athletes with heart disease. Incremental health care cost per life-year gained. Addition of ECG to preparticipation screening saves 2.06 life-years per 1000 athletes at an incremental total cost of $89 per athlete and yields a cost-effectiveness ratio of $42 900 per life-year saved (95% CI, $21 200 to $71 300 per life-year saved) compared with cardiovascular-focused history and physical examination alone. Compared with no screening, ECG plus cardiovascular-focused history and physical examination saves 2.6 life-years per 1000 athletes screened and costs $199 per athlete, yielding a cost-effectiveness ratio of $76 100 per life-year saved ($62 400 to $130 000). Results are sensitive to the relative risk reduction associated with nonparticipation and the cost of initial screening. Effectiveness data are derived from 1 major European study. Patterns of causes of sudden death may vary among countries. Screening young athletes with 12-lead ECG plus cardiovascular-focused history and physical examination may be cost-effective. Stanford Cardiovascular Institute and the Breetwor Foundation.

Social Marketing as a Framework for Youth Physical Activity Initiatives: a 10-Year Retrospective on the Legacy of CDC's VERB Campaign.

PubMed

Huhman, Marian; Kelly, Ryan P; Edgar, Timothy

2017-06-01

In 2002, the U.S. Centers for Disease Control and Prevention (CDC) launched the VERB. It's what you do! campaign to increase physical activity among tweens and concomitantly respond to the rise in childhood obesity. This retrospective study summarizes the history of the VERB campaign's social marketing approach and its effectiveness in promoting behavior change in the targeted population. The legacy of VERB, which ended in 2006, is discussed, with an emphasis on examining initiatives over the last decade and the degree to which they followed (or did not follow) the structural and thematic lead of the campaign. The article ends with suggestions for how VERB still has the potential to inform other social marketing campaigns going forward.

Initial derivation of diagnostic clusters combining history elements and physical examination tests for symptomatic knee osteoarthritis.

PubMed

Décary, Simon; Feldman, Debbie; Frémont, Pierre; Pelletier, Jean-Pierre; Martel-Pelletier, Johanne; Fallaha, Michel; Pelletier, Bruno; Belzile, Sylvain; Sylvestre, Marie-Pierre; Vendittoli, Pascal-André; Desmeules, François

2018-05-21

The aim of the present study was to assess the validity of clusters combining history elements and physical examination tests to diagnose symptomatic knee osteoarthritis (SOA) compared with other knee disorders. This was a prospective diagnostic accuracy study, in which 279 consecutive patients consulting for a knee complaint were assessed. History elements and standardized physical examination tests were obtained independently by a physiotherapist and compared with an expert physician's composite diagnosis, including clinical examination and imaging. Recursive partitioning was used to develop diagnostic clusters for SOA. Diagnostic accuracy measures were calculated, including sensitivity, specificity, and positive and negative likelihood ratios (LR+/-), with associated 95% confidence intervals (CIs). A total of 129 patients had a diagnosis of SOA (46.2%). Most cases (76%) had combined tibiofemoral and patellofemoral knee OA and 63% had radiological Kellgren-Lawrence grades of 2 or 3. Different combinations of history elements and physical examination tests were used in clusters accurately to discriminate SOA from other knee disorders. These included age of patients, body mass index, presence of valgus/varus knee misalignment, palpable knee crepitus and limited passive knee extension. Two clusters to rule in SOA reached an LR+ of 13.6 (95% CI 6.5 to 28.4) and three clusters to rule out SOA reached an LR- of 0.11 (95% CI 0.06 to 0.20). Diagnostic clusters combining history elements and physical examination tests were able to support the differential diagnosis of SOA compared with various knee disorders without relying systematically on imaging. This could support primary care clinicians' role in the efficient management of these patients. Copyright © 2018 John Wiley & Sons, Ltd.

Using Ultrasound to Enhance Medical Students' Femoral Vascular Physical Examination Skills.

PubMed

Ahn, Justin S; French, Andrew J; Thiessen, Molly E W; Browne, Vaughn; Deutchman, Mark; Guiton, Gretchen; Madigosky, Wendy; Kendall, John L

2015-10-01

To determine whether the addition of ultrasound to traditional physical examination instruction improves junior medical students' abilities to locate the femoral pulse. Initially, 150 second-year medical students were taught the femoral pulse examination using traditional bedside teaching on standardized patients and online didactic videos. Students were then randomized into 2 groups: group 1 received ultrasound training first and then completed the standardized examination; and group 2 performed the standardized examination first and then received ultrasound training. On the standardized patients, the femoral artery was marked with invisible ink before the sessions using ultrasound. Compared to these markers, students were then evaluated on the accuracy of femoral artery pulse palpation and the estimated location of the femoral vein. All students completed a self-assessment survey after the ultrasound sessions. Ultrasound training improved the students' ability to palpate the femoral pulse (P= .02). However, ultrasound did not facilitate correct estimation of the femoral vein's anatomic location (P = .09). Confidence levels in localizing the femoral artery and vein were equal between groups at baseline, and both increased after the ultrasound sessions. The addition of ultrasound teaching to traditional physical examination instruction enhanced medical student competency and confidence with the femoral vascular examination. However, understanding of anatomy may require emphasis on precourse didactic material, but further study is required. © 2015 by the American Institute of Ultrasound in Medicine.

Women's use of physical and nonphysical self-defense strategies during incidents of partner violence.

PubMed

Downs, William R; Rindels, Barb; Atkinson, Christine

2007-01-01

Two incidents of partner violence are investigated using qualitative methodology to discover strategies women use to protect themselves and examine women's use of violence. Data were collected from 447 women (age 18 or older) from 7 domestic violence programs and 5 substance use disorder treatment programs in a midwestern state. Women were found to have developed numerous self-protection strategies, some using nonphysical means only, others using physical means only, and others combining nonphysical and physical means. Women often used a variety of strategies in the same incident. Few women initiated violence against partners. Implications for theory and research are discussed.

Time kinetics of physical activity, sitting, and quality of life measures within a regional workplace: a cross-sectional analysis.

PubMed

Lindsay, Daniel B; Devine, Sue; Sealey, Rebecca M; Leicht, Anthony S

2016-08-15

Interventions to increase physical activity and reduce sedentary behaviours within the workplace have been previously investigated. However, the evolution of these constructs without intervention has not been well documented. This retrospective study explored the natural progression or time kinetics of physical activity, sedentary behaviours and quality of life in a professional skilled workplace where focussed interventions were lacking. Participants (n = 346) employed as full-time staff members at a regional university completed an online survey in 2013 assessing physical activity and sedentary behaviours via the International Physical Activity Questionnaire, and quality of life via the Short-Form 36v2 questionnaire. Differences between that cohort of participants and an initial sample of similar participants (2009, n = 297), accounting for gender and staff categories (academic vs. professional), were examined using ANCOVAs with working hours as a co-variate. In comparison to the initial cohort, the follow-up cohort reported significantly less leisure-time, total walking, total vigorous and total physical activity levels, and lower overall physical health for quality of life (p < 0.05). In contrast, the follow-up cohort reported a significantly greater weekly sitting time, greater mental health scores for quality of life and greater total moderate physical activity levels (p < 0.05) compared to the initial cohort. Over a 4-year timeframe and without focussed workplace interventions, total physical activity levels were lower with sedentary behaviours greater at a rate twice that reported previously. Continuation of these undesirable health behaviours may impact negatively on worker productivity and health at a greater rate than that currently reported. Workplace interventions targeting sedentary behaviours and physical activity should be actively incorporated into organisations to counteract the alarming behavioural trends found in this study to maintain and/or enhance employee health and productivity.

Factors Affecting the Misperception of Friendliness Cues in Initial Interactions.

ERIC Educational Resources Information Center

Harnish, Richard J.; And Others

Some researchers have found men to attribute more sexual meaning to heterosexual interactions than do women. This study was conducted to examine factors which may enhance or diminish this gender difference on perceptions of sexual intent by considering the three variables of physical attractiveness of target, similarity of target's personality to…

The Influence of Object Conceptions on the Mechanical Intuitions of Children and Adults.

ERIC Educational Resources Information Center

Rosser, Rosemary A.; Chandler, Kacey

1995-01-01

Examined how children's and adults' initial conceptions of objects and space influence predictions about the physical world, but lead the naive person to misconstrue a dynamic event. Found that participants proficiently anticipated where an oscillating screen would contact a hidden object, but underestimated the distance until contact.…

Aerobic Capacities of Early College High School Students

ERIC Educational Resources Information Center

Loflin, Jerry W.

2014-01-01

The Early College High School Initiative (ECHSI) was introduced in 2002. Since 2002, limited data, especially student physical activity data, have been published pertaining to the ECHSI. The purpose of this study was to examine the aerobic capacities of early college students and compare them to state and national averages. Early college students…

42 CFR 410.16 - Initial preventive physical examination: Conditions for and limitations on coverage.

Code of Federal Regulations, 2011 CFR

2011-10-01

... risk factors for disease, as those terms are defined in this section. (2) Review of the beneficiary's potential (risk factors) for depression, including current or past experiences with depression or other mood... visual acuity screen, and other factors as deemed appropriate, based on the beneficiary's medical and...

How Activists and Media Frame Social Problems: Critical Events versus Performance Trends for Schools.

ERIC Educational Resources Information Center

Pride, Richard A.

1995-01-01

Focuses on the process by which a social problem is redefined in response to a critical events, such as economic depressions, environmental disasters, intense physical confrontations, or strategic initiatives by a social movement organization. Examines a conservative movement's attempt to redefine "the problem" of the schools at the time…

Understanding Great Plains Urbanization through the Lens of South Dakota Townscapes

ERIC Educational Resources Information Center

Conzen, Michael P.

2010-01-01

Most towns were crucial to the initial colonization and economic development of the Great Plains. Many were, directly or indirectly, creatures of railroad corporate planning, owing their location as well as their physical layout to the townsite companies controlled by railroad officials. This article examines how these facts shaped the fundamental…

Establishing a Safe School Culture: An Examination of Current Practices in K through 12 Leadership

ERIC Educational Resources Information Center

Kelly, Zanita V.

2016-01-01

School improvement plans and major reform initiatives most often target core academic competencies. They might include strategies to improve the physical safety of school campuses, but they rarely include discussions about creating psychologically safe environments. School safety has garnered national attention in the aftermath of violent high…

Relationship between Sexual Harassment, Initiator Attractiveness, and Pro-Feminist Attitudes.

ERIC Educational Resources Information Center

Wheeler, R. Wade; And Others

Research has shown that physically attractive people in this culture are treated more favorably than are unattractive people. If this is so, acts of sexual harassment perpetrated by attractive males might be viewed less harshly than the same acts perpetrated by unattractive males. A study was conducted to examine the relationshp between…

Movement Based Language: The Van Dijk Model.

ERIC Educational Resources Information Center

Magin, Kevin D.

The paper examines the development of language in the deaf blind child with emphasis on the child's motoric behavior and imitation as the initial step in language acquisition. Discussed are the following early developmental stages: symbionic (the close physical and emotional identification of child with the mother to be or new mother); resonance…

Initiation of movement and energy expenditure in children with developmental delay: a case-control study.

PubMed

Chen, Chiao-Nan Joyce; Hwang, Ai-Wen; Lin, Shang-Ying; Lin, Yu-Chieh

2014-10-01

Lower levels of physical activity in children with developmental delay (DD) usually are attributed to higher energy costs. However, there is no evidence that children with DD spend more energy on daily physical activities, such as walking. The aim of this study was to compare energy costs during walking and movement initiation times in children with DD and children with typical development (TD) and matched for age. This was a case-control study. Children who were 3 and 5 years old and had DD (n=12) or TD (n=12) participated in the study. Measurements included ranges of motion in the lower extremities, physiological costs of walking, and movement initiation times. A task designed to evaluate the initiation of movement (the "go play with the toy" task) was used to examine the reaction times for children's goal-directed walking. The physiological costs of walking were similar in the 2 groups; however, children with DD walked at a lower speed than children with TD. Importantly, children with DD took more time to initiate goal-directed walking. The nature of the study design limited causal inference from the results. Children who were 3 to 5 years old and had DD had delays in goal-directed movement that may not have been attributable to motor impairments. The findings suggest that therapists should evaluate the movement initiation ability of 3- to 5-year-old children with DD as part of the design of an overall intervention plan. © 2014 American Physical Therapy Association.

Longitudinal Assessment of Health-Related Quality of Life following Adolescent Sports-Related Concussion.

PubMed

Russell, Kelly; Selci, Erin; Chu, Stephanie; Fineblit, Samuel; Ritchie, Lesley; Ellis, Michael J

2017-07-01

To examine initial and longitudinal health-related quality of life (HRQOL) in adolescent sports-related concussion (SRC) patients, a prospective observational case-series study was conducted among adolescent SRC patients who were evaluated at a multi-disciplinary pediatric concussion program. Health-related quality of life was measured using the child self-report Pediatric Quality of Life Inventory (PedsQL) generic score scale (age 13-18 version) and the PedsQL Cognitive Functioning scale. Initial and longitudinal HRQOL outcomes were compared between patients who did and did not develop post-concussion syndrome (PCS). A total of 63 patients met the inclusion criteria during the study period. The mean age of the cohort was 14.57 years (standard deviation, 1.17) and 61.9% were male. The median time from injury to initial consultation was 6.5 days (interquartile range, 5, 11). At initial consultation, impairments in physical and cognitive HRQOL but not social or emotional HRQOL were observed. Initial symptom burden and length of recovery were associated with greater impairment in physical and cognitive HRQOL. Patients who went on to develop PCS had significantly worse physical and cognitive HRQOL at initial consultation and demonstrated a slower rate of recovery in these domains, compared with those who recovered in less than 30 days. Adolescent SRC was associated with HRQOL impairments that correlated with clinical outcomes. No persistent impairments in HRQOL were detected among patients who achieved physician-documented clinical recovery. Future studies are needed to evaluate the clinical utility of HRQOL measurement in the longitudinal management of adolescent SRC and PCS patients.

Engagement in multidisciplinary interventions for pediatric chronic pain: parental expectations, barriers, and child outcomes.

PubMed

Simons, Laura E; Logan, Deirdre E; Chastain, Laura; Cerullo, Madelin

2010-05-01

To examine the adherence to the recommendations of pain treatment among children and adolescents evaluated for a variety of chronic and recurrent pain conditions. Several measures during initial evaluation and after 3 months were collected to assess satisfaction with initial evaluation, adherence to multidisciplinary recommendations, pain ratings, somatic symptoms, functional limitations, and school attendance. Of the 120 patients who initially enrolled in the study, 70 parents and 57 children participated in 3-month follow-up interviews and reported significantly fewer doctor visits, decreased somatic symptoms, fewer functional limitations, and decreased pain compared with their initial evaluation. Adherence to multidisciplinary recommendations ranged from 46.7% to 100% with the highest level of overall adherence to physical therapy. Factors associated with adherence varied across type of recommendation. For medical recommendations, higher parent-reported patient satisfaction and expectations that medical tests would be beneficial were associated with engagement in medical treatment, whereas parent reports of negative attitude-type barriers and experience with surgery were associated with less frequent engagement in recommended treatment. With regard to physical therapy recommendations, only earlier experience with exercise was associated with better adherence. For psychologic recommendations, familiarity with hypnosis and biofeedback in addition to positive expectations regarding psychologic treatment and biofeedback were all associated with subsequent engagement in psychologic treatment. Lastly, we identified modest associations between functional improvements and adherence to specific recommendations. Results of this study support the importance of examining adherence to multidisciplinary interventions among children and adolescents with chronic pain.

Physical activity text messaging interventions in adults: a systematic review.

PubMed

Buchholz, Susan Weber; Wilbur, JoEllen; Ingram, Diana; Fogg, Louis

2013-08-01

Physical inactivity is a leading health risk factor for mortality worldwide. Researchers are examining innovative techniques including the use of mobile technology to promote physical activity. One such technology, text messaging, is emerging internationally as a method to communicate with and motivate individuals to engage in healthy behaviors, including physical activity. Review the existing scientific literature on adult physical activity text messaging interventions. This systematic review examined research papers that addressed physical activity text messaging intervention studies in adults. Using multiple databases, the search strategy included published English language studies through October 1, 2011. An author-developed data collection tool was used independently by two reviewers to extract and examine the selected study variables. The initial search resulted in the identification of 200 publications. Eleven publications representing 10 studies were included in the final review. Studies were conducted in seven countries with over half the studies being randomized controlled trials. Participants of the studies were predominantly young to middle aged women. Physical activity data were mainly obtained by self-report although three studies used pedometers or accelerometers. Interventions ranged from only sending out text messages to combining text messages with educational materials, staff support, and/or Internet technology. Minimal information was given regarding development or number of text messages used. The median effect size for the studies was 0.50. To date, using text messaging as a method to promote physical activity has only been studied by a small group of researchers. Current physical activity text messaging literature is characterized by small sample sizes, heterogeneous but positive effect sizes, and a lack of specificity as to the development of the text messages used in these studies. Further research in this area is imperative to facilitate the expansion of mobile technology to promote physical activity. © 2013 Sigma Theta Tau International.

Shock initiation of nitromethane

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yoo, C.S.; Holmes, N.C.

1994-07-10

The shock initiation processes of nitromethane have been examined by using a fast time-resolved emission spectroscopy at a two-stage gas gun. A broad, but strong emission has been observed in a spectral range between 350 nm and 700 nm from the shocked nitromethane above 9 GPa. The temporal profile suggests that the shocked nitromethane detonates through three characteristic periods, namely an induction period, a shock initiation period, and a thermal explosion period. In this paper we will discuss the temporal and chemical characteristics of these periods and present the temperature of the shock-detonating nitromethane at pressures between 9 and 15more » GPa. [copyright]American Institute of Physics« less

Factor Structure and Measurement Invariance of the Need-Supportive Teaching Style Scale for Physical Education.

PubMed

Liu, Jing-Dong; Chung, Pak-Kwong

2017-08-01

The purpose of the current study was to examine the factor structure and measurement invariance of a scale measuring students' perceptions of need-supportive teaching (Need-Supportive Teaching Style Scale in Physical Education; NSTSSPE). We sampled 615 secondary school students in Hong Kong, 200 of whom also completed a follow-up assessment two months later. Factor structure of the scale was examined through exploratory structural equation modeling (ESEM). Further, nomological validity of the NSTSSPE was evaluated by examining the relationships between need-supportive teaching style and student satisfaction of psychological needs. Finally, four measurement models-configural, metric invariance, scalar invariance, and item uniqueness invariance-were assessed using multiple group ESEM to test the measurement invariance of the scale across gender, grade, and time. ESEM results suggested a three-factor structure of the NSTSSPE. Nomological validity was supported, and weak, strong, and strict measurement invariance of the NSTSSPE was evidenced across gender, grade, and time. The current study provides initial psychometric support for the NSTSSPE to assess student perceptions of teachers' need-supportive teaching style in physical education classes.

The association between mental health, physical function, and hemodialysis mortality.

PubMed

Knight, Eric L; Ofsthun, Norma; Teng, Ming; Lazarus, J Michael; Curhan, Gary C

2003-05-01

Mortality rates for individuals on chronic hemodialysis remain very high; therefore, strategies are needed to identify individuals at greatest risk for mortality so preventive strategies can be implemented. One such approach is to stratify individuals by self-reported mental health and physical function. Examining these parameters at baseline, and over time, may help identify individuals at greater risk for mortality. We enrolled 14,815 individuals with end-stage renal disease (ESRD) and followed these individuals for up to 2 years. The mean age was 61.0 +/- 15.4 years (range, 20 to 96 years) and 31% were African Americans. The SF-36 Health Survey was administered 1 to 3 months after hemodialysis initiation and 6 months later. We examined the associations between the initial SF-36 Health Survey mental component summary (MCS) and physical component summary (PCS) scores and mortality during the follow-up period, and examined the associations between 6-month decline in PCS and MCS scores and subsequent mortality. We also examined the interactions between age and MCS and PCS scores. The general population-based mean of each of these scores was 50 with a standard deviation of 10. The main outcome measurement was death. Self-reported baseline mental health (MCS score) and physical function (PCS score) were both independently associated with increased mortality, and 6-month decline in these parameters was also associated with increased mortality. The multivariate hazard ratios for 1-year mortality for MCS scores of less than 30, 30 to 39, and 40 to 49 were 1.48 (95% CI, 1.32 to 1.64), 1.23 (95% CI, 1.14 to 1.32) and 1.18 (95% CI, 1.10 to 1.26) compared with a MCS score of 50 or more. The hazard ratios for PCS scores of less than 20, 20 to 29, and 30 to 39 were 1.97 (95% CI, 1.64 to 2.36), 1.62 (95% CI, 1.36 to 1.92), and 1.32 (95% CI, 1.11 to 1.57) compared with a PCS score of 50 or more. Six-month decline in self-reported mental health (hazard ratio, 1.07; 95% CI, 1.02 to 1.12, per 10-point decline in MCS score) and physical function (hazard ratio, 1.25; 95% CI, 1.18 to 1.33, per 10-point decline in PCS score) were also both significantly associated with an additional increase in mortality beyond baseline risk. We also found a significant interaction between age and physical function (P = 0.02). Specifically, there was a graded response between the PCS score category and mortality in most age strata, but this relationship was not observed in the oldest age (85 years old or older). In individuals newly initiated on chronic hemodialysis, self-reported baseline mental health and physical function are important, independent predictors of mortality, and there is a graded relationship between these parameters and mortality risk. Following these parameters over time provides additional information on mortality risk. One must also consider age when interpreting the relationship between physical function and mortality.

The effect of pre-service training on post-graduation skill and knowledge retention among mid-level healthcare providers in Mozambique.

PubMed

Feldacker, Caryl; Chicumbe, Sergio; Dgedge, Martinho; Cesar, Freide; Augusto, Gerito; Robertson, Molly; Mbofana, Francisco; O'Malley, Gabrielle

2015-04-16

Mozambique suffers from critical shortages of healthcare workers including non-physician clinicians, Tecnicos de Medicina Geral (TMGs), who are often senior clinicians in rural health centres. The Mozambique Ministry of Health and the International Training and Education Center for Health, University of Washington, Seattle, revised the national curriculum to improve TMG clinical knowledge and skills. To evaluate the effort, data was collected at graduation and 10 months later from pre-revision (initial) and revised curriculum TMGs to determine the following: (1) Did cohorts trained in the revised curriculum score higher on measurements of clinical knowledge, physical exam procedures, and solving clinical case scenarios than those trained in the initial curriculum; (2) Did TMGs in both curricula retain their knowledge over time (from baseline to follow-up); and (3) Did skills and knowledge retention differ over time by curricula? Post-graduation and over time results are presented. t-tests examine differences in scores between curriculum groups. Univariate and multivariate linear regression models assess curriculum-related, demographic, and workplace factors associated with scores on each of three evaluation methods at the p < 0.05 level. Paired t-tests examine within-group changes over time. ANOVA models explore differences between Health Training Institutes (HTIs). Generalized estimating equations determine whether change in scores over time differed by curricula. Mean scores of initial curriculum TMGs at follow-up were 52.7%, 62.6%, and 40.0% on the clinical cases, knowledge test, and physical exam, respectively. Averages were significantly higher among the revised group for clinical cases (60.2%; p < 0.001) and physical exam (47.6%; p < 0.001). HTI was influential on clinical case and physical exam scores. Between graduation and follow-up, clinical case and physical exam scores decreased significantly for initial curriculum students; clinical case scores increased significantly among revised curriculum TMGs. Although curriculum revision had limited effect, marginal improvements in the revised group show promise that these TMGs may have increased ability to synthesize clinical information. Weaknesses in curriculum and practicum implementation likely compromised the effect of curriculum revision. An improvement strategy that includes strengthened TMG training, greater attention to pre-service clinical practice, and post-graduation mentoring may be more advantageous than curriculum revision, alone, to improve care provided by TMGs.

The Structure of Co-Occurring Bullying Experiences and Associations with Suicidal Behaviors in Korean Adolescents

PubMed Central

Roh, Beop-Rae; Yoon, Yoewon; Kwon, Ahye; Oh, Seunga; Lee, Soyoung Irene; Ha, Kyunghee; Shin, Yun Mi; Song, Jungeun; Park, Eun Jin; Yoo, Heejung; Hong, Hyun Ju

2015-01-01

Objective This study had two main goals: to examine the structure of co-occurring peer bullying experiences among adolescents in South Korea from the perspective of victims and to determine the effects of bullying on suicidal behavior, including suicidal ideation and suicide attempts, among adolescents. Method This study used data gathered from 4,410 treatment-seeking adolescents at their initial visits to 31 local mental health centers in Gyeonggi Province, South Korea. The structure of peer bullying was examined using latent class analysis (LCA) to classify participants’ relevant experiences. Then, a binomial logistic regression adjusted by propensity scores was conducted to identify relationships between experiences of being bullied and suicidal behaviors. Results The LCA of experiences with bullying revealed two distinct classes of bullying: physical and non-physical. Adolescents who experienced physical bullying were 3.05 times more likely to attempt suicide than those who were not bullied. Victims of (non-physical) cyber bullying were 2.94 times more likely to attempt suicide than were those who were not bullied. Conclusions Both physical and non-physical bullying were associated with suicide attempts, with similar effect sizes. Schools and mental health professionals should be more attentive than they currently are to non-physical bullying. PMID:26619356

A follow-up study of a large group of children struck by lightning.

PubMed

Silva, Lynette Mary Ann; Cooper, Mary Ann; Blumenthal, Ryan; Pliskin, Neil

2016-08-10

On 11 November 1994, 26 preadolescent girls, 2 adult supervisors and 7 dogs were sleeping in a tent in rural South Africa when the tent was struck by lightning. Four of the girls and 4 of the dogs were killed. The 2 adults were unharmed, but all but 3 of the children suffered significant injuries. An article in 2002 detailed the event and examined the medical and psychological changes in the surviving girls. To understand the medical and psychological changes secondary to lightning strike years after injury. An online questionnaire was prepared that included a checklist of physical and psychological symptoms. Participants were asked to report on both initial and current symptoms. Eleven of the 22 survivors were contacted, and 10 completed the survey. Participants reported that initial physical symptoms generally resolved over time, with ~10 - 20% continuing to experience physical symptoms. Vision problems persisted in 50% of respondents. Psychological symptoms, overall, had a later onset and were more likely to be chronic or currently experienced. Depression and anxiety, specifically, were higher among the survivors than the reported incidence in South Africa. Initial and current/chronic physical and psychological symptoms following lightning strike are reported, adding to the body of literature on the long-term after-effects of lightning strike on survivors. A brief discussion on post-traumatic stress disorder symptomatology and post-lightning shock syndrome is provided.

Walk on the bright side: physical activity and affect in major depressive disorder.

PubMed

Mata, Jutta; Thompson, Renee J; Jaeggi, Susanne M; Buschkuehl, Martin; Jonides, John; Gotlib, Ian H

2012-05-01

Although prescribed exercise has been found to improve affect and reduce levels of depression, we do not know how self-initiated everyday physical activity influences levels of positive affect (PA) and negative affect (NA) in depressed persons. Fifty-three individuals diagnosed with Major Depressive Disorder (MDD) and 53 never-depressed controls participated in a seven-day experience sampling study. Participants were prompted randomly eight times per day and answered questions about their physical activity and affective state. Over the week, the two groups of participants did not differ in average level of physical activity. As expected, participants with MDD reported lower average PA and higher average NA than did never-depressed controls. Both participants with MDD and controls reported higher levels of PA at prompts after physical activity than at prompts after inactive periods; moreover, for both groups of participants, PA increased from a prompt after an inactive period to a subsequent prompt at which activity was reported. Depressed participants in particular showed a dose-response effect of physical activity on affect: longer duration and/or higher intensity of physical activity increased their PA significantly more than did short duration and/or lower intensity physical activity. Physical activity did not influence NA in either group. In contrast to previous treatment studies that examined the effects of prescribed structured exercise, this investigation showed that self-initiated physical activity influences PA. These findings also underscore the importance of distinguishing between PA and NA to gain a more comprehensive understanding of the effects of physical activity on affect in MDD.

Medical and surgical evaluation and care of illness in space

NASA Technical Reports Server (NTRS)

Siegel, John H.

1994-01-01

This report summarizes the work done on the contract NAG9-567, which was activated at the New Jersey Medical School-UMDNJ in April 1992 and carried on during the 1992-93 year to the present 1993-94 year which was terminated in May 1994. The initial examination stage was completed of an interactive program for the recording of physical and physiologic injury information obtained from examination of an injured person, who might be an astronaut sustaining traumatic injury, due to a burn or physical trauma, either in space or in an earth bound training environment. In this report three aspects will be discussed: 1) a description of the system of diagnostic examination graphics, 2) a description of the organization of the therapeutic advisory systems with a demonstration of two specific modules, and 3) a brief technical description of the organization of the programming system carried out on a UNIX based work station using a WINDOWS environment.

Initial Diagnosis and Management of Coma.

PubMed

Traub, Stephen J; Wijdicks, Eelco F

2016-11-01

Coma represents a true medical emergency. Drug intoxications are a leading cause of coma; however, other metabolic disturbances and traumatic brain injury are also common causes. The general emergency department approach begins with stabilization of airway, breathing, and circulation, followed by a thorough physical examination to generate a limited differential diagnosis that is then refined by focused testing. Definitive treatment is ultimately disease-specific. This article presents an overview of the pathophysiology, causes, examination, and treatment of coma. Copyright © 2016 Elsevier Inc. All rights reserved.

Initiation and progression of physical activity after laparoscopic and open gastric bypass surgery.

PubMed

Evans, Ronald K; Bond, Dale S; Demaria, Eric J; Wolfe, Luke G; Meador, Jill G; Kellum, John M

2004-12-01

This study compared postoperative physical activity participation among patients who underwent laparoscopic (LGBS) or open gastric bypass surgery (OGBS). Postoperative physical activity participation is considered important for achieving optimal weight loss and maintenance after gastric bypass surgery. However, no study has examined the relationship between surgery type and postoperative physical activity. Minimal invasiveness and reduced recovery time associated with LGBS compared with OGBS may permit earlier initiation and faster progression of postsurgical physical activity and potentially contribute to greater long-term adherence rates. Self-reported physical activity participation and aerobic physical activity hours per week at 2-weeks, 3-months, and 6-months postsurgery were assessed among LGBS and OGBS patients (presurgical body mass index of 35 to 70 kg/m(2)) at a university hospital from 1988-2002. Of the 2,235 patients, 531 (24%) and 1704 (76%) underwent LGBS and OGBS, respectively. A greater proportion of LGBS patients reported physical activity participation at each time point compared with OGBS patients (2 week, 76% vs 62%; 3 months, 84% vs 74%; 6 months, 85% vs 76%). Furthermore, LGBS patients reported a significantly greater physical activity duration at 2-weeks postsurgery compared with OGBS patients. A nonsignificant trend toward greater physical activity duration was observed in the LGBS patients at 3 months, whereas 6-month physical activity duration was similar between groups. LGBS, compared with OGBS, may promote earlier onset, progression, and maintenance of physical activity until 6 months postsurgery. Future studies need to prospectively determine whether LGBS, via facilitation of greater engagement in postsurgical physical activity, contributes to more successful weight loss and weight maintenance compared with OGBS.

The Impact of TRMM on Mesoscale Model Simulation of Super Typhoon Paka

NASA Technical Reports Server (NTRS)

Tao, W.-K.; Jia, Y.; Halverson, J.; Hou, A.; Olson, W.; Rodgers, E.; Simpson, J.

1999-01-01

Tropical cyclone Paka formed during the first week of December 1997 and underwent three periods of rapid intensification over the following two weeks. During one of these periods, which initiated early on December 10, Paka's Dvorak-measured windspeed increased from 23 to 60 m/s over a 48-hr period. On December 18, during the last rapid deepening episode, Paka became a supertyphoon with a maximum wind speed of about 80 m/s. In this study, the Penn State/NCAR Mesoscale Model (MM5) with improved physics (i.e., cloud microphysics, radiation, land-soil-vegetation-surface processes, and TOGA COARE flux scheme) and a multiple level nesting technique (135, 45 and 15 km horizontal resolution) will be used to simulate supertyphoon Paka. We performed two runs initialized with Goddard Earth Observing System (GEOS) data sets. The first GEOS data set does not incorporate either TRMM (tropical rainfall measuring mission satellite) or SSM/I (sensor microwave imager) observed rainfall fields into the GEOS's assimilation system while the second one does. Preliminary results show that the MM5 simulated surface pressure deepened by more than 25 mb (45 km resolution domain) in the run initialized with the GEOS data set incorporating TRMM and SSM/I derived rainfall, compared to the one initialized without. However, the track and precipitation patterns are quite similar between the runs. In our presentation, we will show the impact of TRMM rainfall upon the MM5 simulation of Paka at various horizontal resolutions. We will also examine the physical processes associated with initial explosive development by comparing MM5 simulated rainfall and latent heat release. In addition, budget (vorticity, PV, momentum and heat) calculations and sensitivity tests will be performed to examine the upper-tropospheric and SST mechanisms responsible for the explosive development of Paka.

Smart Moves: Why Learning Is Not All in Your Head.

ERIC Educational Resources Information Center

Hannaford, Carla

This book examines the body's role in learning, by reviewing recent scientific insights into the ways that movement initiates and supports mental processes. Part 1 focuses on the brain and physical development, emphasizing the growth of the body/mind capacities with which we learn. It explores three distinct but interconnected kinds of body/mind…

Initial Considerations for Helping Your Infant Learn To Eat [and] Strategies To Promote Oral Eating in Infants.

ERIC Educational Resources Information Center

Pagano, John

These two papers offer parents of infants and toddlers with developmental disabilities and feeding problems both general advice and specific intervention strategies. The first paper examines the causes of feeding difficulty (such as a physical structure problem, fear of eating, or difficulty learning to eat); the need for intervention while…

Healthy Living Initiative: Running/Walking Club

ERIC Educational Resources Information Center

Stylianou, Michalis; Kulinna, Pamela Hodges; Kloeppel, Tiffany

2014-01-01

This study was grounded in the public health literature and the call for schools to serve as physical activity intervention sites. Its purpose was twofold: (a) to examine the daily distance covered by students in a before-school running/walking club throughout 1 school year and (b) to gain insights on the teachers perspectives of the club.…

The Graduate Experience in Engineering and the Physical Sciences: Gender and Ethnic Differences in Initial Expectations and Departmental Incorporation.

ERIC Educational Resources Information Center

Santiago, Anna M.; Einarson, Marne K.

This study examined the relative impact of both student-driven and institutional factors on anticipated academic and career outcomes among first-year graduate students. The study addressed two primary questions: (1) whether significant gender and ethnic differences exist in the academic credentials, expectations, and degree of incorporation within…

Toward a Tripartite Model of Research Motivation: Development and Initial Validation of the Research Motivation Scale

ERIC Educational Resources Information Center

Deemer, Eric D.; Martens, Matthew P.; Buboltz, Walter C.

2010-01-01

An instrument designed to measure a 3-factor model of research motivation was developed and psychometrically examined in the present research. Participants were 437 graduate students in biology, chemistry/biochemistry, physics/astronomy, and psychology. A principal components analysis supported the retention of 20 items representing the 3-factor…

Association between physiological falls risk and physical performance tests among community-dwelling older adults.

PubMed

Singh, Devinder K A; Pillai, Sharmila G K; Tan, Sin Thien; Tai, Chu Chiau; Shahar, Suzana

2015-01-01

Physical performance and balance declines with aging and may lead to increased risk of falls. Physical performance tests may be useful for initial fall-risk screening test among community-dwelling older adults. Physiological profile assessment (PPA), a composite falls risk assessment tool is reported to have 75% accuracy to screen for physiological falls risk. PPA correlates with Timed Up and Go (TUG) test. However, the association between many other commonly used physical performance tests and PPA is not known. The aim of the present study was to examine the association between physiological falls risk measured using PPA and a battery of physical performance tests. One hundred and forty older adults from a senior citizens club in Kuala Lumpur, Malaysia (94 females, 46 males), aged 60 years and above (65.77±4.61), participated in this cross-sectional study. Participants were screened for falls risk using PPA. A battery of physical performance tests that include ten-step test (TST), short physical performance battery (SPPB), functional reach test (FRT), static balance test (SBT), TUG, dominant hand-grip strength (DHGS), and gait speed test (GST) were also performed. Spearman's rank correlation and binomial logistic regression were performed to examine the significantly associated independent variables (physical performance tests) with falls risk (dependent variable). Approximately 13% older adults were at high risk of falls categorized using PPA. Significant differences (P<0.05) were demonstrated for age, TST, SPPB, FRT, SBT, TUG between high and low falls risk group. A significant (P<0.01) weak correlation was found between PPA and TST (r=0.25), TUG (r=0.27), SBT (r=0.23), SPPB (r=-0.33), and FRT (r=-0.23). Binary logistic regression results demonstrated that SBT measuring postural sways objectively using a balance board was the only significant predictor of physiological falls risk (P<0.05, odds ratio of 2.12). The reference values of physical performance tests in our study may be used as a guide for initial falls screening to categorize high and low physiological falls risk among community-dwelling older adults. A more comprehensive assessment of falls risk can be performed thereafter for more specific intervention of underlying impairments.

SCREENING FOR REFERRAL BY A SPORTS PHYSICAL THERAPIST REVEALS AN EFFORT THROMBOSIS IN A COLLEGIATE PITCHER: A CASE REPORT.

PubMed

VanWye, William R; Pinerola, Jase; Ogle, Karen Craig; Wallmann, Harvey W

2016-08-01

Screening for referral, regardless of setting, is the responsibility of all physical therapists. A serious condition that sports physical therapists may encounter is upper extremity (UE) deep venous thrombosis (DVT), which can result in the important and sometimes fatal complication of pulmonary embolism. A 22 year-old male right-hand dominant collegiate pitcher was referred for physical therapist evaluation and treatment secondary to acute right UE pain and swelling. The athlete described the onset of these symptoms as insidious, denying any form of trauma. The athlete had undergone testing, which included UE Doppler ultrasound of the bilateral UE veins and a computed tomography (CT) scan of the chest without contrast; both of which were deemed negative. He was subsequently diagnosed with thoracic outlet syndrome and referred to the team physical therapist. After examination, the physical therapist hypothesized the athlete was presenting with a possible vascular compromise. Findings leading to this decision were: 1) insidious onset, 2) inability to account for the athlete's pain with ROM, strength, neurological, or provocation testing, 3) significant swelling of the right UE (arm and forearm), 4) increased discomfort with palpation in the supraclavicular region, and 5) history of strenuous UE use. The athlete was referred back to the orthopedist. A venogram CT was ordered, which revealed an axillary and subclavian DVT and the presence of venous collaterals. The athlete was referred to a vascular surgeon who performed a right first rib removal. The athlete was able to complete post-operative rehabilitation and successfully return to competitive throwing the following spring. The delay in the initial diagnosis may have been due to the vague symptomology associated with venous complications and negative findings upon initial diagnostic testing. This case report highlights the importance of subjective and physical examination findings and use of diagnostic testing for timely identification of an UE DVT. Ultimately, the physical therapist in this case was able to screen for referral, which led to the correct diagnosis and allowed the athlete to safely and successfully return to sport. Physical therapists should include effort thrombosis in their upper quarter differential diagnosis list for athletes who perform strenuous UE activity. 4.

Patterns of Clinical Reasoning in Physical Therapist Students.

PubMed

Gilliland, Sarah; Wainwright, Susan Flannery

2017-05-01

Clinical reasoning is a complex, nonlinear problem-solving process that is influenced by models of practice. The development of physical therapists' clinical reasoning abilities is a crucial yet underresearched aspect of entry-level (professional) physical therapist education. The purpose of this qualitative study was to examine the types of clinical reasoning strategies physical therapist students engage in during a patient encounter. A qualitative descriptive case study design involving within and across case analysis was used. Eight second-year, professional physical therapist students from 2 different programs completed an evaluation and initial intervention for a standardized patient followed by a retrospective think-aloud interview to explicate their reasoning processes. Participants' clinical reasoning strategies were examined using a 2-stage qualitative method of thematic analysis. Participants demonstrated consistent signs of development of physical therapy-specific reasoning processes, yet varied in their approach to the case and use of reflection. Participants who gave greater attention to patient education and empowerment also demonstrated greater use of reflection-in-action during the patient encounter. One negative case illustrates the variability in the rate at which students may develop these abilities. Participants demonstrated development toward physical therapist--specific clinical reasoning, yet demonstrated qualitatively different approaches to the patient encounter. Multiple factors, including the use of reflection-in-action, may enable students to develop greater flexibility in their reasoning processes. © 2017 American Physical Therapy Association

Effects of exercise on physical self-concept, global self-esteem, and depression in women of low socioeconomic status with elevated depressive symptoms.

PubMed

Legrand, Fabien D

2014-08-01

We examined the possible mediating role of physical self-perceptions, physical self-esteem, and global self-esteem in the relationships between exercise and depression in a group of socioeconomically disadvantaged women with elevated symptoms of depression. Forty-four female residents of a low-income housing complex were randomized into a 7-week-long exercise-training group or a wait-list group. Depression, physical self-perceptions and self-esteem were measured repeatedly. Significant changes were found for depression, self-esteem, physical self-worth, and self-perceived physical condition in the exercise-training group. Intent-to-treat analyses did not alter the results. Most of the reduction in depression occurred between Week 2 and Week 4 while initial improvement in physical self-worth and self-perceived physical condition was observed between baseline and Week 2. These variables can be seen as plausible mechanisms for effects of exercise on depression.

Enhancing community capacity to support physical activity: the development of a community-based indoor-outdoor walking program.

PubMed

Riley-Jacome, Mary; Gallant, Mary P; Fisher, Brian D; Gotcsik, Frances S; Strogatz, David S

2010-04-01

The University at Albany Prevention Research Center, guided by a needs assessment in two underserved communities (one urban, one rural), initiated a pilot project that opened a public school for community walking in a rural setting. This study examined a 9-week program for potential barriers, benefits, influential factors, and the physical activity levels of program participants. Evaluation was based on daily logs, pedometer diaries, participant surveys, and focus groups. Results indicated that rural schools provide a useful resource for residents and increase participants' physical activity levels. A more comprehensive rural community walking program has been implemented as a result of these findings.

Examining the effectiveness of home-based parent aide services to reduce risk for physical child abuse and neglect: six-month findings from a randomized clinical trial.

PubMed

Guterman, Neil B; Tabone, Jiyoung K; Bryan, George M; Taylor, Catherine A; Napoleon-Hanger, Cynthia; Banman, Aaron

2013-08-01

This study set out to carry out a feasible, real-world, randomized clinical trial to examine the benefits of home-based paraprofessional parent aide services in reducing physical abuse and neglect risk in high-risk parents. Families were randomly assigned to receive either parent aide plus case management services (n = 73) or case management services only (n = 65), collecting in-home data on physical child abuse and neglect and proximal risk and protective factors, just prior to service initiation, and again after six months of services. Mothers receiving parent aide and case management services reported significant improvements from baseline to six-month follow-up in self-reported indicators of physical child abuse risk, as well as improvements on parental stress, mastery, depression, and anxiety, whereas mothers receiving only case management services did not. The slopes of such observed changes across groups, however, were not found to be statistically significantly different. No discernable improvements were found with regard to indicators of risk for child neglect. As the first randomized clinical trial examining the effectiveness of parent aide services, this study provides the first controlled evidence examining the potential benefits of this service modality. This study suggests promising trends regarding the benefit of parent aide services with respect to physical child abuse risk reduction and related predictors, but evidence does not appear to suggest that such services, as they are presently delivered, reduce child neglect. These findings support the continued use of parent aide services in cases of physical child abuse and also suggest careful consideration of the ways such services may be better configured to extend their impact, particularly with respect to child neglect risk. Copyright © 2013 Elsevier Ltd. All rights reserved.

Hierarchy of higher-level physical functions: a longitudinal investigation on a nationally representative population of community-dwelling middle-aged and elderly persons.

PubMed

Yeh, Chih-Jung; Wang, Ching-Yi; Tang, Pei-Fang; Lee, Meng-Chih; Lin, Hui-Sheng; Chen, Hui-Ya

2012-01-01

Understanding the hierarchy of higher-level physical functions to infer disability level (mild, moderate or severe) is essential for the precise targeting of preventive interventions and has been examined previously in a cross-sectional study. Based on longitudinal data, this study evaluated the hierarchy of higher-level physical functions. Data from a cohort of 2729 community-dwelling persons aged over 50 with no initial disability were drawn from the "Survey of Health and Living Status of the Elderly in Taiwan" from 1996 through 2007. The three-level hierarchy of eight chosen activities was examined by the median ages to disability onset with survival analyses and by Cox regressions, which examined the effects of sex and age on the development of this hierarchy. The progression of incident disability was as follows: mild level-running, carrying weight, and squatting; moderate level-climbing stairs, walking, and standing; and severe level-grasping and raising arms up. Women and older persons were at greater risk of developing more severe levels of disability. Another Cox regression with one index activity from each hierarchical level revealed similar results. The three-level hierarchy of higher-level physical functions has been validated longitudinally, suggesting rich research and clinical implications.

Determinants of handicap after stroke: the North East Melbourne Stroke Incidence Study (NEMESIS).

PubMed

Sturm, Jonathan W; Donnan, Geoffrey A; Dewey, Helen M; Macdonell, Richard A L; Gilligan, Amanda K; Thrift, Amanda G

2004-03-01

Handicap, although more relevant to the patient than impairment or disability, has received little attention in people with stroke. The aim of this study was to identify, in an unselected population, factors determining handicap at 2 years after stroke. All first-ever cases of stroke in a population of 306 631 over a 1-year period were assessed. Stroke severity, comorbidity, and demographic information was recorded. Among survivors, 2-year poststroke handicap was assessed with the London Handicap Scale. Disability, physical impairment, depression, anxiety, living arrangements, and recurrent stroke at 2 years were documented. If necessary, proxy assessments were obtained, except for mood. Linear regression analyses were performed to identify factors independently associated with handicap. First, all assessments (proxy and nonproxy) were examined; then, the nonproxy assessments were used to examine the effects of mood. Of 266 patients with incident stroke who were alive at 2 years, 226 (85%) were assessed. Significant determinants of handicap on univariable analysis were age, female sex, socioeconomic status, alcohol intake, stroke subtype, initial stroke severity; 2-year physical impairment, disability, depression and anxiety scores; institutionalization; and recurrent stroke. On multivariable analysis, the independent determinants of handicap were age and 2-year physical impairment and disability. In analysis restricted to nonproxy data, depression and anxiety were also independently associated with handicap. Age, concurrent disability, and physical impairment were more important determinants of handicap than other demographic factors or initial stroke severity. Because depression and anxiety were independently associated with handicap, their treatment may potentially reduce handicap in stroke patients.

The impact of the Oklahoma City bombing on children in the community.

PubMed

Pfefferbaum, B

2001-12-01

This study examined the influence of exposure on post-traumatic stress symptomatology in children following the 1995 Oklahoma City bombing. Over 2,000 children were surveyed 7 weeks after the bombing. Initial reaction and emotional exposure were important predictors of post-traumatic stress symptomatology in the full sample. Children who reported no physical or emotional exposure had significantly lower scores than exposed children on television viewing, initial reaction, and post-traumatic stress symptomatology. Within the nonexposed group, those with high television exposure had significantly more post-traumatic stress symptoms. Children with strong initial reactions should be followed over time, and disaster-related television viewing should be carefully monitored.

The stress of food allergy issues in daily life.

PubMed

Peniamina, Rana L; Mirosa, Miranda; Bremer, Philip; Conner, Tamlin S

2016-06-01

Food allergies are a growing health concern, but their implications for daily psychological functioning are unknown. This micro-longitudinal study investigated the daily frequency of food allergy issues and how this related to experiences of stress, mood and physical energy. One hundred and eight adults with physician-diagnosed food allergies completed an initial Internet survey followed by a 2-week Internet daily diary survey. The initial survey collected socio-demographic and food allergy information. The daily survey collected information about the participants' experiences of stress, mood, physical energy and food allergy issues during that day. Commonly experienced allergy issues included negative physical symptoms, higher food prices, anxiety about safety of food, trouble maintaining a healthy diet and anxiety/stress at social occasions. Furthermore, multilevel modelling analyses showed that stress and negative mood were significantly higher on days with more allergy issues. Older adults experienced lower positive mood and physical energy on days with more issues. This is the first study to incorporate near to real-time tracking to examine the frequency of food allergy issues and the implications for daily psychological functioning. Targeting the issues we identified could reduce stress in patients with food allergies and improve their overall quality of life.

Effects of mother-son incest and positive perceptions of sexual abuse experiences on the psychosocial adjustment of clinic-referred men.

PubMed

Kelly, Robert J; Wood, Jeffrey J; Gonzalez, Lauren S; MacDonald, Virginia; Waterman, Jill

2002-04-01

The primary objective was to examine the long-term impact of mother-son incest and positive initial perceptions of sexual abuse experiences on adult male psychosocial functioning. Sixty-seven clinic-referred men with a history of sexual abuse participated. The participants completed self-report measures regarding their current psychosocial functioning and described the nature of their sexual and physical abuse experiences during childhood. Seventeen men reported mother-son incest, and these men endorsed more trauma symptoms than did other sexually abused men, even after controlling for a history of multiple perpetrators and physical abuse. Mother-son incest was likely to be subtle, involving behaviors that may be difficult to distinguish from normal caregiving (e.g., genital touching), despite the potentially serious long-term consequences. Twenty-seven men recalled positive or mixed initial perceptions of the abuse, including about half of the men who had been abused by their mothers. These men reported more adjustment problems than did men who recalled purely negative initial perceptions. Mother-son incest and positive initial perceptions of sexual abuse experiences both appear to be risk factors for more severe psychosocial adjustment problems among clinic-referred men.

Addison disease - diagnosis and initial management.

PubMed

O'Connell, Susan; Siafarikas, Aris

2010-11-01

Adrenal insufficiency is a rare disease caused by either primary adrenal failure (Addison disease) or by impairment of the hypothalamic-pituitary-adrenal axis. Steroid replacement therapy normalises quality of life, however, adherence can be problematic. This article provides information on adrenal insufficiency focusing on awareness of initial symptoms and on risk scenarios, emergency management and baseline investigations, complete investigations and long term management. Early recognition of adrenal insufficiency is essential to avoid associated morbidity and mortality. Initial diagnosis and decision to treat are based on history and physical examination. Appropriate management includes emergency resuscitation and steroid administration. Initial investigations can include sodium, potassium and blood glucose levels. However, complete investigations can be deferred. Specialist advice should be obtained and long term management includes a Team Care Arrangement. For patients, an emergency plan and emergency identification are essential.

[Analysis of occupational burnout and its influencing factors of colliery migrant workers in Guizhou Province].

PubMed

Zhao, Xiaodeng; Tuo, Anxie; Peng, Anhui; He, Wanjing; Zhu, Peijia; Yan, Zheng

2015-11-01

To understand the status of occupational burnout of colliery migrant workers and its influencing factors. The occupational burnout of 1161 colliery migrant workers in Jinsha County, Guizhou Province was measured with MBI-GS and the self-made questionnaire. All dimensions of MBI-GS Cronbach's α coefficient was in the range of 0.86-0.88, all 15 items of MBI-GS were subjected to factor analysis, and three latent factors were identified, which explained 68.86% of the total variance and consisted with the theory model. The score of occupational burnout of each dimension, differences in different individual characteristics (physical examination, sleep, et al) were statistically significant (P <0.05). The influence factors of occupational burnout of colliery migrant workers were physical examination, chronic disease, smoking, physical exercise, sleep, initial work in coal mine, production post and labor intensity. MBI-GS can be used to study the occupational burnout of colliery migrant workers. Different individual characteristics effect the occurrence of occupational burnout.

Self-esteem mediates associations of physical activity with anxiety in college women.

PubMed

Herring, Matthew P; O'Connor, Patrick J; Dishman, Rodney K

2014-10-01

Why physically active people report lower anxiety than those who are inactive is not well understood. This study examined whether physical self-concept and self-esteem would mediate associations of self-reported physical activity with anxiety disorder symptoms in young women, a population with elevated risk for developing an anxiety disorder. College women (N = 1036, mean ± SD = 19.7 ± 2.9 yr) completed a physical activity recall, the Psychiatric Diagnostic Screening Questionnaire, and the Physical Self-Description Questionnaire. Structural equation modeling was used to test hypotheses. Physical activity had inverse, indirect associations with symptoms of social phobia, generalized anxiety disorder, and obsessive-compulsive disorder that were expressed through its positive association with specific and global physical self-concept and self-esteem. The results were independent of similar relations with symptoms of major depressive disorder as well as the estimates of body fatness and use of psychotropic medications. These correlational findings provide initial evidence to warrant experimental efficacy trials of whether physical activity will reduce the risk of anxiety disorders in young women by positive influences on physical self-concept and self-esteem.

DIFFERENTIAL DIAGNOSTIC PROCESS AND CLINICAL DECISION MAKING IN A YOUNG ADULT FEMALE WITH LATERAL HIP PAIN: A CASE REPORT.

PubMed

Livingston, Jennifer I; Deprey, Sara M; Hensley, Craig P

2015-10-01

differential diagnosis and clinical decision making. Young adults with lateral hip pain are often referred to physical therapy (PT). A thorough examination is required to obtain a diagnosis and guide management. The purpose of this case report is to describe the physical therapist's differential diagnostic process and clinical decision making for a subject with the referring diagnosis of trochanteric bursitis. A 29-year-old female presented to PT with limited sitting and running tolerance secondary to right lateral hip pain. Her symptoms began three months prior when she abruptly changed her running intensity and frequency of weight bearing activities, including running and low impact plyometrics for the lower extremity. Physical examination revealed a positive Trendelenburg sign, manual muscle test that was weak and painless of the right hip abductors, and pain elicited when performing a vertical hop on a concrete surface (+single leg hop test), but pain-free when performing the same single leg hop on a foam surface. Examination findings warranted discussion with the referring physician for further diagnostic imaging. Magnetic resonance imaging revealed a focus of edema in the posterior acetabulum, suspicious for an acetabular stress fracture. The subject was subsequently diagnosed with an acetabular stress fracture and restricted from running and plyometrics for four weeks. Thorough examination and appropriate clinical decision making by the physical therapist at the initial examination led to the diagnosis of an acetabular stress fracture in this subject. Clinicians must be aware of symptoms and signs which place the subject at risk for stress fracture for timely referral and management. 4.

The role of smartphones in encouraging physical activity in adults

PubMed Central

Stuckey, Melanie I; Carter, Shawn W; Knight, Emily

2017-01-01

Lack of physical activity is a global public health issue. Behavioral change interventions utilizing smartphone applications (apps) are considered a potential solution. The purpose of this literature review was to: 1) determine whether smartphone-based interventions encourage the initiation of, and participation in, physical activity; 2) explore the success of interventions in different populations; and 3) examine the key factors of the interventions that successfully encouraged physical activity. Eight databases (Medline, Scopus, EBM Reviews–Cochrane Central Register of Controlled Trials, EBM Reviews–Cochrane Database of Systematic Reviews, PsycInfo, SportDISCUS, CINAHL, and EMBASE) were searched and studies reporting physical activity outcomes following interventions using smartphone apps in adults were included in the narrative review. Results were mixed with eight studies reporting increased physical activity and ten reporting no change. Interventions did not appear to be successful in specific populations defined by age, sex, country, or clinical diagnosis. There was no conclusive evidence that a specific behavioral theory or behavioral change technique was superior in eliciting behavioral change. The literature remains limited primarily to short-term studies, many of which are underpowered feasibility or pilot studies; therefore, many knowledge gaps regarding the effectiveness of smartphone apps in encouraging physical activity remain. Robust studies that can accommodate the fast pace of the technology industry are needed to examine outcomes in large populations. PMID:28979157

Catch-Up Growth Assessment in Long-Term Physically Neglected and Emotionally Abused Preschool Age Male Children.

ERIC Educational Resources Information Center

Olivan, Gonzalo

2003-01-01

A longitudinal study examined 20 neglected and emotionally abused boys (ages 30-42 months) who entered foster residential care and remained a year after initial placement. At placement, children showed a mild form of chronic malnutrition with growth failure. Growth failure was reversible after the first year of stay. (Contains references.)…

Dating Violence Victimization: Associated Drinking and Sexual Risk Behaviors of Asian, Native Hawaiian, and Caucasian High School Students in Hawaii

ERIC Educational Resources Information Center

Ramisetty-Mikler, Suhasini; Goebert, Deborah; Nishimura, Stephanie; Caetano, Raul

2006-01-01

Ethnic minority groups such as Asian/Pacific Islanders (APIs) and native populations in Hawaii are seldom studied in the area of intimate relationships. Using the 1999 Hawaii Youth Risk Behavior Survey, this study examined gender and ethnic differences in experiencing physical dating violence and whether drinking (early initiation, binge…

Application of GPS Technology to Monitor Traffic Intensity and Soil Impacts in a Forest Harvest Operation

Treesearch

Emily A. Carter; Timothy P. McDonald; John L. Torbert

1999-01-01

A study was initiated in the Winter of 1998 to examine the utility of employing Global Positioning Systems (GPS) to monitor harvest traffic throughout a loblolly pine plantation and utilize traffic intensity information to assess impacts of select soil physical properties. Traffic maps prepared from GPS positional data indicated the highest concentration of traffic...

Brodie Abscess

DTIC Science & Technology

2007-10-01

swelling and tenderness to palpation at the medial ankle and the patient was treated for an ankle sprain . The patient returned to clinic due to...lacking an inciting traumatic event and systemic symptoms. While radiographs are the initial diagnostic modality, Magnetic Resonance (MR) imaging...became manifest. History: A 15 year old white male presented to clinic due to six months of right ankle pain. The physical examination revealed mild

The Level of Anxiety and Depression in Dialysis Patients Undertaking Regular Physical Exercise Training--a Preliminary Study.

PubMed

Dziubek, Wioletta; Kowalska, Joanna; Kusztal, Mariusz; Rogowski, Łukasz; Gołębiowski, Tomasz; Nikifur, Małgorzata; Szczepańska-Gieracha, Joanna; Zembroń-Łacny, Agnieszka; Klinger, Marian; Woźniewski, Marek

2016-01-01

The aim of the study was to evaluate the effects of a six-month physical training undertaken by haemodialysis (HD) patients, on the depression and anxiety. Patients with end stage renal disease (ESRD) were recruited from the dialysis station at the Department of Nephrology and Transplantation Medicine in Wroclaw. Physical training took place at the beginning of the first 4-hours of dialysis, three times a week for six months. A personal questionnaire, Beck Depression Inventory (BDI) and State-Trait Anxiety Inventory (STAI) were used in the study. A total of 28 patients completed the study: 20 were randomised to endurance training and 8 were randomised to resistance training. Statistical analysis of depression and anxiety at the initial (t1) and final examination (t2) indicated a significant reduction in depression and anxiety, particularly anxiety as a trait (X2) in the whole study group. The change in anxiety as a state correlated with the disease duration, duration of dialysis and the initial level of anxiety as a state (t1X1). The change in anxiety as a trait significantly correlated with age and the initial level of anxiety (t1X2). Undertaking physical training during dialysis by patients with ESRD is beneficial in reducing their levels of anxiety and depression. Both resistance and endurance training improves mood, but only endurance training additionally results in anxiety reduction. © 2016 S. Karger AG, Basel.

Analysis of Otologic Injuries Due to Blast Trauma by Handmade Explosives

PubMed Central

Aslıer, Mustafa; Aslıer, Nesibe Gül Yüksel

2017-01-01

Objective The aim of this study is to identify the otologic injuries due to handmade explosive-welded blast travma in the law enforcement officers during the combat operations in the curfew security region and to specify the disorders that Otolaryngology and Head Neck Surgery (OHNS) physicians can face during such operations. Methods Medical records of patients in law enforcement who were initially treated by OHNS physicians of Silopi State Hospital during combat operations, between December 14, 2015 and January 15, 2016 were reviewed. Twenty-five patients with otologic injuries due to blast trauma were included in the study. Trauma characteristics, physical examination findings, and beginning treatments were identified. Results Primary blast injury (PBI) was identified as the major disorder in all 24 cases. Tinnitus and hearing loss were the most frequent complaints. In physical examination, tympanic membrane perforations were found in four ears of three patients. Oral methylprednisolone in decreasing doses for 10 days was commenced as an initial treatment in patients with PBI. Secondary blast injury presented in the form of soft tissue damage in the auricular helix due to shrapnel pieces in one patient and a minor surgery was performed. Conclusion Otologic injuries due to blast trauma may often develop during this type of combat operations. Otologic symptoms should be checked, otoscopic examination should be performed, and patients should consult OHNS physicians as soon as possible after trauma. PMID:29392057

Analysis of Otologic Injuries Due to Blast Trauma by Handmade Explosives.

PubMed

Aslıer, Mustafa; Aslıer, Nesibe Gül Yüksel

2017-06-01

The aim of this study is to identify the otologic injuries due to handmade explosive-welded blast travma in the law enforcement officers during the combat operations in the curfew security region and to specify the disorders that Otolaryngology and Head Neck Surgery (OHNS) physicians can face during such operations. Medical records of patients in law enforcement who were initially treated by OHNS physicians of Silopi State Hospital during combat operations, between December 14, 2015 and January 15, 2016 were reviewed. Twenty-five patients with otologic injuries due to blast trauma were included in the study. Trauma characteristics, physical examination findings, and beginning treatments were identified. Primary blast injury (PBI) was identified as the major disorder in all 24 cases. Tinnitus and hearing loss were the most frequent complaints. In physical examination, tympanic membrane perforations were found in four ears of three patients. Oral methylprednisolone in decreasing doses for 10 days was commenced as an initial treatment in patients with PBI. Secondary blast injury presented in the form of soft tissue damage in the auricular helix due to shrapnel pieces in one patient and a minor surgery was performed. Otologic injuries due to blast trauma may often develop during this type of combat operations. Otologic symptoms should be checked, otoscopic examination should be performed, and patients should consult OHNS physicians as soon as possible after trauma.

Prevalence and Predictors of Anxiety in Doctor of Physical Therapy Students.

PubMed

Macauley, Kelly; Plummer, Laura

2017-01-01

Anxiety is a condition with multiple physical manifestations and sequelae, including negatively impacting learning. The prevalence of anxiety and the factors that predict it in health professions students are unknown. The current study assessed the prevalence of anxiety in DPT students and examined the predictors of anxiety. The findings showed high student anxiety levels that were analogous to military recruits. Female gender and low GPA were predictors of anxiety in the sample. Further research is necessary to determine other factors that contribute to anxiety so that interventions to reduce anxiety in health professions students can be initiated.

Adaptation of bone to physiological stimuli.

PubMed

Judex, S; Gross, T S; Bray, R C; Zernicke, R F

1997-05-01

The ability of bone to alter its morphology in response to local physical stimuli is predicated upon the appropriate recruitment of bone cell populations. In turn, the ability to initiate cellular recruitment is influenced by numerous local and systemic factors. In this paper, we discuss data from three ongoing projects from our laboratory that examine how physiological processes influence adaptation and growth in the skeleton. In the first study, we recorded in vivo strains to quantify the locomotion-induced distribution of two parameters closely related to bone fluid flow strain rate and strain gradients. We found that the magnitude of these parameters (and thus the implied fluid flow) varies substantially within a given cross-section, and that while strain rate magnitude increases uniformly with elevated speed, strain gradients increase focally as gait speed is increased. Secondly, we examined the influence of vascular alterations on bone adaptation by assessing bone blood flow and bone mechanical properties in an in vivo model of trauma-induced joint laxity. A strong negative correlation (r2 = 0.8) was found between increased blood flow (76%) in the primary and secondary spongiosa and decreased stiffness (-34%) following 14 weeks of joint laxity. These data suggest that blood flow and/or vascular adaptation may interact closely with bone adaptation initiated by trauma. Thirdly, we examined the effect of a systemic influence upon skeletal health. After 4 weeks old rats were fed high fat-sucrose diets for 2 yr, their bone mechanical properties were significantly reduced. These changes were primarily due to interference with normal calcium absorption. In the aggregate, these studies emphasize the complexity of bone's normal physical environment, and also illustrate the potential interactions of local and systemic factors upon the process by which bone adapts to physical stimuli.

A three-dimensional simulation of transition and early turbulence in a time-developing mixing layer

NASA Technical Reports Server (NTRS)

Cain, A. B.; Reynolds, W. C.; Ferziger, J. H.

1981-01-01

The physics of the transition and early turbulence regimes in the time developing mixing layer was investigated. The sensitivity of the mixing layer to the disturbance field of the initial condition is considered. The growth of the momentum thickness, the mean velocity profile, the turbulence kinetic energy, the Reynolds stresses, the anisotropy tensor, and particle track pictures of computations are all examined in an effort to better understand the physics of these regimes. The amplitude, spectrum shape, and random phases of the initial disturbance field were varied. A scheme of generating discrete orthogonal function expansions on some nonuniform grids was developed. All cases address the early or near field of the mixing layer. The most significant result shows that the secondary instability of the mixing layer is produced by spanwise variations in the straining field of the primary vortex structures.

Disorders of the neonatal nasal cavity: Fundamentals for practice.

PubMed

Sohal, Maheep; Schoem, Scott R

2016-08-01

Neonatal nasal obstruction is a well-known clinical entity. Fortunately, it is rarely life-threatening and usually resolves with conservative management. As with most conditions, a systematic history and thorough physical examination are crucial for correct diagnosis and management. The initial diagnosis may be elusive and require either serial or more in-depth evaluations. Occasionally, examination may reveal structural abnormalities necessitating surgical intervention. Fortunately most of these abnormalities are amenable to surgery; however, a select few are notoriously difficult to treat. Copyright © 2016. Published by Elsevier Ltd.

Anterior vaginal wall tenderness (AVWT) as a physical symptom in chronic pelvic pain.

PubMed

Paulson, John D; Paulson, Joseph N

2011-01-01

Chronic pelvic pain is often difficult to diagnose and treat properly. Physicians called on to treat this problem may not be able to give a specific diagnosis. The aim of this study was to see whether the physical presence of anterior vaginal wall tenderness could help narrow down and elucidate diagnoses in a practice focusing on diagnosis and treatment of chronic pelvic pain. The study cohort comprised 284 patients with chronic pelvic pain limited to gynecologic and lower urinary problems. Histories, physical examinations, and endoscopic procedures were performed on each patient. An analysis of this information was conducted. Of the chronic pelvic pain patients, 78% had endometriosis, 81% had interstitial cystitis, and 61% had both concurrently. The sensitivity of anterior vaginal wall tenderness (AVWT) in patients with interstitial cystitis was 95%, and in those with only endometriosis and no interstitial cystitis, the sensitivity was 17%. The positive predictive value for interstitial cystitis was 85%, and for endometriosis it was 67%. Examination of the anterior vaginal wall with an empty bladder at the initial examination can lead one to suspect interstitial cystitis and possibly either concomitant or singular endometriosis and allow the physician to approach the workup accordingly.

Playing it safe: addressing the emotional and physical health of lesbian and gay pupils in the U.K.

PubMed

Warwick, I; Aggleton, P; Douglas, N

2001-02-01

Compared to young people in general, young lesbians and gay men can face specific challenges to their physical and emotional well-being. These include discrimination, victimization, homophobic bullying and an elevated suicide risk. Relative to initiatives which attempt to address bullying in general, little has been done in schools in the U.K. to address physical and verbal homophobic bullying. This paper reports on an exploratory study to examine teachers' perceptions of homophobic bullying, the responses made to this form of bullying, and the factors which impact on the provision of education and support to lesbian and gay pupils. Findings suggested that teachers were aware of homophobic bullying but were confused, unable or unwilling to address the needs of lesbian and gay pupils. Implications for policy, practice and research are discussed. While current U.K. Government policy promoting Healthy Schools and Citizenship education offers hope for the future, much remains to be done to ensure that such initiatives are inclusive of all pupils. Copyright 2001 The Association for Professionals in Services for Adolescents.

Child maltreatment and age of alcohol and marijuana initiation in high-risk youth.

PubMed

Proctor, Laura J; Lewis, Terri; Roesch, Scott; Thompson, Richard; Litrownik, Alan J; English, Diana; Arria, Amelia M; Isbell, Patricia; Dubowitz, Howard

2017-12-01

Youth with a history of child maltreatment use substances and develop substance use disorders at rates above national averages. Thus far, no research has examined pathways from maltreatment to age of substance use initiation for maltreated youth. We examined the longitudinal impact of maltreatment in early childhood on age of alcohol and marijuana use initiation, and whether internalizing and externalizing behaviors at age 8 mediates the link between maltreatment and age of substance use initiation. Data were drawn from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN) at ages 4, 8, 12, and 18. Maltreatment was assessed through reviews of administrative records and youth self-reports. Behavior problems were assessed with the Child Behavior Checklist. Age of substance use initiation was assessed with the Young Adult version of the Diagnostic Interview Schedule for Children. Path analyses indicated mediated effects from a history of maltreatment to age at first alcohol and marijuana use through externalizing behaviors. Considering type of maltreatment, direct effects were found from physical abuse to age of alcohol initiation, and mediated effects were found from sexual abuse and neglect to initial age of alcohol and marijuana use through externalizing behaviors. Direct effects for marijuana use initiation and indirect effects through internalizing behavior problems were not significant for either substance. Externalizing behavior is one pathway from childhood maltreatment to age of substance use initiation. Services for maltreated youth should incorporate substance use prevention, particularly among those with early externalizing problems. Copyright © 2017 Elsevier Ltd. All rights reserved.

The Role of Placement History and Current Family Environment in Children's Aggression in Foster Care.

PubMed

Perry, Kristin J; Price, Joseph

2017-04-01

Predictors of the physical and relational aggressive behavior of children in foster care were examined ( N = 160, 50.9% male, M age = 7.57, SD = 2.39). First, predictors representative of children's placement histories were examined in relation to the children's aggression at T1. Next, predictors representing characteristics of the current family environment were examined in relation to the children's aggression at T2 (four months later). Results revealed that a greater number of prior group home placements and being in a non-kinship home were associated with higher physical aggression at T1. A greater number of prior group home placements, a fewer number of regular home placements, being in a non-kinship home, and prior removal from the home due to neglect were associated with higher relational aggression at T1. The results also revealed that higher foster sibling relational aggression at T1 predicted lower child physical aggression at T2. If foster siblings were biological children of the foster parent, higher levels of a foster sibling's physical aggression at T1 predicted reduced child physical aggression at T2. The opposite pattern was observed if foster siblings were not biological children of the foster parent. Lastly, longer time in the current placement, more children in the home, and the presence of a sibling that was a biological child of the parent predicted higher child relational aggression at T2. These findings provide initial insights into how placement history and current family environment are associated with the physical and relational aggressive behavior of children in foster care.

A retrospective study on changes in residents' physical activities, social interactions, and neighborhood cohesion after moving to a walkable community.

PubMed

Zhu, Xuemei; Yu, Chia-Yuan; Lee, Chanam; Lu, Zhipeng; Mann, George

2014-12-01

This study is to examine changes in residents' physical activities, social interactions, and neighborhood cohesion after they moved to a walkable community in Austin, Texas. Retrospective surveys (N=449) were administered in 2013-2014 to collect pre- and post-move data about the outcome variables and relevant personal, social, and physical environmental factors. Walkability of each resident's pre-move community was measured using the Walk Score. T tests were used to examine the pre-post move differences in the outcomes in the whole sample and across sub-groups with different physical activity levels, neighborhood conditions, and neighborhood preferences before the move. After the move, total physical activity increased significantly in the whole sample and all sub-groups except those who were previously sufficiently active; lived in communities with high walkability, social interactions, or neighborhood cohesion; or had moderate preference for walkable neighborhoods. Walking in the community increased in the whole sample and all subgroups except those who were previously sufficiently active, moved from high-walkability communities, or had little to no preference for walkable neighborhoods. Social interactions and neighborhood cohesion increased significantly after the move in the whole sample and all sub-groups. This study explored potential health benefits of a walkable community in promoting physically and socially active lifestyles, especially for populations at higher risk of obesity. The initial result is promising, suggesting the need for more work to further examine the relationships between health and community design using pre-post assessments. Copyright © 2014 Elsevier Inc. All rights reserved.

Dimensions of physical punishment and their associations with children's cognitive performance and school adjustment.

PubMed

Font, Sarah A; Cage, Jamie

2018-01-01

This study examined how a range of physical punishment measures, ranging from mild corporal punishment to physical abuse, are associated with cognitive performance, school engagement, and peer isolation over a 3- year span among 658 children initially observed between the ages of 8 and 14. Physical punishment was captured in three groups: mild corporal punishment, harsh corporal punishment, and physical abuse, and both caregiver- and child-reported punishment measures were considered. After accounting for socioeconomic and demographic characteristics, only Ninitial exposure to physical abuse was significantly associated with declines in cognitive performance. However, all forms of physical punishment were associated with declines in school engagement, and harsh corporal punishment was associated with increased peer isolation. Our findings were relatively consistent regardless of whether physical punishment was reported by the child or caregiver. Overall, our findings suggest that the prevention of physical abuse may enhance children's cognitive performance, but that alone may not be sufficient to ensure children are engaged and well-adjusted in school. Copyright © 2017 Elsevier Ltd. All rights reserved.

One physical educator's career cycle: strong start, great run, approaching finish.

PubMed

Woods, Amelia Mays; Lynn, Susan K

2014-03-01

This article is nested within a longitudinal project examining 6 teachers' journeys along their career cycles (Lynn & Woods, 2010; Woods & Earls, 1995; Woods & Lynn, 2001). Two participants from the initial 6 continue to teach K-12 physical education; 1 of these participants, Everett, is examined in the current study. This veteran teacher's career-cycle movement and the environmental factors that both enhanced and constrained his career development are examined through the lens of Fessler and Christensen's career cycle model (1992). Data sources included: 8 formal interviews with Everett; formal interviews with his university teacher educators, student-teacher supervisor, principal, and spouse; informal interviews; field notes; and systematic teaching observations. An interpretative framework was used to assess the perceptions and meanings Everett gave to experiences as a physical educator and coach. Several factors acutely influenced Everett's career progression, including: (a) his individual disposition, (b) the impact and continued influence of a professional preparation program, and (c) his school and community support. He entered the profession with great promise and spent most of his career in the enthusiastic and growing, and the career stability, stages before shifting into the career frustration stage where he currently remains. Everett was able to negotiate personal and organizational environmental factors that have been identified as barriers for some physical educators. Therefore, viewing his professional life through the lens of the career cycle provides insights into the areas of change necessary to motivate and retain high-quality physical educators such as Everett.

ASTRO's core physics curriculum for radiation oncology residents.

PubMed

Klein, Eric E; Balter, James M; Chaney, Edward L; Gerbi, Bruce J; Hughes, Lesley

2004-11-01

In 2002, the Radiation Physics Committee of the American Society of Therapeutic Radiology and Oncology (ASTRO) appointed an Ad-hoc Committee on Physics Teaching to Medical Residents. The main initiative of the committee was to develop a core curriculum for physics education. Prior publications that have analyzed physics teaching have pointed to wide discrepancies among teaching programs. The committee was composed of physicists or physicians from various residency program based institutions. Simultaneously, members had associations with the American Association of Physicists in Medicine (AAPM), ASTRO, Association of Residents in Radiation Oncology (ARRO), American Board of Radiology (ABR), and the American College of Radiology (ACR). The latter two organizations' representatives were on the physics examination committees, as one of the main agendas was to provide a feedback loop between the examining organizations and ASTRO. The document resulted in a recommended 54-h course. Some of the subjects were based on American College of Graduate Medical Education (ACGME) requirements (particles, hyperthermia), whereas the majority of the subjects along with the appropriated hours per subject were devised and agreed upon by the committee. For each subject there are learning objectives and for each hour there is a detailed outline of material to be covered. Some of the required subjects/h are being taught in most institutions (i.e., Radiation Measurement and Calibration for 4 h), whereas some may be new subjects (4 h of Imaging for Radiation Oncology). The curriculum was completed and approved by the ASTRO Board in late 2003 and is slated for dissemination to the community in 2004. It is our hope that teaching physicists will adopt the recommended curriculum for their classes, and simultaneously that the ABR for its written physics examination and the ACR for its training examination will use the recommended curriculum as the basis for subject matter and depth of understanding. To ensure that the subject matter and emphasis remain current and relevant, the curriculum will be updated every 2 years.

Effects of attractiveness and gender on the perception of achievement-related variables.

PubMed

Chia, R C; Allred, L J; Grossnickle, W F; Lee, G W

1998-08-01

The present study was an examination of the effects of physical attractiveness and gender on perceptions of academic success, achievement-related traits, intelligence, initiative, and attributions of ability and effort in relation to academic success. It was hypothesized that attractive persons and men would be rated more favorably along these dimensions than would unattractive persons and women. The participants were 144 U.S. undergraduates who observed photographs of attractive and unattractive men and women and then rated the persons in the photographs on the aforementioned dimensions. Physical attractiveness had a differential effect on the dimensions within achievement. Also, being perceived as physically attractive created positive impressions of achievement-related traits for men but negative impressions for women.

History of childhood trauma and disruptive behaviors in the medical setting.

PubMed

Sansone, Randy A; Farukhi, Shahzad; Wiederman, Michael W

2012-03-01

In this study, we examined relationships between five types of childhood trauma and 17 disruptive behaviors in the medical setting. Using a cross-sectional consecutive sample of 394 internal medicine outpatients, we surveyed participants about five types of childhood trauma (i.e. witnessing of violence, physical neglect, emotional abuse, physical abuse, and sexual abuse) and 17 disruptive behaviors in the medical setting (e.g., yelling, cursing, threatening medical personnel). Initial correlations indicated relationships between four of the five forms of childhood trauma and the number of different disruptive behaviors endorsed. However, using multiple regression analysis, only witnessing violence and physical abuse remained independent predictors of disruptive behaviors in the medical setting. Individuals with childhood histories of witnessing violence and/or physical abuse are at-risk for perpetrating various disruptive behaviors in the medical setting.

Critical Parameters of the Initiation Zone for Spontaneous Dynamic Rupture Propagation

NASA Astrophysics Data System (ADS)

Galis, M.; Pelties, C.; Kristek, J.; Moczo, P.; Ampuero, J. P.; Mai, P. M.

2014-12-01

Numerical simulations of rupture propagation are used to study both earthquake source physics and earthquake ground motion. Under linear slip-weakening friction, artificial procedures are needed to initiate a self-sustained rupture. The concept of an overstressed asperity is often applied, in which the asperity is characterized by its size, shape and overstress. The physical properties of the initiation zone may have significant impact on the resulting dynamic rupture propagation. A trial-and-error approach is often necessary for successful initiation because 2D and 3D theoretical criteria for estimating the critical size of the initiation zone do not provide general rules for designing 3D numerical simulations. Therefore, it is desirable to define guidelines for efficient initiation with minimal artificial effects on rupture propagation. We perform an extensive parameter study using numerical simulations of 3D dynamic rupture propagation assuming a planar fault to examine the critical size of square, circular and elliptical initiation zones as a function of asperity overstress and background stress. For a fixed overstress, we discover that the area of the initiation zone is more important for the nucleation process than its shape. Comparing our numerical results with published theoretical estimates, we find that the estimates by Uenishi & Rice (2004) are applicable to configurations with low background stress and small overstress. None of the published estimates are consistent with numerical results for configurations with high background stress. We therefore derive new equations to estimate the initiation zone size in environments with high background stress. Our results provide guidelines for defining the size of the initiation zone and overstress with minimal effects on the subsequent spontaneous rupture propagation.

Healthy, wealthy, and wise: retirement planning predicts employee health improvements.

PubMed

Gubler, Timothy; Pierce, Lamar

2014-09-01

Are poor physical and financial health driven by the same underlying psychological factors? We found that the decision to contribute to a 401(k) retirement plan predicted whether an individual acted to correct poor physical-health indicators revealed during an employer-sponsored health examination. Using this examination as a quasi-exogenous shock to employees' personal-health knowledge, we examined which employees were more likely to improve their health, controlling for differences in initial health, demographics, job type, and income. We found that existing retirement-contribution patterns and future health improvements were highly correlated. Employees who saved for the future by contributing to a 401(k) showed improvements in their abnormal blood-test results and health behaviors approximately 27% more often than noncontributors did. These findings are consistent with an underlying individual time-discounting trait that is both difficult to change and domain interdependent, and that predicts long-term individual behaviors in multiple dimensions. © The Author(s) 2014.

Incidence and risk factors for lower limb lymphedema after gynecologic cancer surgery with initiation of periodic complex decongestive physiotherapy.

PubMed

Deura, Imari; Shimada, Muneaki; Hirashita, Keiko; Sugimura, Maki; Sato, Seiya; Sato, Shinya; Oishi, Tetsuro; Itamochi, Hiroaki; Harada, Tasuku; Kigawa, Junzo

2015-06-01

Lower limb lymphedema (LLL) is one of the most frequent postoperative complications of retroperitoneal lymphadenectomy for gynecologic cancer. LLL often impairs quality of life, activities of daily living, sleep, and sex in patients with gynecologic cancer. We conducted this study to evaluate the incidence and risk factors for LLL after gynecologic cancer surgery in patients who received assessment and periodic complex decongestive physiotherapy (CDP). We retrospectively reviewed 126 cases of gynecologic cancer that underwent surgery involving retroperitoneal lymphadenectomy at Tottori University Hospital between 2009 and 2012. All patients received physical examinations to detect LLL and underwent CDP by nurse specialists within several months after surgery. The International Society of Lymphology staging of lymphedema severity was used as the diagnostic criteria. Of 126 patients, 57 (45.2%) had LLL, comprising 45 and 12 patients with stage 1 and stage 2 LLL, respectively. No patient had stage 3 LLL. LLL was present in 37 (29.4%) patients at the initial physical examination. Multivariate analysis revealed that adjuvant concurrent chemoradiotherapy and age ≥ 55 years were independent risk factors for ≥ stage 2 LLL. To minimize the incidence of ≥ stage 2 LLL, gynecologic oncologists should be vigilant for this condition in patients who are ≥ 55 years and in those who undergo adjuvant chemoradiotherapy. Patients should be advised to have a physical assessment for LLL and to receive education about CDP immediately after surgery involving retroperitoneal lymphadenectomy for gynecologic cancer.

Baseline assessment of campus-wide general health status and mental health: Opportunity for tailored suicide prevention and mental health awareness programming.

PubMed

Hawley, Lisa D; MacDonald, Michael G; Wallace, Erica H; Smith, Julia; Wummel, Brian; Wren, Patricia A

2016-01-01

A campus-wide assessment examined the physical and mental health status of a midsize midwestern public university. Two thousand and forty-nine students, faculty, and staff on a single college campus were assessed in March-April 2013. Participants completed an online survey with sections devoted to demographics, physical and mental health status, and suicide knowledge and experiences. This study captured broad physical and mental health indicators. Students, faculty, and staff in certain demographic groups were more likely to report significant problems associated with mental and physical health. Specifically, women, faculty and staff of color, and nonheterosexual persons reported worse health outcomes. Across 8 mental health indicators, students reported consistently worse mental health than their faculty/staff counterparts. This paper presents findings from a significant campus-wide physical and mental health surveillance initiative. Results indicate the need for targeted physical and mental health support and intervention among these demographic groups.

Follow-up of 100 dogs with acute diarrhoea in a primary care practice.

PubMed

Berset-Istratescu, C M; Glardon, O J; Magouras, I; Frey, C F; Gobeli, S; Burgener, I A

2014-01-01

This study aimed to examine the aetiology of acute diarrhoea and the relapse rate in 100 client-owned dogs presented to a first-opinion clinic. History, physical examination, faecal testing and owner questionnaire data were collected at initial presentation (T0) and at either the time of relapse or at a recheck performed within 3 months. All dogs received treatment according to their clinical signs. Of 96 dogs that completed the study, 37 (38.5%) relapsed during the study period, 21 (21.9%) relapsed within 3 months, and 16 others (16.6%) at 3 months to 1 year after initial examination. Dogs that had undergone a change in housing location within 1 month prior to presentation and dogs <1 year old were significantly more likely to have positive parasitological analyses (P=0.02 and P=0.001, respectively). Pica was a risk factor for relapse (P=0.0002). Copyright © 2013 Elsevier Ltd. All rights reserved.

A hypothesis-driven physical examination learning and assessment procedure for medical students: initial validity evidence.

PubMed

Yudkowsky, Rachel; Otaki, Junji; Lowenstein, Tali; Riddle, Janet; Nishigori, Hiroshi; Bordage, Georges

2009-08-01

Diagnostic accuracy is maximised by having clinical signs and diagnostic hypotheses in mind during the physical examination (PE). This diagnostic reasoning approach contrasts with the rote, hypothesis-free screening PE learned by many medical students. A hypothesis-driven PE (HDPE) learning and assessment procedure was developed to provide targeted practice and assessment in anticipating, eliciting and interpreting critical aspects of the PE in the context of diagnostic challenges. This study was designed to obtain initial content validity evidence, performance and reliability estimates, and impact data for the HDPE procedure. Nineteen clinical scenarios were developed, covering 160 PE manoeuvres. A total of 66 Year 3 medical students prepared for and encountered three clinical scenarios during required formative assessments. For each case, students listed anticipated positive PE findings for two plausible diagnoses before examining the patient; examined a standardised patient (SP) simulating one of the diagnoses; received immediate feedback from the SP, and documented their findings and working diagnosis. The same students later encountered some of the scenarios during their Year 4 clinical skills examination. On average, Year 3 students anticipated 65% of the positive findings, correctly performed 88% of the PE manoeuvres and documented 61% of the findings. Year 4 students anticipated and elicited fewer findings overall, but achieved proportionally more discriminating findings, thereby more efficiently achieving a diagnostic accuracy equivalent to that of students in Year 3. Year 4 students performed better on cases on which they had received feedback as Year 3 students. Twelve cases would provide a reliability of 0.80, based on discriminating checklist items only. The HDPE provided medical students with a thoughtful, deliberate approach to learning and assessing PE skills in a valid and reliable manner.

Aging Well Among Women Veterans Compared With Non-Veterans in the Women’s Health Initiative

PubMed Central

LaCroix, Andrea Z.; Rillamas-Sun, Eileen; Woods, Nancy F.; Weitlauf, Julie; Zaslavsky, Oleg; Shih, Regina; LaMonte, Michael J.; Bird, Chloe; Yano, Elizabeth M.; LeBoff, Meryl; Washington, Donna; Reiber, Gayle

2016-01-01

Abstract Purpose of the Study: To examine whether Veteran status influences (a) women’s survival to age 80 years without disease and disability and (b) indicators of successful, effective, and optimal aging at ages 80 years and older. Design and Methods: The Women’s Health Initiative (WHI) enrolled 161,808 postmenopausal women aged 50–79 years from 1993 to 1998. We compared successful aging indicators collected in 2011–2012 via mailed questionnaire among 33,565 women (921 Veterans) who reached the age of 80 years and older, according to Veteran status. A second analysis focused on women with intact mobility at baseline who could have reached age 80 years by December 2013. Multinominal logistic models examined Veteran status in relation to survival to age 80 years without major disease or mobility disability versus having prevalent or incident disease, having mobility disability, or dying prior to age 80 years. Results: Women Veterans aged 80 years and older reported significantly lower perceived health, physical function, life satisfaction, social support, quality of life, and purpose in life scale scores compared with non-Veterans. The largest difference was in physical function scores (53.0 for Veterans vs 59.5 for non-Veterans; p < .001). Women Veterans were significantly more likely to die prior to age 80 years than non-Veteran WHI participants (multivariate adjusted odds ratio = 1.20; 95% confidence interval, 1.04–1.38). In both Veteran and non-Veteran women, healthy survival was associated with not smoking, higher physical activity, healthy body weight, and fewer depressive symptoms. Implications: Intervening upon smoking, low physical activity, obesity, and depressive symptoms has potential to improve chances for healthy survival in older women including Veterans. PMID:26768388

The "ripple effect": Health and community perceptions of the Indigenous Marathon Program on Thursday Island in the Torres Strait, Australia.

PubMed

Macniven, Rona; Plater, Suzanne; Canuto, Karla; Dickson, Michelle; Gwynn, Josephine; Bauman, Adrian; Richards, Justin

2018-02-19

Physical inactivity is a key health risk among Aboriginal and Torres Strait Islander (Indigenous) Australians. We examined perceptions of the Indigenous Marathon Program (IMP) in a remote Torres Strait island community. Semi-structured interviews with community and program stakeholders (n = 18; 14 Indigenous) examined barriers and enablers to running and the influence of the IMP on the community. A questionnaire asked 104 running event participants (n = 42 Indigenous) about their physical activity behaviours, running motivation and perceptions of program impact. Qualitative data were analysed using thematic content analysis, and quantitative data were analysed using descriptive statistics. Interviews revealed six main themes: community readiness, changing social norms to adopt healthy lifestyles, importance of social support, program appeal to hard-to-reach population groups, program sustainability and initiation of broader healthy lifestyle ripple effects beyond running. Barriers to running in the community were personal (cultural attitudes; shyness) and environmental (infrastructure; weather; dogs). Enablers reflected potential strategies to overcome described barriers. Indigenous questionnaire respondents were more likely to report being inspired to run by IMP runners than non-Indigenous respondents. Positive "ripple" effects of the IMP on running and broader health were described to have occurred through local role modelling of healthy lifestyles by IMP runners that reduced levels of "shame" and embarrassment, a common barrier to physical activity among Indigenous Australians. A high initial level of community readiness for behaviour change was also reported. SO WHAT?: Strategies to overcome this "shame" factor and community readiness measurement should be incorporated into the design of future Indigenous physical activity programs. © 2018 Australian Health Promotion Association.

Assimilation, Segregation, or Integration? A Teaching Project Examining Approaches to Religious and Ideological Diversity in the Classroom

ERIC Educational Resources Information Center

Bender-Szymanski, Dorothea

2012-01-01

In this article, we describe the multiple phases of a project that was constructed around the real case of a young Muslim student who wished to be exempted from coeducational physical education on religious grounds. When the school refused her initial request, she decided to take legal measures which ended up in the German Federal Administrative…

The association of physical examination abnormalities and carboxyhemoglobin concentrations in 21 dogs trapped in a kennel fire.

PubMed

Ashbaugh, Elizabeth A; Mazzaferro, Elisa M; McKiernan, Brendan C; Drobatz, Kenneth J

2012-06-01

To evaluate physical examination findings and their association with carboxyhemoglobin (COHb) concentrations in 21 dogs that were exposed to smoke during a kennel fire. Twenty-one dogs were exposed to a kennel fire. Physical exam findings, presenting, and posttherapy COHb concentrations as well as therapeutic interventions were evaluated. COHb concentrations upon presentation were increased in all smoke inhalation exposed dogs. These dogs were compared to a small set of clinically normal staff-owned dogs who were not exposed to fire. Physical parameters significantly associated with higher COHb concentrations included lower body temperature, increased respiratory effort, abnormal respiratory auscultation, altered neurologic status, and length of hospital stay. Oxygen therapy resulted in a more rapid decline in COHb concentrations although 5 dogs still had mildly increased COHb concentrations 24-hour postadmission. This study describes the relationship of admitting clinical findings of dogs exposed to a kennel fire with their initial blood COHb concentrations. It also describes the resolution of increased COHb concentrations with use of oxygen therapy and hospitalization. Additionally, COHb concentrations for a control group of dogs was evaluated and compared to the dogs exposed to smoke inhalation. © Veterinary Emergency and Critical Care Society 2012.

Systemic effects of screening for retinopathy of prematurity.

PubMed Central

Laws, D E; Morton, C; Weindling, M; Clark, D

1996-01-01

AIMS: To detect systemic complications of screening for retinopathy of prematurity (ROP), paying particular attention to the physical examination. METHODS: Oxygen saturation, pulse rate, and blood pressure were monitored before, during, and after 110 ROP screening examinations. RESULTS: Following topical mydriatics diastolic blood pressure was elevated by a mean of 6 (SD 7.2) mm Hg. Immediately after the examination there was a further rise in both systolic and diastolic pressure of 4.3 (14.5) mm Hg and 3.3 (11.6) mm Hg, respectively. Oxygen saturation and pulse rate remained stable during the control period and administration of eyedrops. Saturation fell by a median of 3% (95% confidence interval plus or minus 1.2%) after the examination while there was rise in pulse rate of 7 (SD 23.1) beats per minute. This change in pulse rate was not observed in infants on concurrent methylxanthine therapy. No infant had clinically significant changes at the end of the study. CONCLUSION: The initial changes in blood pressure may represent side effects of topical mydriatics but the later changes following the physical examination may be an additional response to the stress of ROP screening. PMID:8695564

Clinical and Organizational Factors in the Initial Evaluation of Patients With Lung Cancer

PubMed Central

Jim Yeung, Sai-Ching; Tanoue, Lynn T.; Gould, Michael K.

2013-01-01

Background: This guideline is intended to provide an evidence-based approach to the initial evaluation of patients with known or suspected lung cancer. It also includes an assessment of the impact of timeliness of care and multidisciplinary teams on outcome. Methods: The applicable current medical literature was identified by a computerized search and evaluated using standardized methods. Recommendations were framed using the approach described by the Guidelines Oversight Committee of the American College of Chest Physicians. Data sources included MEDLINE and the Cochrane Database of Systematic Reviews. Results: Initial evaluation should include a thorough history and physical examination; CT imaging; pulmonary function tests; and hemoglobin, electrolyte, liver function, and calcium levels. Additional testing for distant metastases and paraneoplastic syndromes should be determined on the basis of these results. Paraneoplastic syndromes may have an adverse impact on cancer treatment, so they should be controlled rapidly with the goal of proceeding with definitive cancer treatment in a timely manner. Although the relationship between timeliness of care and survival is difficult to quantify, efforts to deliver timely care are reasonable and should be balanced with the need to attend to other dimensions of health-care quality (eg, safety, effectiveness, efficiency, equality, consistency with patient values and preferences). Quality care will require multiple disciplines. Although it is difficult to assess the impact, we suggest that a multidisciplinary team approach to care be used, particularly for patients requiring multimodality therapy. Conclusions: The initial evaluation of patients with lung cancer should include a thorough history and physical examination, pulmonary function tests, CT imaging, basic laboratory tests, and selective testing for distant metastases and paraneoplastic syndromes. PMID:23649435

Using the Physical Examination to Diagnose Patients with Acute Dizziness and Vertigo.

PubMed

Edlow, Jonathan A; Newman-Toker, David

2016-04-01

Emergency department (ED) patients who present with acute dizziness or vertigo can be challenging to diagnose. Roughly half have general medical disorders that are usually apparent from the context, associated symptoms, or initial laboratory tests. The rest include a mix of common inner ear disorders and uncommon neurologic ones, particularly vertebrobasilar strokes or posterior fossa mass lesions. In these latter cases, misdiagnosis can lead to serious adverse consequences for patients. Our aim was to assist emergency physicians to use the physical examination effectively to make a specific diagnosis in patients with acute dizziness or vertigo. Recent evidence indicates that the physical examination can help physicians accurately discriminate between benign inner ear conditions and dangerous central ones, enabling correct management of peripheral vestibular disease and avoiding dangerous misdiagnoses of central ones. Patients with the acute vestibular syndrome mostly have vestibular neuritis, but some have stroke. Data suggest that focused eye movement examinations, at least when performed by specialists, are more sensitive for detecting early stroke than brain imaging, including diffusion-weighted magnetic resonance imaging. Patients with the triggered episodic vestibular syndrome mostly have benign paroxysmal positional vertigo (BPPV), but some have posterior fossa mass lesions. Specific positional tests to provoke nystagmus can confirm a BPPV diagnosis at the bedside, enabling immediate curative therapy, or indicate the need for imaging. Emergency physicians can effectively use the physical examination to make a specific diagnosis in patients with acute dizziness or vertigo. They must understand the limitations of brain imaging. This may reduce misdiagnosis of serious central causes of dizziness, including posterior circulation stroke and posterior fossa mass lesions, and improve resource utilization. Copyright © 2016 Elsevier Inc. All rights reserved.

Association between physiological falls risk and physical performance tests among community-dwelling older adults

PubMed Central

Singh, Devinder KA; Pillai, Sharmila GK; Tan, Sin Thien; Tai, Chu Chiau; Shahar, Suzana

2015-01-01

Background Physical performance and balance declines with aging and may lead to increased risk of falls. Physical performance tests may be useful for initial fall-risk screening test among community-dwelling older adults. Physiological profile assessment (PPA), a composite falls risk assessment tool is reported to have 75% accuracy to screen for physiological falls risk. PPA correlates with Timed Up and Go (TUG) test. However, the association between many other commonly used physical performance tests and PPA is not known. The aim of the present study was to examine the association between physiological falls risk measured using PPA and a battery of physical performance tests. Methods One hundred and forty older adults from a senior citizens club in Kuala Lumpur, Malaysia (94 females, 46 males), aged 60 years and above (65.77±4.61), participated in this cross-sectional study. Participants were screened for falls risk using PPA. A battery of physical performance tests that include ten-step test (TST), short physical performance battery (SPPB), functional reach test (FRT), static balance test (SBT), TUG, dominant hand-grip strength (DHGS), and gait speed test (GST) were also performed. Spearman’s rank correlation and binomial logistic regression were performed to examine the significantly associated independent variables (physical performance tests) with falls risk (dependent variable). Results Approximately 13% older adults were at high risk of falls categorized using PPA. Significant differences (P<0.05) were demonstrated for age, TST, SPPB, FRT, SBT, TUG between high and low falls risk group. A significant (P<0.01) weak correlation was found between PPA and TST (r=0.25), TUG (r=0.27), SBT (r=0.23), SPPB (r=−0.33), and FRT (r=−0.23). Binary logistic regression results demonstrated that SBT measuring postural sways objectively using a balance board was the only significant predictor of physiological falls risk (P<0.05, odds ratio of 2.12). Conclusion The reference values of physical performance tests in our study may be used as a guide for initial falls screening to categorize high and low physiological falls risk among community-dwelling older adults. A more comprehensive assessment of falls risk can be performed thereafter for more specific intervention of underlying impairments. PMID:26316727

Traditional circumcision during manhood initiation rituals in the Eastern Cape, South Africa: a pre-post intervention evaluation

PubMed Central

Peltzer, Karl; Nqeketo, Ayanda; Petros, George; Kanta, Xola

2008-01-01

Background Circumcisions undertaken in non-clinical settings can have significant risks of serious adverse events, including death. The aim of this study was to test an intervention for safe traditional circumcision in the context of initiation into manhood among the Xhosa, Eastern Cape, South Africa. Methods Traditional surgeons and nurses registered with the health department were trained over five days on ten modules including safe circumcision, infection control, anatomy, post-operative care, detection and early management of complications and sexual health education. Initiates from initiation schools of the trained surgeons and nurses were examined and interviewed on 2nd, 4th, 7th and 14th day after circumcision. Results From 192 initiates physically examined at the 14th day after circumcision by a trained clinical nurse high rates of complications were found: 40 (20.8%) had mild delayed wound healing, 31 (16.2%) had a mild wound infection, 22 (10.5%) mild pain and 20 (10.4%) had insufficient skin removed. Most traditional surgeons and nurses wore gloves during operation and care but did not use the recommended circumcision instrument. Only 12% of the initiates were circumcised before their sexual debut and they reported a great deal of sexual risk behaviour. Conclusion Findings show weak support for scaling up traditional male circumcision. PMID:18284673

Correlations between physical properties of jawbone and dental implant initial stability.

PubMed

Seong, Wook-Jin; Kim, Uk-Kyu; Swift, James Q; Hodges, James S; Ko, Ching-Chang

2009-05-01

There is confusion in the literature about how physical properties of bone vary between maxillary and mandibular regions and which physical properties affect initial implant stability. The purpose of this study was to determine correlations between physical properties of bone and initial implant stability, and to determine how physical properties and initial stability vary among regions of jawbone. Four pairs of edentulous maxillae and mandibles were retrieved from fresh human cadavers. Six implants per pair were placed in different anatomical regions (maxillary anterior, right and left maxillary posterior, mandibular anterior, right and left mandibular posterior). Immediately after surgery, initial implant stability was measured with a resonance frequency device and a tapping device. Implant surgeries and initial stability measurements were performed within 72 hours of death. Elastic modulus (EM) and hardness were measured using nano-indentation. Composite apparent density (cAD) was measured using Archimedes' principle. Bone-implant contact percentage and cortical bone thickness were recorded histomorphometrically. Mixed linear models and univariate-correlation analyses were used (alpha=.05). Generally, mandibular bone had higher initial implant stability and physical properties than maxillary bone. Initial implant stability was higher in the anterior region than in the posterior. EM was higher in the posterior region than in the anterior; the reverse was true for cAD. Of the properties evaluated, cAD had the highest correlation with initial implant stability (r=0.82). Both physical properties of bone and initial implant stability differed between regions of jawbone.

Nonideal Rayleigh–Taylor mixing

PubMed Central

Lim, Hyunkyung; Iwerks, Justin; Glimm, James; Sharp, David H.

2010-01-01

Rayleigh–Taylor mixing is a classical hydrodynamic instability that occurs when a light fluid pushes against a heavy fluid. The two main sources of nonideal behavior in Rayleigh–Taylor (RT) mixing are regularizations (physical and numerical), which produce deviations from a pure Euler equation, scale invariant formulation, and nonideal (i.e., experimental) initial conditions. The Kolmogorov theory of turbulence predicts stirring at all length scales for the Euler fluid equations without regularization. We interpret mathematical theories of existence and nonuniqueness in this context, and we provide numerical evidence for dependence of the RT mixing rate on nonideal regularizations; in other words, indeterminacy when modeled by Euler equations. Operationally, indeterminacy shows up as nonunique solutions for RT mixing, parametrized by Schmidt and Prandtl numbers, in the large Reynolds number (Euler equation) limit. Verification and validation evidence is presented for the large eddy simulation algorithm used here. Mesh convergence depends on breaking the nonuniqueness with explicit use of the laminar Schmidt and Prandtl numbers and their turbulent counterparts, defined in terms of subgrid scale models. The dependence of the mixing rate on the Schmidt and Prandtl numbers and other physical parameters will be illustrated. We demonstrate numerically the influence of initial conditions on the mixing rate. Both the dominant short wavelength initial conditions and long wavelength perturbations are observed to play a role. By examination of two classes of experiments, we observe the absence of a single universal explanation, with long and short wavelength initial conditions, and the various physical and numerical regularizations contributing in different proportions in these two different contexts. PMID:20615983

Physics Teachers' Views on Their Initial Teacher Education

ERIC Educational Resources Information Center

Buabeng, Isaac; Conner, Lindsey; Winter, David

2016-01-01

This paper explores New Zealand (NZ) physics teachers' and physics educators' views about Initial Teacher Education (ITE). Perspectives of physics teachers nationally indicated that in general, teachers considered themselves not well-prepared in some content areas including electronics, modern physics, and atomic and nuclear physics. This may be…

Curricular Adaptations in Introductory Physics Labs

NASA Astrophysics Data System (ADS)

Dreyfus, Benjamin W.; Ewell, Mary; Moore, Kimberly

2017-01-01

When curricular materials are disseminated to new sites, there can be a tension between fidelity to the original intent of the developers and adaptation to local needs. In this case study we look at a lab activity that was initially developed for an introductory physics for the life sciences (IPLS) course at the University of Maryland, then implemented at George Mason University with significant adaptations. The goals of the two implementations were overlapping, but also differed in ways that are reflected in the two versions of the lab. We compare student lab report data from the two sites to examine the impacts of the adaptation on how students engaged with the lab.

Triceps tendon tear in a middle-aged weightlifter.

PubMed

Molloy, Joseph M; Aberle, Curtis J; Escobar, Eduardo

2013-11-01

The patient was a 47-year-old man who was evaluated by a physical therapist for a chief complaint of posterior right elbow pain. The patient routinely participated in weightlifting activities and reported a sudden onset of triceps weakness and posterior elbow pain while performing clap push-ups 3 days prior. A physician assistant ordered radiographs, which were initially interpreted as normal, and routine magnetic resonance imaging for the right elbow. Following examination by a physical therapist, due to concern for a triceps tendon tear, the previously ordered magnetic resonance imaging was expedited, which revealed a partial triceps tendon tear with partial tendon retraction medially.

Sociocultural Influences on Weight-Related Behaviors in African American Adolescents.

PubMed

Tate, Nutrena H; Davis, Jean E; Yarandi, Hossein N

2015-12-01

The purpose of this study was to examine the sociocultural factors related to weight behaviors in African American adolescents utilizing a social ecological approach. A descriptive correlational design included a sample of 145 African American adolescents. Perceived familial socialization, ethnic identity, physical activity, and eating behavior patterns were measured. Data were analyzed using descriptive statistics, Pearson product-moment correlations, and multiple regression equations. Perceived maternal socialization was significantly related to adolescent eating behaviors and physical activity whereas perceived paternal socialization was significantly related only to their physical activity. The adolescents' ethnic identity was not significantly related to their eating behaviors or physical activity. Health care providers who work with adolescents and their families can use the initial findings from this study to encourage healthy weight-related behaviors while reducing the obesity epidemic within the African American adolescent population in a developmentally appropriate and culturally sensitive manner. © The Author(s) 2014.

The Role of Placement History and Current Family Environment in Children’s Aggression in Foster Care

PubMed Central

Perry, Kristin J.; Price, Joseph

2017-01-01

Predictors of the physical and relational aggressive behavior of children in foster care were examined (N = 160, 50.9% male, M age = 7.57, SD = 2.39). First, predictors representative of children’s placement histories were examined in relation to the children’s aggression at T1. Next, predictors representing characteristics of the current family environment were examined in relation to the children’s aggression at T2 (four months later). Results revealed that a greater number of prior group home placements and being in a non-kinship home were associated with higher physical aggression at T1. A greater number of prior group home placements, a fewer number of regular home placements, being in a non-kinship home, and prior removal from the home due to neglect were associated with higher relational aggression at T1. The results also revealed that higher foster sibling relational aggression at T1 predicted lower child physical aggression at T2. If foster siblings were biological children of the foster parent, higher levels of a foster sibling’s physical aggression at T1 predicted reduced child physical aggression at T2. The opposite pattern was observed if foster siblings were not biological children of the foster parent. Lastly, longer time in the current placement, more children in the home, and the presence of a sibling that was a biological child of the parent predicted higher child relational aggression at T2. These findings provide initial insights into how placement history and current family environment are associated with the physical and relational aggressive behavior of children in foster care. PMID:29551877

The association between risk factors and hypertension in perak, malaysia.

PubMed

Loh, K W; Rani, F; Chan, T C; Loh, H Y; Ng, C W; Moy, F M

2013-08-01

Hypertension is a major public health problem in Malaysia. A survey was initiated to examine the association of modifiable and non-modifiable risk factors for hypertension in Perak, Malaysia. A total of 2025 respondents aged 30 years and above were recruited using a multi-stage sampling method. Hypertension was defined as self-reported hypertension and/or average of two blood pressure readings at single occasion with SBP ≥ 140mmHg or DBP ≥ 90 mmHg. Body mass index (BMI) was defined using the Asian criteria and International Physical Activity Questionnaire (IPAQ) was used to evaluate physical activity. Body weight, height and blood pressure were obtained using standard procedures. Univariate analyses were conducted to examine the associations between risk factors and hypertension. Multiple logistic regression was used to examine each significant risk factor on hypertension after adjusted for confounders. In total, 1076 (54.9%) respondents were found to be hypertensive. Significant associations (p <0.001) with hypertension were noted for increasing age, low physical activity, obese BMI, no education background and positive family history of hypertension. After adjusting for age, sex, ethnicity, education background, family history, BMI, physical activity, smoking and diet, respondents who were obese and had positive family history had higher odds for hypertension (OR:2.34; 95% CI:1.84-3.17 and 1.96 (1.59-2.42) respectively. A significant increase (p <0.001) in risk for hypertension was noted for age. Those with moderate physical activities were 1.40 (1.04-1.78) times more of having hypertension than those active. Poor diet score and smoking were not significantly associated with increased risk for hypertension. In conclusion, modifiable risk factors such as BMI and physical activity are important risk factors to target in reducing the risk for hypertension.

Modeling Aspects Of Nature Of Science To Preservice Elementary Teachers

NASA Astrophysics Data System (ADS)

Ashcraft, Paul

2007-01-01

Nature of science was modeled using guided inquiry activities in the university classroom with elementary education majors. A physical science content course initially used an Aristotelian model where students discussed the relationship between distance from a constant radiation source and the amount of radiation received based on accepted ``truths'' or principles and concluded that there was an inverse relationship. The class became Galilean in nature, using the scientific method to test that hypothesis. Examining data, the class rejected their hypothesis and concluded that there is an inverse square relationship. Assignments, given before and after the hypothesis testing, show the student's misconceptions and their acceptance of scientifically acceptable conceptions. Answers on exam questions further support this conceptual change. Students spent less class time on the inverse square relationship later when examining electrostatic force, magnetic force, gravity, and planetary solar radiation because the students related this particular experience to other physical relationships.

TA Beliefs in a SCALE-UP Style Classroom

NASA Astrophysics Data System (ADS)

DeBeck, George; Settelmeyer, Sam; Li, Sissi; Demaree, Dedra

2010-10-01

In Spring 2010, the Oregon State University physics department instituted a SCALE-UP (Student-Centered Active Learning Environment for Undergraduate Programs) style studio classroom in the introductory, calculus-based physics series. In our initial implementation, comprised of two hours lecture, two hours of studio, and two hours lab work, the studio session was lead by a faculty member and either 2 GTAs or 1 GTA and 1 LA. We plan to move to a model where senior GTAs can lead studio sections after co-teaching with the faculty member. It is critical that we know how to prepare and support the instructional team in facilitating student learning in this setting. We examine GTA and LA pedagogical beliefs through reflective journaling, interviews, and personal experience of the authors. In particular, we examine how these beliefs changed over their first quarter of instruction, as well as the resources used to adapt to the new classroom environment.

Parental punishment and peer victimization as developmental precursors to physical dating violence involvement among girls

PubMed Central

Hipwell, Alison E.; Stepp, Stephanie D.; Xiong, Shuangyan; Keenan, Kate; Blokland, Arjan; Loeber, Rolf

2012-01-01

The current study examined harsh punishment and peer victimization as developmental precursors to girls’ involvement in physical dating violence (PDV), and the putative mediating effect of rejection sensitivity. The sample comprised 475 African American and European American participants of the longitudinal Pittsburgh Girls Study who were dating at age 17. About 10% of girls reported significant perpetration and/or victimization of physical aggression in the relationship. Results showed that initial level and escalation in harsh punishment (between 10–13 years) and escalation in peer victimization (10–15 years) predicted PDV involvement, but this relationship was not mediated by rejection sensitivity. The results highlight the need to consider the impact of early experience of different forms of aggression on girls’ risk for PDV involvement. PMID:24591807

Small cell lung cancer presenting as dermatomyositis: mistaken for single connective tissue disease.

PubMed

Chao, Guanqun; Fang, Lizheng; Lu, Chongrong; Chen, Zhouwen

2012-06-01

Dermatomyositis (DM) is well-known to be associated with several types of malignancy. This case emphasizes the importance of a thorough examination for an underlying cancer, in patients with the symptoms of dermatomyositis. We report the case of a 62-year-old Chinese man who presented with a two-month history of edema of face and neck, together with erythema of the eyelids diagnosed of small cell lung cancer. Initially, it was thought to be single connective tissue disease such as DM. This study highlights the importance of a thorough physical examination when visiting a patient.

Development of countermeasures for use in space missions. [to adaptive response to space flight

NASA Technical Reports Server (NTRS)

Nicogossian, A. E. T.; Pool, S.; Huntoon, C. S. L.; Leonard, J. I.

1985-01-01

Several measures used to mitigate the inappropriate adaptive responses of space flight are investigated. Weighlessness results in a cephalic fluid shift, which causes a reduction in the circulating blood volume, and removal of weight bearing forces from musculoskeletal systems. The physiological changes that occur from one-g initiated hypovolemia and zero-g initiated fluild shifts are analyzed and compared. The role of barorecptors on the activation of the adrenergic responses that occurs as a result of hypovolemia is studied. The proper selection and administration of in-flight and post flight countermeasures, which include passive and active physical conditioning techniques, drugs, and vitamins are examined.

Dysphagia in the elderly.

PubMed

Khan, Abraham; Carmona, Richard; Traube, Morris

2014-02-01

Dysphagia, or difficulty swallowing, is a common problem in the elderly. Based on the initial clinical history and physical examination, the dysphagia is assessed as either primarily oropharyngeal or esophageal in origin. Most oropharyngeal dysphagia is of neurologic origin, and management is coordinated with a clinical swallow specialist in conjunction with an ear, nose, and throat (ENT) physician if warning signs imply malignancy. Several structural and functional esophageal disorders can cause dysphagia. If a patient has likely esophageal dysphagia, a video barium esophagram is a good initial test, and referral to a gastroenterologist is generally warranted leading to appropriate treatment. Copyright © 2014 Elsevier Inc. All rights reserved.

Clinical predictors of vestibulo-ocular dysfunction in pediatric sports-related concussion.

PubMed

Ellis, Michael J; Cordingley, Dean M; Vis, Sara; Reimer, Karen M; Leiter, Jeff; Russell, Kelly

2017-01-01

OBJECTIVE There were 2 objectives of this study. The first objective was to identify clinical variables associated with vestibulo-ocular dysfunction (VOD) detected at initial consultation among pediatric patients with acute sports-related concussion (SRC) and postconcussion syndrome (PCS). The second objective was to reexamine the prevalence of VOD in this clinical cohort and evaluate the effect of VOD on length of recovery and the development of PCS. METHODS A retrospective review was conducted for all patients with acute SRC and PCS who were evaluated at a pediatric multidisciplinary concussion program from September 2013 to May 2015. Acute SRS was defined as presenting < 30 days postinjury, and PCS was defined according to the International Classification of Diseases, 10th Revision criteria and included being symptomatic 30 days or longer postinjury. The initial assessment included clinical history and physical examination performed by 1 neurosurgeon. Patients were assessed for VOD, defined as the presence of more than 1 subjective vestibular and oculomotor complaint (dizziness, diplopia, blurred vision, etc.) and more than 1 objective physical examination finding (abnormal near point of convergence, smooth pursuits, saccades, or vestibulo-ocular reflex testing). Poisson regression analysis was used to identify factors that increased the risk of VOD at initial presentation and the development of PCS. RESULTS Three hundred ninety-nine children, including 306 patients with acute SRC and 93 with PCS, were included. Of these patients, 30.1% of those with acute SRC (65.0% male, mean age 13.9 years) and 43.0% of those with PCS (41.9% male, mean age 15.4 years) met the criteria for VOD at initial consultation. Independent predictors of VOD at initial consultation included female sex, preinjury history of depression, posttraumatic amnesia, and presence of dizziness, blurred vision, or difficulty focusing at the time of injury. Independent predictors of PCS among patients with acute SRC included the presence of VOD at initial consultation, preinjury history of depression, and posttraumatic amnesia at the time of injury. CONCLUSIONS This study identified important potential risk factors for the development of VOD following pediatric SRC. These results provide confirmatory evidence that VOD at initial consultation is associated with prolonged recovery and is an independent predictor for the development of PCS. Future studies examining clinical prediction rules in pediatric concussion should include VOD. Additional research is needed to elucidate the natural history of VOD following SRC and establish evidence-based indications for targeted vestibular rehabilitation.

MoveU? Assessing a Social Marketing Campaign to Promote Physical Activity.

PubMed

Scarapicchia, Tanya M F; Sabiston, Catherine M F; Brownrigg, Michelle; Blackburn-Evans, Althea; Cressy, Jill; Robb, Janine; Faulkner, Guy E J

2015-01-01

MoveU is a social marketing initiative aimed at increasing moderate-to-vigorous physical activity (MVPA) among undergraduate students. Using the Hierarchy of Effects model (HOEM), this study identified awareness of MoveU and examined associations between awareness, outcome expectations, self-efficacy, intentions, and MVPA. Students (N = 2,784) from a Canadian university in March 2013. A secondary analysis of the National College Health Assessment-II survey and measures specific to the MoveU campaign. The main associations were examined in a path analysis. MoveU awareness (36.4%) was lower than other well-established university health campaigns. Younger students, females, and individuals living on campus were more likely to be aware of MoveU. The HOEM was supported, and improvements in model fit were evident, with additional direct relationships between outcome expectancy and intention, and between self-efficacy and MVPA. The intended population was aware of the campaign. The HOEM was useful in the development and evaluation of the MoveU campaign. Longitudinal studies are needed to further test the efficacy of the HOEM in the social marketing of physical activity.

JPRS Report, Arms Control.

DTIC Science & Technology

1991-01-14

people in the group, with the exception of N . S . Petrushenko, have nothing to do with either the army or nuclear physics. [Soshnikov] But since you can...Weapon [A. Malikov; Moscow Radio 27 Dec] 18 Nuclear Modernization in Britain Examined [ S . Sayenko; Moscow International 28 Dec] 19... N . I. Ryzhkov. Scientists and testers wrote him at their own initiative. There was no answer. Last November, because of the whipping up of the

Pityriasis rosea. Appearance and distribution of macules aid diagnosis.

PubMed

Karnath, Bernard; Hussain, Nasir; Bevin, Mary

2003-05-01

A 40-year-old man presented with a 1-week history of a diffuse pruritic rash. The patient denied having had fever, chills, or a recent respiratory infection. He could not recall having an initial patch. Physical examination revealed numerous small, scaly patches on his trunk (figure 1). The rash spared the palms of his hands and soles of his feet as well as the distal extremities.

The utility and cost of routine follow-up procedures in the surveillance of ovarian and primary peritoneal carcinoma: a 16-year institutional review.

PubMed

Rettenmaier, N B; Rettenmaier, C R; Wojciechowski, T; Abaid, L N; Brown, J V; Micha, J P; Goldstein, B H

2010-11-23

The purpose of this study was to evaluate the number of ovarian cancer and primary peritoneal cancer (PPC) progressive disease cases identified via routine follow-up procedures and the corresponding cost throughout a 16-year period at a single medical institution. Previously undiagnosed epithelial ovarian (n=241), PPC (n=23), and concurrent ovarian and uterine (n=24) cancer patients were treated and then followed via CA-125, imaging (e.g., CT scan, chest X-ray), physical examination and vaginal cytology. In the group of 287 patients, there were 151 cases of disease progression. Serial imaging detected the highest number of progressive disease cases (66 initial and 45 confirmatory diagnoses), but the cost was rather high ($13,454 per patient recurrence), whereas CA-125 testing (74 initial and 20 corroborative diagnoses) was the least expensive ($3,924) per recurrent diagnosis. The total cost of surveillance during the 16-year period was nearly $2,400,000. Ultimately, serial imaging and the CA-125 assay detected the highest number of ovarian cancer and PCC progressive disease cases in comparison to physical examination and vaginal cytology, but nevertheless, all of the procedures were conducted at a considerable financial expense.

Promoting Physical Activity in Low-Active Adolescents via Facebook: A Pilot Randomized Controlled Trial to Test Feasibility.

PubMed

Wójcicki, Thomas R; Grigsby-Toussaint, Diana; Hillman, Charles H; Huhman, Marian; McAuley, Edward

2014-10-30

The World Wide Web is an effective method for delivering health behavior programs, yet major limitations remain (eg, cost of development, time and resource requirements, limited interactivity). Social media, however, has the potential to deliver highly customizable and socially interactive behavioral interventions with fewer constraints. Thus, the evaluation of social media as a means to influence health behaviors is warranted. The objective of this trial was to examine and demonstrate the feasibility of using an established social networking platform (ie, Facebook) to deliver an 8 week physical activity intervention to a sample of low-active adolescents (N=21; estimated marginal mean age 13.48 years). Participants were randomized to either an experimental (ie, Behavioral) or attentional control (ie, Informational) condition. Both conditions received access to a restricted-access, study-specific Facebook group where the group's administrator made two daily wall posts containing youth-based physical activity information and resources. Primary outcomes included physical activity as assessed by accelerometry and self-report. Interactions and main effects were examined, as well as mean differences in effect sizes. Analyses revealed significant improvements over time on subjectively reported weekly leisure-time physical activity (F1,18=8.426, P=.009, η2 = .319). However, there was no interaction between time and condition (F1,18=0.002, P=.968, η2 = .000). There were no significant time or interaction effects among the objectively measured physical activity variables. Examination of effect sizes revealed moderate-to-large changes in physical activity outcomes. Results provide initial support for the feasibility of delivery of a physical activity intervention to low-active adolescents via social media. Whether by employing behavioral interventions via social media can result in statistically meaningful changes in health-related behaviors and outcomes remains to be determined. ClinicalTrials.gov NCT01870323; http://clinicaltrials.gov/show/NCT01870323 (Archived by WebCite at http://www.webcitation.org/6SUTmSeZZ).

Predictors of physical activity and barriers to exercise in nursing and medical students.

PubMed

Blake, Holly; Stanulewicz, Natalia; Mcgill, Francesca

2017-04-01

To investigate physical activity levels of nursing and medicine students, examine predictors of physical activity level and examine the most influential benefits and barriers to exercise. Healthcare professionals have low levels of physical activity, which increases their health risk and may influence their health promotion practices with patients. We surveyed 361 nursing (n = 193) and medicine (n = 168) students studying at a UK medical school. Questionnaire survey, active over 12 months in 2014-2015. Measures included physical activity level, benefits and barriers to exercise, social support, perceived stress and self-efficacy for exercise. Many nursing and medicine students did not achieve recommended levels of physical activity (nursing 48%; medicine 38%). Perceived benefits of exercise were health related, with medicine students identifying additional benefits for stress relief. Most notable barriers to exercise were as follows: lack of time, facilities having inconvenient schedules and exercise not fitting around study or placement schedules. Nursing students were less active than medicine students; they perceived fewer benefits and more barriers to exercise and reported lower social support for exercise. Physical activity of nursing and medicine students was best predicted by self-efficacy and social support, explaining 35% of the variance. Physical activity should be promoted in nursing and medicine students. Interventions should aim to build self-efficacy for exercise and increase social support. Interventions should be developed that are targeted specifically to shift-working frontline care staff, to reduce schedule-related barriers to exercise and to increase accessibility to workplace health and well-being initiatives. © 2016 John Wiley & Sons Ltd.

Influence of the workplace on learning physical examination skills

PubMed Central

2014-01-01

Background Hospital clerkships are considered crucial for acquiring competencies such as diagnostic reasoning and clinical skills. The actual learning process in the hospital remains poorly understood. This study investigates how students learn clinical skills in workplaces and factors affecting this. Methods Six focus group sessions with 32 students in Internal Medicine rotation (4–9 students per group; sessions 80–90 minutes). Verbatim transcripts were analysed by emerging themes and coded independently by three researchers followed by constant comparison and axial coding. Results Students report to learn the systematics of the physical examination, gain agility and become able to recognise pathological signs. The learning process combines working alongside others and working independently with increasing responsibility for patient care. Helpful behaviour includes making findings explicit through patient files or during observation, feedback by abnormal findings and taking initiative. Factors affecting the process negatively include lack of supervision, uncertainty about tasks and expectations, and social context such as hierarchy of learners and perceived learning environment. Conclusion Although individual student experiences vary greatly between different hospitals, it seems that proactivity and participation are central drivers for learning. These results can improve the quality of existing programmes and help design new ways to learn physical examination skills. PMID:24678562

Let It Go: Lingering Negative Affect in Response to Daily Stressors Is Associated With Physical Health Years Later.

PubMed

Leger, Kate A; Charles, Susan T; Almeida, David M

2018-03-01

The way we respond to life's daily stressors has strong implications for our physical health. Researchers have documented the detrimental effects of initial emotional reactivity to daily stressors on future physical health outcomes but have yet to examine the effects of emotions that linger after a stressor occurs. The current study investigated how negative affect that lingers the day after a minor stressor occurs is associated with health-related outcomes. Participants ( N = 1,155) in a community-based, nationwide study answered questions about daily stressors and affect across 8 consecutive days and about their physical health almost 10 years later. Multilevel models indicated that people experience heightened levels of negative affect the day after a stressor occurs. Furthermore, higher levels of lingering negative affect are associated with greater numbers of chronic conditions and worse functional limitations 10 years later. Findings suggest that affective recovery from daily stressors has unique importance for long-term physical health.

Eating behaviors and weight over time in a prospective study: the Healthy Twin Study.

PubMed

Song, Yun-Mi; Lee, Kayoung; Sung, Joohon

2014-01-01

We examined the relationships of combined initial restrained and external/emotional eating with initial BMI and change in weight and these subscales over time. BMI and the Dutch Eating Behavior Questionnaire were twicemeasured in 1361 Korean twins and families (482 men, 879 women) over a period of 2.7±0.9 years. Subjects were classified by combination of initial sex-specific restrained and external (or emotional) eating tertiles. Linear mixed models were performed after adjusting for confounders at baseline (household, sibling relations, sex, age, education level, smoking, alcohol use, energy intake, physical activity, and medical history). In adjusted models, initial BMI increased with increasing tertiles of initial restrained eating across initial external/emotional eating tertiles. Weight was less likely to increase over time with increasing tertiles of initial restrained eating in the lowest external eating tertile and middle tertile of emotional eating at baseline. Subscale scores decreased over time with increasing tertiles of corresponding subscales at baseline. These findings suggest that high dietary restraint and external/emotional eating may indicate concurrent high BMI and attenuated weight gain and decreases in corresponding subscales over time.

Physical activity and cancer prevention : pathways and targets for intervention.

PubMed

Rogers, Connie J; Colbert, Lisa H; Greiner, John W; Perkins, Susan N; Hursting, Stephen D

2008-01-01

The prevalence of obesity, an established epidemiological risk factor for many cancers, has risen steadily for the past several decades in the US and many other countries. Particularly alarming are the increasing rates of obesity among children, portending continuing increases in the rates of obesity and obesity-related cancers for many years to come. Modulation of energy balance, via increased physical activity, has been shown in numerous comprehensive epidemiological reviews to reduce cancer risk. Unfortunately, the effects and mechanistic targets of physical activity interventions on the carcinogenesis process have not been thoroughly characterized. Studies to date suggest that exercise can exert its cancer-preventive effects at many stages during the process of carcinogenesis, including both tumour initiation and progression. As discussed in this review, exercise may be altering tumour initiation events by modifying carcinogen activation, specifically by enhancing the cytochrome P450 system and by enhancing selective enzymes in the carcinogen detoxification pathway, including, but not limited to, glutathione-S-transferases. Furthermore, exercise may reduce oxidative damage by increasing a variety of anti-oxidant enzymes, enhancing DNA repair systems and improving intracellular protein repair systems. In addition to altering processes related to tumour initiation, exercise may also exert a cancer-preventive effect by dampening the processes involved in the promotion and progression stages of carcinogenesis, including scavenging reactive oxygen species (ROS); altering cell proliferation, apoptosis and differentiation; decreasing inflammation; enhancing immune function; and suppressing angiogenesis. A paucity of data exists as to whether exercise may be working as an anti-promotion strategy via altering ROS in initiated or preneoplastic models; therefore, no conclusions can be made about this possible mechanism. The studies directly examining cell proliferation and apoptosis have shown that exercise can enhance both processes, which is difficult to interpret in the context of carcinogenesis. Studies examining the relationship between exercise and chronic inflammation suggest that exercise may reduce pro-inflammatory mediators and reduce the state of low-grade, chronic inflammation. Additionally, exercise has been shown to enhance components of the innate immune response (i.e. macrophage and natural killer cell function). Finally, only a limited number of studies have explored the relationship between exercise and angiogenesis; therefore, no conclusions can be made currently about the role of exercise in the angiogenesis process as it relates to tumour progression. In summary, exercise can alter biological processes that contribute to both anti-initiation and anti-progression events in the carcinogenesis process. However, more sophisticated, detailed studies are needed to examine each of the potential mechanisms contributing to an exercise-induced decrease in carcinogenesis in order to determine the minimum dose, duration and frequency of exercise needed to yield significant cancer-preventive effects, and whether exercise can be used prescriptively to reverse the obesity-induced physiological changes that increase cancer risk.

Factors affecting disclosure among Israeli children in residential care due to domestic violence.

PubMed

Lev-Wiesel, Rachel; Gottfried, Ruth; Eisikovits, Zvi; First, Maya

2014-04-01

Disclosure of child abuse may enable initiating interventions to end maltreatment and mediate its negative physical and psychological consequences. The present study reviews the field of disclosure and examines factors affecting disclosure among a service population of abused children who were placed in residential care due to various forms of abuse (e.g., physical, sexual, emotional, neglect and witnessing domestic violence). The sample consisted of 286 Israeli (Hebrew and Arabic speaking) children aged 12-17 (mean=14±1). Following approval of the Ethics committee of the University and parents' written consent, participants were administered a self-report questionnaire that included the following measures: a Socio-Demographic Questionnaire, the Childhood Trauma Questionnaire (CTQ), the Juvenile Victimization Questionnaire (JVQ), and the Disclosure of Trauma Questionnaire (DTQ). Results indicated that the three key factors enhancing the likelihood of disclosure were: moral factors, external initiatives and intolerable physical pain. The three key factors inhibiting disclosure were feelings of shame, fear of losing social support and uncertainty as to how and to whom to disclose. Results also showed that children preferred to disclose to their nuclear family members (parents and siblings) in comparison with professionals. Copyright © 2014 Elsevier Ltd. All rights reserved.

Diagnostic Validity of Combining History Elements and Physical Examination Tests for Traumatic and Degenerative Symptomatic Meniscal Tears.

PubMed

Décary, Simon; Fallaha, Michel; Frémont, Pierre; Martel-Pelletier, Johanne; Pelletier, Jean-Pierre; Feldman, Debbie E; Sylvestre, Marie-Pierre; Vendittoli, Pascal-André; Desmeules, François

2018-05-01

The current approach to the clinical diagnosis of traumatic and degenerative symptomatic meniscal tears (SMTs) proposes combining history elements and physical examination tests without systematic prescription of imaging investigations, yet the evidence to support this diagnostic approach is scarce. To assess the validity of diagnostic clusters combining history elements and physical examination tests to diagnose or exclude traumatic and degenerative SMT compared with other knee disorders. Prospective diagnostic accuracy study. Patients were recruited from 2 orthopedic clinics, 2 family medicine clinics, and from a university community. A total of 279 consecutive patients who underwent consultation for a new knee complaint. Each patient was assessed independently by 2 evaluators. History elements and standardized physical examination tests performed by a physiotherapist were compared with the reference standard: an expert physicians' composite diagnosis including a clinical examination and confirmatory magnetic resonance imaging. Participating expert physicians were orthopedic surgeons (n = 3) or sport medicine physicians (n = 2). Penalized logistic regression (least absolute shrinkage and selection operator) was used to identify history elements and physical examination tests associated with the diagnosis of SMT and recursive partitioning was used to develop diagnostic clusters. Diagnostic accuracy measures were calculated including sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios (LR+/-) with associated 95% confidence intervals (CIs). Eighty patients had a diagnosis of SMT (28.7%), including 35 traumatic tears and 45 degenerative tears. The combination a history of trauma during a pivot, medial knee pain location, and a positive medial joint line tenderness test was able to diagnose (LR+ = 8.9; 95% CI 6.1-13.1) or exclude (LR- = 0.10; 95% CI 0.03-0.28) a traumatic SMT. Combining a history of progressive onset of pain, medial knee pain location, pain while pivoting, absence of valgus or varus knee misalignment, or full passive knee flexion was able to moderately diagnose (LR+ = 6.4; 95% CI 4.0-10.4) or exclude (LR- = 0.10; 95% CI 0.03-0.31) a degenerative SMT. Internal validation estimates were slightly lower for all clusters but demonstrated positive LR superior to 5 and negative LR inferior to 0.2 indicating moderate shift in posttest probability. Diagnostic clusters combining history elements and physical examination tests can support the differential diagnosis of SMT. These results represent the initial derivation of the clusters and external validation is mandatory. I. Copyright © 2018 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Rectal bleeding in a 4-month-old boy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dutro, J.A.; Santanello, S.A.; Unger, F.

1986-10-24

A case of bleeding Meckel's diverticulum is described in an infant. A 4-month-old boy was seen initially with a 24-hour history of painless hematochezia. His parents had noted two episodes of maroon-colored stool that did not appear to be associated with any abdominal distress. His medical history was unremarkable, with normal growth and development. Physical examination revealed a well-nourished, well-hydrated infant in no apparent distress. Vital signs were normal. Rectal examination revealed no masses, but bright-red blood was noted on the examining finger. Findings from the remainder of the examination were normal. An upright roentgenogram of the abdomen was obtainedmore » and demonstrated no abnormalities. The abdominal technetium scan was abnormal. An exploratory laparotomy was performed later on the day of admission.« less

EDITORIAL: Crisis management - and creation

NASA Astrophysics Data System (ADS)

Dobson Honorary Editor, Ken

1996-11-01

At the time of writing an ad hoc group set up by a governmental quango - the Schools Curriculum and Assessment Authority - is rewriting the subject cores for AS and A-level physics. The current version was introduced to general disapprobation from informed users, and especially from the Institute of Physics, and was examined for the first time in 1996. The main points of criticism of the current subject core were that it is too prescriptive, too large (especially at AS) and preserves an old-fashioned view of physics. It was seen as essentially all rather boring and quite unlikely to make it easier for teachers to attract more students into A-level physics courses. The core will, presumably, form the bulk of the new-style AS levels, an intriguingly innovative feature of the Dearing 16 - 19 proposals that, in principle, provides an opportunity to revitalize post-16 physics for a wide variety of potential users. But the other predicted consequence of a nationally (legally) prescribed core was a kind of instant fossilization of curriculum development and innovation. Creativity is effectively banned. Taking risks becomes unthinkable. Taken in conjunction with the less well known (except to examiners) increasingly close bureaucratic supervision of the examining process itself, the aim seems to be consistent mediocrity rather than the adventurous exploration of physics at what must be one of the most exciting (and rapidly changing) times in its history. The September issue of this journal dealt with some aspects of the new thinking about an education in (and through) physics, in the context of the IoP initiative to produce a modern physics curriculum for the year 2000. It is foreseeably improbable that the new subject core will be such as to encourage creative initiatives, other than by a third-law reaction effect. I am told that the ad hoc committee (membership unknown) will work for at least three whole days to produce the core; it will then be submitted for approval by yet more unknown persons. But we live in a democracy, and the new core will be put out for consultation. This will take place between November 1st and 20th, and so will be over, more or less, by the time you read this Editorial. Ordinary teachers of physics are unlikely to be asked for opinions. However, the Institute's informal rapid response team will do their best to represent the interests not only of its members but of the wider physics community. The question remains, however, as to why such rapid reactions are necessary. Surely now is the time to reflect upon the consequences of the rushed initiatives of the past eight years or so in education, and indeed undertake a professional, independent evaluation of them. But our rulers seem incapable of doing other than create crises, and then managing the crises they create by creating even more. There are of course alternatives to this, as could easily be discovered by looking north of Hadrian's Wall, where change is taking placed in a managed, courteous fashion, and where the numbers of students studying physics post-16 is gently increasing. The Scottish Office Education Department has recently taken part in an OECD study of curriculum innovation in 13 countries. The department reports some key findings in the Scottish initiative which are in fact common to all the successful initiatives reported [1, 2]. The message is clear: curriculum change will fail - either completely or at least in reaching the anticipated outcome fully - if certain requirements are not met. The most significant of these, reported in the OECD study, are: Teachers will respond to challenges to become involved in curriculum innovation and to acquire new skills and competences if they are given encouragement and reassurance that they will be well supported in their efforts. Innovation must be systemic, i.e. showing an awareness that many aspects of education are interrelated (so that a change in one affects others). Teacher involvement is vital (how teachers make sense of it is what really matters; they need not only support but time for reflection). Innovation needs to be well informed about how children learn - and must listen more to what they say. There are more - see the references. Almost all contradict the current UK approach, seemingly beloved by both government and potential government, that the way to improve education is to lay down rules from above. Guidelines yes; tramlines no. References [1] Black P and Atkin M (ed) 1996 Changing the Subject: Innovations in Science, Mathematics and Technology Education (London: Routledge) [2] Key Outcomes for Policy Makers, School Managers and Class Teachers part of a Report on Technology in Case Study Primary Schools in Scotland (Edinburgh: The Scottish Office)

Arab-American Hookah Smokers: Initiation, and Pros and Cons of Hookah Use.

PubMed

Kassem, Nada O F; Kassem, Noura O; Jackson, Sheila R; Daffa, Reem M; Liles, Sandy; Hovell, Melbourne F

2015-09-01

To examine initiation, pros and cons of hookah tobacco smoking among Arab Americans. In this descriptive cross-sectional study, we recruited a community-based convenience sample of 458 adult Arab-American hookah smokers, mean age 28.4 years, who completed self-administered questionnaires. Irrespective of sex, most participants initiated hookah tobacco use by young adulthood in private homes or hookah lounges influenced by friends and family. Women initiated hookah use later than men. Ever dual smokers (hookah smokers who ever smoked a cigarette) initiated hookah use later than cigarettes; however, early hookah initiators < 18 years initiated hookah and cigarettes concurrently. Participants enjoyed the flavors of hookah tobacco, and complained about coughing, dizziness, and headaches. Early and late initiation of hookah tobacco use warrant prevention programs targeting the youth and older adults in communities, colleges, and middle and high schools that include health education campaigns, and encouragement of voluntary smokefree home rules. Tobacco control policies aimed to prevent initiation of hookah use should include regulation of hookah tobacco flavors, and should target the physical environments in neighborhoods, especially around schools and colleges, to reduce the proliferation of hookah lounges. Dual hookah tobacco and cigarette use warrant continuous monitoring.

Normal Anal Examination After Penetration: A Case Report.

PubMed

Slingsby, Brett; Goldberg, Amy

2018-03-01

Physical findings are rare after anal penetration. Furthermore, children delay in disclosing or are reticent to discuss penetration. A 12-year-old boy presented to medical care multiple times over a several-week period complaining of abdominal pain, bloody diarrhea, and poor appetite. On colonoscopy, he was found to have a cylindrical foreign body (measuring 7 cm tall and 7 cm in diameter) in his rectum, which had been present for at least 2 weeks. He initially denied knowing how the object got into his rectum and later stated that he inserted it himself out of curiosity. One week after the object was removed, follow-up examination using video colposcopy revealed a completely normal anal examination; the patient had a normal anal examination despite known anal penetration and removal of the object. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Children can have a normal anal examination despite anal penetration, and do not always disclose anal penetration. The aforementioned concepts can be applied to situations related to child sexual abuse in the emergency department, where physical examinations are frequently normal and children delay in disclosing the abuse. When there is concern for sexual abuse, even in the absence of a disclosure or examination findings, patients should be referred for a child abuse pediatrics evaluation if available. Copyright © 2017 Elsevier Inc. All rights reserved.

Physical activity moderates stressor-induced rumination on cortisol reactivity

PubMed Central

Puterman, Eli; O’Donovan, Aoife; Adler, Nancy E.; Tomiyama, A. Janet; Kemeny, Margaret; Wolkowitz, Owen M.; Epel, Elissa

2011-01-01

Objective Physically active individuals have lower rates of morbidity and mortality, and recent evidence indicates that physical activity may be particularly beneficial to those experiencing chronic stress. The tendency to ruminate increases and prolongs physiological stress responses, including hypothalamic-pituitary adrenal (HPA) axis responses as indexed by cortisol reactivity to stressful experiences. We examined the association between ruminating in response to a laboratory stressor task and HPA axis reactivity and recovery, and whether a physically active lifestyle moderates the associations between rumination and cortisol output trajectories. Methods Forty-six post-menopausal women underwent the Trier Social Stress Test while salivary cortisol was repeatedly measured. Twenty-five minutes after the end of the stressor, participants reported level of rumination in response to the stress. Results Findings indicate that physical activity moderated the initial rate (B = −.10, SE = .04, p < .05) and curvature (B = −.03, SE = .01, p = .06) of the relationship between rumination and log-transformed cortisol trajectory. Among sedentary participants, those who responded to the stressor with higher levels of rumination had a more rapid initial increase in cortisol (0.26 vs 0.21, p < .001), a later peak (56 vs. 39 minutes), and a delayed recovery (curvature −0.07 vs. −0.08, p < .001) compared to those with lower levels of rumination. In active participants, cortisol trajectories were equivalent, regardless of level of rumination. Conclusions In sum, individuals who maintain a physically active lifestyle may be protected against the effects of rumination on HPA axis reactivity to and recovery from acute stress. PMID:21873586

Hormone therapy and physical function change among older women in the Women’s Health Initiative: a randomized controlled trial

PubMed Central

Michael, Yvonne L.; Gold, Rachel; Manson, JoAnn E.; Keast, Erin M.; Cochrane, Barbara B.; Woods, Nancy F.; Brzyski, Robert G.; McNeeley, S. Gene; Wallace, Robert B.

2011-01-01

Objective Although estrogen may be linked to biological pathways that maintain higher physical function, the evidence is derived mostly from observational epidemiology and therefore has numerous limitations. We examined whether hormone therapy affected physical function in women 65 to 79 years of age at enrollment. Methods This study involves an analysis of the Women’s Health Initiative randomized controlled trials of hormone therapy in which 922 nondisabled women who had previous hysterectomies were randomized to receive estrogen therapy or a placebo and 1,458 nondisabled women with intact uteri were randomized to receive estrogen + progestin therapy or a placebo. Changes in physical function were analyzed for treatment effect, and subgroup differences were evaluated. All women completed performance-based measures of physical function (grip strength, chair stands, and timed walk) at baseline. These measures were repeated after 1, 3, and 6 years. Results Overall, participants’ grip strength declined by 12.0%, chair stands declined by 3.5%, and walk pace slowed by 11.4% in the 6 years of follow-up (all P values <0.0001). Hormone therapy, as compared with placebo, was not associated with an increased or decreased risk of decline in physical function in either the intention-to-treat analyses or in analyses restricted to participants who were compliant in taking study pills. Conclusions Hormone therapy provided no overall protection against functional decline in nondisabled postmenopausal women 65 years or older in 6 years of follow-up. This study did not address the influence of hormone therapy for women of younger ages. PMID:19858764

Does Witnessing Animal Cruelty and Being Abused During Childhood Predict the Initial Age and Recurrence of Committing Childhood Animal Cruelty?

PubMed

Browne, John A; Hensley, Christopher; McGuffee, Karen M

2017-12-01

The goal of the current study was to examine the association between demographic characteristics and childhood experiences on the respondents' age of committing childhood animal cruelty and its recurrency. Using data collected from 257 male inmates at a Southern medium-security state prison, the current study seeks to replicate a study by Hensley, Tallichet, and Dutkiewicz. Results revealed that those respondents who were physically abused as children reported engaging in recurrent animal cruelty. The younger the age of respondent for first witnessing animal cruelty, the sooner his initiation to hurting and killing animals occurred. In addition, those who reported witnessing a parent commit acts of animal abuse reported that they committed animal abuse themselves at an older age, while those who witnessed a brother/sister commit animal abuse reported engaging in it at an earlier age. Therefore, physical abuse and witnessing primary socializers engage in animal abuse seem to be important in understanding the respondents' age of onset and repeated childhood animal cruelty.

The need for monetary information within corporate water accounting.

PubMed

Burritt, Roger L; Christ, Katherine L

2017-10-01

A conceptual discussion is provided about the need to add monetary data to water accounting initiatives and how best to achieve this if companies are to become aware of the water crisis and to take actions to improve water management. Analysis of current water accounting initiatives reveals the monetary business case for companies to improve water management is rarely considered, there being a focus on physical information about water use. Three possibilities emerge for mainstreaming the integration of monetization into water accounting: add-on to existing water accounting frameworks and tools, develop new tools which include physical and monetary information from the start, and develop environmental management accounting (EMA) into a water-specific application and set of tools. The paper appraises these three alternatives and concludes that development of EMA would be the best way forward. Suggestions for further research include the need to examine the use of a transdisciplinary method to address the complexities of water accounting. Copyright © 2017 Elsevier Ltd. All rights reserved.

Atlantoaxial Instability in a Patient with Neck Pain and Ankylosing Spondylitis.

PubMed

Lyons, Christian; Ross, Michael; Elliott, Ryan; Tall, Michael

2018-03-26

The purpose of this report is to describe the evaluation and treatment of a patient with neck pain and ankylosing spondylitis who had underlying atlantoaxial instability. The patient was a 31-yr-old man diagnosed with ankylosing spondylitis 1 yr prior who was referred to a physical therapist for the treatment of chronic, worsening low back and hip pain. He also had secondary complaints of neck, upper back, and shoulder pain. The patient worked as a military pilot. As part of the patient's physical examination, a Sharp-Purser test was performed, which was positive for excessive motion. Diagnostic imaging confirmed the atlantoaxial instability; it was also determined that the patient's atlanto-occipital joints were fused. Despite evidence of atlantoaxial instability, it was determined the patient would be managed through nonsurgical interventions. The patient was prescribed etanercept by his rheumatologist and the physical therapist developed a comprehensive rehabilitation program that addressed relevant impairments of the spine, hips, and shoulders. At 3 yr following his initial evaluation with the physical therapist, the patient continued to report minimal bodily pain and no limitations in his functional capabilities. Additionally, the patient had earned a high profile flying position with an aggressive flying schedule and he successfully completed his first running marathon. It is important for clinicians to have an understanding of the clinical findings associated with atlantoaxial instability, as these findings provide guidance for diagnostic imaging and specialist referral prior to initiating conservative management strategies, such as physical therapy.

Work Characteristics Associated with Physical Functioning in Women

PubMed Central

Palumbo, Aimee J.; De Roos, Anneclaire J.; Cannuscio, Carolyn; Robinson, Lucy; Mossey, Jana; Weitlauf, Julie; Garcia, Lorena; Wallace, Robert; Michael, Yvonne

2017-01-01

Women make up almost half of the labor force with older women becoming a growing segment of the population. Work characteristics influence physical functioning and women are at particular risk for physical limitations. However, little research has explored the effects of work characteristics on women’s physical functioning. U.S. women between the ages of 50 and 79 were enrolled in the Women’s Health Initiative Observational Study between 1993 and 1998. Women provided job titles and years worked at their three longest-held jobs (n = 79,147). Jobs were linked to characteristics in the Occupational Information Network. Three categories of job characteristics related to substantive complexity, physical demand, and social collaboration emerged. The association between job characteristics and physical limitations in later life, measured using a SF-36 Physical Functioning score <25th percentile, was examined using modified Poisson regression. After controlling for confounding variables, high physical demand was positively associated with physical limitations (RR = 1.09 CI: 1.06–1.12) and substantively complex work was negatively associated (RR = 0.94, CI: 0.91–0.96). Jobs requiring complex problem solving, active learning, and critical thinking were associated with better physical functioning. Employers should explore opportunities to reduce strain from physically demanding jobs and incorporate substantively complex tasks into women’s work to improve long-term health. PMID:28420131

Social and physical environmental correlates of adults' weekend sitting time and moderating effects of retirement status and physical health.

PubMed

Van Holle, Veerle; McNaughton, Sarah A; Teychenne, Megan; Timperio, Anna; Van Dyck, Delfien; De Bourdeaudhuij, Ilse; Salmon, Jo

2014-09-19

Emerging research suggests that prolonged sedentary behaviour (SB) is detrimental to health. Changes in SB patterns are likely to occur during particular life stages, for example at retirement age (55-65-year-old). Evidence on socio-ecological SB correlates is scarce and inconsistent in this age group. Moreover, the influence of socio-ecological correlates may vary depending on health and retirement status. This study examined social and environment correlates of overall weekend day sitting among adults at or approaching retirement age, and moderating effects of perceived physical health and retirement status. Baseline data from the Wellbeing, Eating and Exercise for a Long Life study in 2839 Australian adults (55-65-year-old) were analysed. Participants self-reported proximal social factors, neighbourhood social and physical environment, physical health and retirement status. MLwiN multilevel regression analyses were conducted. In the multivariable model, only social support from friends/colleagues to discourage sitting (B = -0.891; p = 0.036) was associated with overall weekend day sitting. No moderation of retirement status, nor physical health were found in the multivariable results. Results from this study suggest the importance of social factors in relation to weekend day sitting among 55-65-year-old adults. Health promotion initiatives in this age group should pay special attention to enhancing social interaction opportunities. Moreover, findings suggest that SB-specific correlates may need to be examined in future research.

Physical fitness of children and adolescents in the United States: status and secular change.

PubMed

Malina, Robert M

2007-01-01

The physical fitness of school-age children in the United States is considered from two perspectives--status and secular change. This chapter principally examines health-related fitness, including the BMI, though performance-related fitness is briefly considered. Concepts of reference data and standards and factors that may influence secular change are initially discussed. National data on the physical fitness status of school children in the continental United States are limited to the 1980s. Ethnic variation in physical fitness is not considered except for the prevalence of overweight and obesity. More recent physical fitness data, including examination of ethnic variation, are based on several statewide and more local surveys. Although results vary by test, the majority of American school children meet or exceed criterion-referenced standards, although sex differences are not consistent. Poor morphological fitness manifest in obesity is an exception. The prevalence of overweight and obesity has increased since the early 1980s. Secular data for specific fitness items are less extensive. Regression analyses suggest a recent decline in maximal aerobic power in girls, but fairly stable levels between the 1930s and today in boys. However, the highest values for boys occur in the 1960s and 1970s and more recent values are somewhat lower. The general trend may be consistent with the decline since the 1980s in aerobic performance assessed with the 20 m shuttle run. These trends highlight the need for updated national physical fitness data for American youth.

Simulation experience enhances physical therapist student confidence in managing a patient in the critical care environment.

PubMed

Ohtake, Patricia J; Lazarus, Marcilene; Schillo, Rebecca; Rosen, Michael

2013-02-01

Rehabilitation of patients in critical care environments improves functional outcomes. This finding has led to increased implementation of intensive care unit (ICU) rehabilitation programs, including early mobility, and an associated increased demand for physical therapists practicing in ICUs. Unfortunately, many physical therapists report being inadequately prepared to work in this high-risk environment. Simulation provides focused, deliberate practice in safe, controlled learning environments and may be a method to initiate academic preparation of physical therapists for ICU practice. The purpose of this study was to examine the effect of participation in simulation-based management of a patient with critical illness in an ICU setting on levels of confidence and satisfaction in physical therapist students. A one-group, pretest-posttest, quasi-experimental design was used. Physical therapist students (N=43) participated in a critical care simulation experience requiring technical (assessing bed mobility and pulmonary status), behavioral (patient and interprofessional communication), and cognitive (recognizing a patient status change and initiating appropriate responses) skill performance. Student confidence and satisfaction were surveyed before and after the simulation experience. Students' confidence in their technical, behavioral, and cognitive skill performance increased from "somewhat confident" to "confident" following the critical care simulation experience. Student satisfaction was highly positive, with strong agreement the simulation experience was valuable, reinforced course content, and was a useful educational tool. Limitations of the study were the small sample from one university and a control group was not included. Incorporating a simulated, interprofessional critical care experience into a required clinical course improved physical therapist student confidence in technical, behavioral, and cognitive performance measures and was associated with high student satisfaction. Using simulation, students were introduced to the critical care environment, which may increase interest in working in this practice area.

Planning Mediates Between Self-Efficacy and Physical Activity Among Motivated Young Adults.

PubMed

Zhou, Guangyu; Wang, Dongmei; Knoll, Nina; Schwarzer, Ralf

2016-01-01

Often, motivation to be physically active is a necessary precondition of action but still does not suffice to initiate the target behavior. Instead, motivation needs to be translated into action by a self-regulatory process. Self-efficacy and planning are considered to be useful constructs that help to facilitate such translations. The aim is to examine the roles of motivation, planning, and self-efficacy as well as the mechanisms that operate in the change of physical activity levels. In a longitudinal observation study with 249 young adults, self-efficacy, planning, motivation, and physical activity were assessed at 2 points in time, 3 months apart. Planning served as a mediator between self-efficacy and physical activity, controlling for baseline activity. In addition to this indirect effect, a moderator effect was found between self-efficacy and stages of change on planning. The mediation operated only in motivated, but not in unmotivated students. A mediation from self-efficacy via planning to physical activity seems to be likely only when people are motivated to become more active.

IGF-I, IGFBPs, and inflammatory cytokine responses during gender-integrated Israeli Army basic combat training.

PubMed

Nindl, Bradley C; Scofield, Dennis E; Strohbach, Cassandra A; Centi, Amanda J; Evans, Rachel K; Yanovich, Ran; Moran, Daniel S

2012-07-01

Insulin-like growth factor 1 (IGF-I) is a robust metabolic and anabolic biomarker that has been demonstrated to be reflective of military training-induced body composition changes and influenced by initial aerobic fitness level. Greater mechanistic insight into the IGF-I response to physical training can potentially be gleaned by also examining other regulatory factors that influence IGF-I biological activity (i.e., insulin-like growth factor-binding proteins [IGFBPs] and inflammatory cytokine responses). The purpose of this study was to assess the influence of sex and initial fitness level on the IGF-I and inflammatory cytokine response to gender-integrated Israeli Defense Forces (IDF) basic combat training (BCT). Recruits (29 men, 19.1 ± 1.3 years; 93 women, 18.8 ± 0.6 years) were recruited from a 4-month gender-integrated BCT of the IDF. Blood was drawn and assayed for total IGF-I, free IGF-I, IGFBPs 1-6, tumor necrosis factor alpha (TNF-α), interleukin 6, and interleukin 1 beta. Body composition was determined via a 4-site skinfold (biceps, triceps, suprailiac, and subscapular) equation. Physical performance was assessed via a maximum volume of oxygen consumption (V[Combining Dot Above]O₂max) test using a treadmill protocol. All measures were obtained pre- and posttraining. A 2-way (sex × time) analysis of variance was used to test for statistical differences (p ≤ 0.05). Additionally, subjects were further partitioned (men and women separately) by tertiles of initial V[Combining Dot Above]O₂max to assess the influence of initial fitness level on the IGF-I system and inflammatory cytokine responses to physical training. Pearson product moment correlational analysis was also used to examine relationships between percent changes in blood measures and physical performance and body composition changes. All data are presented as mean ± SE. Time effects were observed only for total IGF-I, IGFBP-2, TNF-α, V[Combining Dot Above]O₂max, fat-free mass, and fat mass. The only significant (p ≤ 0.05) correlations observed for percent changes were in men between total IGF-I and V[Combining Dot Above]O₂max (r = 0.49) and body mass (r = -0.42) During gender-integrated Israeli Army BCT, men and women generally respond in a similar fashion with regard to blood measures (IGF-I system and inflammatory cytokines) and V[Combining Dot Above]O₂max. Initial fitness level only influenced the IGF-I response to training in women. Although the training-induced changes in total IGF-I (increase), IGFBP-2 (decrease), and TNF-α (decrease) are all indicative of an enhanced circulating anabolic milieu, only total IGF-I for the men was correlated with body composition and fitness improvements.

An exploration of gender participation patterns in science competitions

NASA Astrophysics Data System (ADS)

Arámbula Greenfield, Teresa

This study investigated participation in a state-level science competition over most of its 35-year history. Issues examined included whether different gender patterns occurred with respect to entry rate, project topic (life science, physical science, earth science, and math), and project type (research or display). The study also examined to what extent the identified patterns reflected or contradicted nationwide patterns of girls' academic performance in science over roughly the same time period. It was found that although girls initially participated in the fair less frequently than boys, for the past 20 years their participation rate has been greater than that of boys. Examination of topic preferences over the years indicates that both girls and boys have traditionally favored life science; however, boys have been and continue to be more likely to prepare physical, earth, and math/computer science projects than girls. Another gender difference is that girls are generally less likely than boys to prepare projects based on experimental research as opposed to library research. The study provides some suggestions for teachers and teacher educators for addressing these disparities.Received: 4 February 1994; Revised: 12 January 1995;

Self-Efficacy versus Perceived Enjoyment as Predictors of Physical Activity Behavior

PubMed Central

Lewis, Beth A.; Williams, David M.; Frayeh, Amanda L.; Marcus, Bess H.

2015-01-01

Objective Self-efficacy and physical activity (PA) enjoyment are related to PA behavior, but it is unclear which is more important and how they interrelate. The purpose of this study was to examine how these two constructs interrelate to influence PA behavior. Design Participants were low active adults (n=448) participating in a RCT examining the effect of a PA promotion intervention. Participants completed physical activity, enjoyment, and self-efficacy measures at baseline, six, and 12 months. Results Self-efficacy and enjoyment at both baseline and six months predicted PA at 12 months. However, enjoyment was a stronger predictor than self-efficacy in that self-efficacy no longer predicted PA behavior when included alongside enjoyment. In follow-up mediation analyses, enjoyment at six months did not mediate the effect of baseline self-efficacy on 12-month PA; however, six-month self-efficacy mediated the effect of baseline enjoyment on 12-month PA. Conclusion Our results indicate that interventions should perhaps initially focus on increasing enjoyment of physical activity. Greater PA enjoyment appears to influence individuals’ self-reported ability to engage in regular PA (i.e., higher self-efficacy ratings). Additional research is needed to better understand the interrelationships between self-efficacy and enjoyment and how these constructs affect PA. PMID:26541890

Self-efficacy versus perceived enjoyment as predictors of physical activity behaviour.

PubMed

Lewis, Beth A; Williams, David M; Frayeh, Amanda; Marcus, Bess H

2016-01-01

Self-efficacy and physical activity (PA) enjoyment are related to PA behaviour, but it is unclear which is more important and how they interrelate. The purpose of this study was to examine how these two constructs interrelate to influence PA behaviour. Participants were low-active adults (n = 448) participating in a RCT examining the effect of a PA promotion intervention. Participants completed physical activity, enjoyment and self-efficacy measures at baseline, six and 12 months. Self-efficacy and enjoyment at both baseline and six months predicted PA at 12 months. However, enjoyment was a stronger predictor than self-efficacy, in that self-efficacy no longer predicted PA behaviour when included alongside enjoyment. In follow-up mediation analyses, enjoyment at six months did not mediate the effect of baseline self-efficacy on 12-month PA; however, six-month self-efficacy mediated the effect of baseline enjoyment on 12-month PA. Our results indicate that interventions should perhaps initially focus on increasing enjoyment of physical activity. Greater PA enjoyment appears to influence individuals' self-reported ability to engage in regular PA (i.e. higher self-efficacy ratings). Additional research is needed to better understand the interrelationships between self-efficacy and enjoyment and how these constructs affect PA.

Low back pain during military service predicts low back pain later in life.

PubMed

Mattila, Ville M; Kyröläinen, Heikki; Santtila, Matti; Pihlajamäki, Harri

2017-01-01

The aim of the present study was to assess associations between physician diagnosed unspecified low back pain (LBP) during compulsory military service and self-reported LBP and physical fitness measured on average four years after military service. From a total of 1155 persons who had been pass medical examination for military service and who had completed physically demanding military training between 1997 and 2007, 778 men participated in a refresher military training course and physical tests. In this study, the association between LBP during military service and LBP in later life in addition to the association between LBP and physical fitness were examined. A total of 219 out of 778 participants (28%) had visited a physician due to some musculoskeletal symptom (ICD-10 M-diagnosis) during their military service. Seventy-four participants (9.5%) had visited a physician due to unspecified LBP during their service, and 41 (5.3%) had temporarily been absent from duty due to LBP. At the follow-up examination, 122 (15.7%) had reported LBP during the past month. LBP during military service was associated with self-reported LBP in the follow-up (p = 0.004). Of those who had been absent from duty due to LBP during their military service, 13 (31.7%) reported LBP during the past month. In risk factor analysis, no initial health behaviour and physical performance variables were associated with baseline LBP in the follow-up. The main finding of the present study was that unspecified LBP during military service predicts LBP in later life. On the basis of previous literature, it is also known that LBP is a common symptom and thus, one cannot expect to be symptomless the entire life. Interestingly, none of the health behaviours nor the physical performance studied in the follow-up were associated with baseline LBP. It appears that individuals prone to LBP have symptoms during physically demanding military service and also later in their life.

Low back pain during military service predicts low back pain later in life

PubMed Central

Mattila, Ville M.; Kyröläinen, Heikki; Santtila, Matti; Pihlajamäki, Harri

2017-01-01

The aim of the present study was to assess associations between physician diagnosed unspecified low back pain (LBP) during compulsory military service and self-reported LBP and physical fitness measured on average four years after military service. From a total of 1155 persons who had been pass medical examination for military service and who had completed physically demanding military training between 1997 and 2007, 778 men participated in a refresher military training course and physical tests. In this study, the association between LBP during military service and LBP in later life in addition to the association between LBP and physical fitness were examined. A total of 219 out of 778 participants (28%) had visited a physician due to some musculoskeletal symptom (ICD-10 M-diagnosis) during their military service. Seventy-four participants (9.5%) had visited a physician due to unspecified LBP during their service, and 41 (5.3%) had temporarily been absent from duty due to LBP. At the follow-up examination, 122 (15.7%) had reported LBP during the past month. LBP during military service was associated with self-reported LBP in the follow-up (p = 0.004). Of those who had been absent from duty due to LBP during their military service, 13 (31.7%) reported LBP during the past month. In risk factor analysis, no initial health behaviour and physical performance variables were associated with baseline LBP in the follow-up. The main finding of the present study was that unspecified LBP during military service predicts LBP in later life. On the basis of previous literature, it is also known that LBP is a common symptom and thus, one cannot expect to be symptomless the entire life. Interestingly, none of the health behaviours nor the physical performance studied in the follow-up were associated with baseline LBP. It appears that individuals prone to LBP have symptoms during physically demanding military service and also later in their life. PMID:28282419

Prevalence of posterior elbow problems in Japanese high school baseball players.

PubMed

Kida, Yoshikazu; Morihara, Toru; Furukawa, Ryuhei; Sukenari, Tsuyoshi; Kotoura, Yoshihiro; Yoshioka, Naoki; Hojo, Tatsuya; Oda, Ryo; Arai, Yuji; Sawada, Koshiro; Fujiwara, Hiroyoshi; Kubo, Toshikazu

2016-09-01

Various posterior elbow problems cause posterior elbow pain among baseball players. We aimed to determine the prevalence and diagnoses associated with posterior elbow problems and post-treatment recovery time for returning to sports in Japanese high school baseball players when treated in the off-season. A total of 576 Japanese high school baseball players who participated in baseball skill training camp during the off-season were enrolled in the study. The elbow of each player's throwing arm was assessed by use of a questionnaire and physical examination. Players with abnormal results were advised to visit the hospital. Players who visited the hospital were initially treated conservatively and underwent surgery if necessary. Retrospectively, players with positive physical examination results associated with posterior elbow pain, defined as olecranon tenderness and/or a positive elbow extension impingement test, were selected. Information about their position, elbow pain, physical examination results, diagnosis, treatment, and recovery time before returning to playing sports was assessed. Olecranon tenderness and/or positive elbow extension impingement test results were found in 76 players (13.2%). Of these, 33 agreed to visit the hospital for further diagnostic imaging and 25 players (75.8%) were diagnosed with posteromedial elbow impingement. By the next spring, 87.9% of players returned to sport, and 100% of players returned to sport before the next summer. The average recovery period was 77 ± 47 days. Physical examinations related to posterior elbow injuries were positive in 13.2% of high school baseball players. The most common diagnosis for posterior elbow pain was posteromedial elbow impingement. All players returned to competitive sports activity levels within 77 ± 47 days. Copyright © 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Physical space and long-tail markets

NASA Astrophysics Data System (ADS)

Bentley, R. Alexander; Madsen, Mark E.; Ormerod, Paul

2009-03-01

The Internet is known to have had a powerful impact on on-line retailer strategies in markets characterised by long-tail distribution of sales [C. Anderson, Long Tail: Why the Future of Business is Selling Less of More, Hyperion, New York, 2006]. Such retailers can exploit the long tail of the market, since they are effectively without physical limit on the number of choices on offer. Here we examine two extensions of this phenomenon. First, we introduce turnover into the long-tail distribution of sales. Although over any given period such as a week or a month, the distribution is right-skewed and often power law distributed, over time there is considerable turnover in the rankings of sales of individual products. Second, we establish some initial results on the implications for shelf-space and physical retailers in such markets.

Testing multi-theory model (MTM) in predicting initiation and sustenance of physical activity behavior among college students.

PubMed

Nahar, Vinayak K; Sharma, Manoj; Catalano, Hannah Priest; Ickes, Melinda J; Johnson, Paul; Ford, M Allison

2016-01-01

Most college students do not adequately participate in enough physical activity (PA) to attain health benefits. A theory-based approach is critical in developing effective interventions to promote PA. The purpose of this study was to examine the utility of the newly proposed multi-theory model (MTM) of health behavior change in predicting initiation and sustenance of PA among college students. Using a cross-sectional design, a valid and reliable survey was administered in October 2015 electronically to students enrolled at a large Southern US University. The internal consistency Cronbach alphas of the subscales were acceptable (0.65-0.92). Only those who did not engage in more than 150 minutes of moderate to vigorous intensity aerobic PA during the past week were included in this study. Of the 495 respondents, 190 met the inclusion criteria of which 141 completed the survey. The majority of participants were females (72.3%) and Caucasians (70.9%). Findings of the confirmatory factor analysis (CFA) confirmed construct validity of subscales (initiation model: χ2 = 253.92 [df = 143], P < 0.001, CFI = 0.91, RMSEA = 0.07, SRMR = 0.07; sustenance model: χ2= 19.40 [df = 22], P < 0.001, CFI = 1.00, RMSEA = 0.00, SRMR = 0.03). Multivariate regression analysis showed that 26% of the variance in the PA initiation was explained by advantages outweighing disadvantages, behavioral confidence, work status, and changes in physical environment. Additionally, 29.7% of the variance in PA sustenance was explained by emotional transformation, practice for change, and changes in social environment. Based on this study's findings, MTM appears to be a robust theoretical framework for predicting PA behavior change. Future research directions and development of suitable intervention strategies are discussed.

Testing multi-theory model (MTM) in predicting initiation and sustenance of physical activity behavior among college students

PubMed Central

Nahar, Vinayak K.; Sharma, Manoj; Catalano, Hannah Priest; Ickes, Melinda J.; Johnson, Paul; Ford, M. Allison

2016-01-01

Background: Most college students do not adequately participate in enough physical activity (PA) to attain health benefits. A theory-based approach is critical in developing effective interventions to promote PA. The purpose of this study was to examine the utility of the newly proposed multi-theory model (MTM) of health behavior change in predicting initiation and sustenance of PA among college students. Methods: Using a cross-sectional design, a valid and reliable survey was administered in October 2015 electronically to students enrolled at a large Southern US University. The internal consistency Cronbach alphas of the subscales were acceptable (0.65-0.92). Only those who did not engage in more than 150 minutes of moderate to vigorous intensity aerobic PA during the past week were included in this study. Results: Of the 495 respondents, 190 met the inclusion criteria of which 141 completed the survey. The majority of participants were females (72.3%) and Caucasians (70.9%). Findings of the confirmatory factor analysis (CFA) confirmed construct validity of subscales (initiation model: χ2 = 253.92 [df = 143], P < 0.001, CFI = 0.91, RMSEA = 0.07, SRMR = 0.07; sustenance model: χ2= 19.40 [df = 22], P < 0.001, CFI = 1.00, RMSEA = 0.00, SRMR = 0.03). Multivariate regression analysis showed that 26% of the variance in the PA initiation was explained by advantages outweighing disadvantages, behavioral confidence, work status, and changes in physical environment. Additionally, 29.7% of the variance in PA sustenance was explained by emotional transformation, practice for change, and changes in social environment. Conclusion: Based on this study’s findings, MTM appears to be a robust theoretical framework for predicting PA behavior change. Future research directions and development of suitable intervention strategies are discussed. PMID:27386419

Renal transitional cell carcinoma with bilateral ocular metastasis in a cat

PubMed Central

Grader, Irit; Southard, Teresa L; Neaderland, Marjorie H

2016-01-01

Case summary A 4-year-old, spayed female, domestic shorthair cat was presented for evaluation due to a 4 day history of inappetence and lethargy. Physical examination revealed mild dehydration and blindness of the left eye. Abnormal imaging findings included a well-margined soft tissue mass with irregular central cavity located in the dorsal aspect of the caudal lung lobe. Cytological examination of the mass revealed chronic inflammation with hemorrhage. Tests for parasitic and fungal diseases were negative. Ophthalmic examination 17 days after the cat was initially presented revealed severe diffuse pathology of both retinas. Left renomegaly was noted 22 days after the initial presentation, and cytological examination of samples obtained from the right vitreous, left kidney and the pulmonary mass yielded atypical epithelial cells exhibiting malignant changes. Post-mortem examination following euthanasia revealed renal transitional cell carcinoma with metastasis to both eyes, lungs and skeletal muscle. Immunohistochemical evaluation of the neoplastic cells in the eye revealed moderate cytoplasmic reactivity for CK7. CK20 immunohistochemistry was negative. Relevance and novel information To the best of our knowledge, this is the first report of renal transitional cell carcinoma with ocular metastasis in a cat. In addition, this report describes immunohistochemistry results of transitional cell carcinoma in a cat using CK7 and CK20. PMID:28491432

Renal transitional cell carcinoma with bilateral ocular metastasis in a cat.

PubMed

Grader, Irit; Southard, Teresa L; Neaderland, Marjorie H

2016-01-01

Case summary A 4-year-old, spayed female, domestic shorthair cat was presented for evaluation due to a 4 day history of inappetence and lethargy. Physical examination revealed mild dehydration and blindness of the left eye. Abnormal imaging findings included a well-margined soft tissue mass with irregular central cavity located in the dorsal aspect of the caudal lung lobe. Cytological examination of the mass revealed chronic inflammation with hemorrhage. Tests for parasitic and fungal diseases were negative. Ophthalmic examination 17 days after the cat was initially presented revealed severe diffuse pathology of both retinas. Left renomegaly was noted 22 days after the initial presentation, and cytological examination of samples obtained from the right vitreous, left kidney and the pulmonary mass yielded atypical epithelial cells exhibiting malignant changes. Post-mortem examination following euthanasia revealed renal transitional cell carcinoma with metastasis to both eyes, lungs and skeletal muscle. Immunohistochemical evaluation of the neoplastic cells in the eye revealed moderate cytoplasmic reactivity for CK7. CK20 immunohistochemistry was negative. Relevance and novel information To the best of our knowledge, this is the first report of renal transitional cell carcinoma with ocular metastasis in a cat. In addition, this report describes immunohistochemistry results of transitional cell carcinoma in a cat using CK7 and CK20.

Analysis of Urine as Indicators of Specific Body Conditions

NASA Astrophysics Data System (ADS)

Dey, Souradeep; Saha, Triya; Narendrakumar, Uttamchand

2017-11-01

Urinalysis can be defined as a procedure for examining various factors of urine, which include physical properties, particulate matter, cells, casts, crystals, organisms and solutes. Urinalysis is recommended to be a part of the initial examination of all patients as its cheap, feasible and gives productive results. This paper focuses on the analysis of urine collected at specific body conditions. Here we illustrate the urine profile of different persons having various body conditions, which include, having urinary tract infection, undergoing strenuous exercise, having back pain regularly, having very low urine output and a person who is on 24 hours of diet. Examination of urine collected from different persons having specific body conditions usually helps us in the diagnosis of various diseases, which it indicates.

USE OF TRANS-CONTEXTUAL MODEL-BASED PHYSICAL ACTIVITY COURSE IN DEVELOPING LEISURE-TIME PHYSICAL ACTIVITY BEHAVIOR OF UNIVERSITY STUDENTS.

PubMed

Müftüler, Mine; İnce, Mustafa Levent

2015-08-01

This study examined how a physical activity course based on the Trans-Contextual Model affected the variables of perceived autonomy support, autonomous motivation, determinants of leisure-time physical activity behavior, basic psychological needs satisfaction, and leisure-time physical activity behaviors. The participants were 70 Turkish university students (M age=23.3 yr., SD=3.2). A pre-test-post-test control group design was constructed. Initially, the participants were randomly assigned into an experimental (n=35) and a control (n=35) group. The experimental group followed a 12 wk. trans-contextual model-based intervention. The participants were pre- and post-tested in terms of Trans-Contextual Model constructs and of self-reported leisure-time physical activity behaviors. Multivariate analyses showed significant increases over the 12 wk. period for perceived autonomy support from instructor and peers, autonomous motivation in leisure-time physical activity setting, positive intention and perceived behavioral control over leisure-time physical activity behavior, more fulfillment of psychological needs, and more engagement in leisure-time physical activity behavior in the experimental group. These results indicated that the intervention was effective in developing leisure-time physical activity and indicated that the Trans-Contextual Model is a useful way to conceptualize these relationships.

American Society of Clinical Oncology 2006 update of the breast cancer follow-up and management guidelines in the adjuvant setting.

PubMed

Khatcheressian, James L; Wolff, Antonio C; Smith, Thomas J; Grunfeld, Eva; Muss, Hyman B; Vogel, Victor G; Halberg, Francine; Somerfield, Mark R; Davidson, Nancy E

2006-11-01

To update the 1999 American Society of Clinical Oncology (ASCO) guideline on breast cancer follow-up and management in the adjuvant setting. An ASCO Expert Panel reviewed pertinent information from the literature through March 2006. More weight was given to studies that tested a hypothesis directly relating testing to one of the primary outcomes in a randomized design. The evidence supports regular history, physical examination, and mammography as the cornerstone of appropriate breast cancer follow-up. All patients should have a careful history and physical examination performed by a physician experienced in the surveillance of cancer patients and in breast examination. Examinations should be performed every 3 to 6 months for the first 3 years, every 6 to 12 months for years 4 and 5, and annually thereafter. For those who have undergone breast-conserving surgery, a post-treatment mammogram should be obtained 1 year after the initial mammogram and at least 6 months after completion of radiation therapy. Thereafter, unless otherwise indicated, a yearly mammographic evaluation should be performed. Patients at high risk for familial breast cancer syndromes should be referred for genetic counseling. The use of CBCs, chemistry panels, bone scans, chest radiographs, liver ultrasounds, computed tomography scans, [18F]fluorodeoxyglucose-positron emission tomography scanning, magnetic resonance imaging, or tumor markers (carcinoembryonic antigen, CA 15-3, and CA 27.29) is not recommended for routine breast cancer follow-up in an otherwise asymptomatic patient with no specific findings on clinical examination. Careful history taking, physical examination, and regular mammography are recommended for appropriate detection of breast cancer recurrence.

Depressive symptoms and rates of bone loss at the hip in older men.

PubMed

Diem, S J; Harrison, S L; Haney, E; Cauley, J A; Stone, K L; Orwoll, E; Ensrud, K E

2013-01-01

In this prospective cohort study, depressive symptoms were associated with higher rates of bone loss in older men. Poorer performance on physical function tests partly explained the association between depressive symptoms and bone loss, suggesting that efforts to increase exercise and improve physical performance in depressed men may be beneficial. The aim of this study was to ascertain whether depressive symptoms are associated with increased rates of bone loss at the hip in older men. A population-based prospective cohort study of 2,464 community-dwelling men, aged 68 and older, enrolled in the Osteoporosis in Men Sleep Ancillary Study had depressive symptoms assessed by the Geriatric Depression Scale (GDS). Subjects were categorized as depressed if GDS ≥6 at the initial examination. Bone mineral density (BMD) at the hip was measured using dual-energy X-ray absorptiometry at the initial and follow-up examination (average 3.4 years between exams). Use of antidepressant medications was assessed by interview and verified from medication containers at the two examinations. A computerized dictionary was used to categorize type of medication. In a base model adjusted for age, race/ethnicity, and clinic site, the mean total hip BMD decreased 0.70 %/year in 136 men with a GDS score of ≥6 compared to 0.39 %/year in 2,328 men with a GDS score of <6 (p = 0.001). Walking speed and timed chair stand partly explained the association between depressive symptoms and rates of bone loss. Depression, as defined by a score of 6 or greater on the Geriatric Depression Scale, is associated with an increased rate of bone loss at the hip in this cohort of older men. Adjustment for walking speed and timed chair stand attenuated the strength of the association, suggesting that differences in physical functioning do partially explain the observed association.

Risk factors for benign prostatic enlargement: The role of lifestyle habits at younger age. The #Controllati2017 initiative study group.

PubMed

Mirone, Vincenzo; Carrieri, Giuseppe; Morgia, Giuseppe; Carmignani, Luca; Vespasiani, Giuseppe; Parazzini, Fabio; Artibani, Walter

2017-12-31

The risk factors for benign prostatic enlargement (BPE) are not well understood and particularly few data are available from Italian population. This was an observational cross sectional study aimed to examine the association between several risk factors and BPE. During the "#Controllati2017" initiative, men aged 18 years or more were invited to attend participating urologic centers for a free of charge visit for counseling about urologic or andrologic conditions. Each participating man underwent a physical examination including digital rectal examination (DRE). Further he was asked about his medical history, urologic symptoms, sexual activity and related problems. Diagnosis of BPE was made by the urologist after DRE. Out of the 1902 [mean age 54 years (SD 12, range 18-92)] considered men, a total of 603 subjects (31.7%) had diagnosis of BPE. The diagnosis of BPE increased from 9.3% in men aged < = 50 years, to 34.1% in those aged 51-60 years and to 58.7% among men aged > 60 years. A history of hypertension, diabetes, heart diseases, hypercholesterolemia and hypertriglyceridemia were all significantly associated with an increased risk of BPE in the total series and, although not always in a statistically significant way, in strata of age. Physical activity (PA) was significantly associated with a decreased risk of BPE. We have further analyzed the risk of BPE in men with one or more of the identified risk factors (i.e. hypertension, diabetes, heart disease, hypercholesterolemia, hypertriglyceridemia and low PA): the risk of BPE increased with number of risk factors reported by the subjects. The estimated risk were higher among younger men. In our study a history of hypertension, diabetes, heart disease, hypercholesterolemia and hypertriglyceridemia increased the risk and physical activity lowered the risk of BPE. This risk profile was observed also in men aged < 50 years.

Efficacy of knee joint aspiration in patients with acute ACL injury in the emergency department.

PubMed

Wang, Joon Ho; Lee, Jin Hyuck; Cho, Youngsuk; Shin, Jung Min; Lee, Byung Hoon

2016-08-01

To evaluate the influence of joint aspiration on the sensitivity of physical examination for diagnosing acute anterior cruciate ligament (ACL) lesion in the second outpatient-department (OPD) follow-up referred from emergency department (ED). This retrospective study included sixty patients underwent ACL reconstruction with initial visit at ED. They were divided into two groups based on the presence or absence of joint aspiration at ED. All participants were referred to second OPD follow-up within 7-14days after the injury. Clinical manifestation (including visual analogue scale (VAS) for pain, range of motion (ROM), and severity of knee effusion) and physical examination (Lachman test and pivot shift test) were checked in ED and the second OPD follow-up. The group of patients with joint aspiration (G1) showed substantial decreases in mean values of VAS for pain (p=0.005), ROM (p=0.001), and effusion level (p<0.001), even higher VAS and effusion level and lower ROM at the initial visit of ED than the other group (G2). The sensitivity of positive Lachman and pivot shift test was significantly (p<0.05) increased following knee joint aspiration. Positive Lachman test was recorded at 76.5% in the second follow-up in G1, which was significantly (p=0.047) higher than that (47.6%) in G2. The percentage of positive pivot shift test was recorded at 76.5% in the second follow-up in G1, which as significantly (p<0.001) higher than that (31.0%) in G2. Knee joint aspiration in acute ACL injury with suspected hemarthrosis could be considered as a diagnostic procedure. Joint aspiration in early medical attendance might be able to lower pain scores or raise the sensitivity of physical examination for diagnosing acute ACL injury at follow up visit in orthopedic outpatient department. Retrospective cohort study III. Copyright © 2016 Elsevier Ltd. All rights reserved.

Using Simulation to Model and Validate Invasive Breast Cancer Progression in Women in the Study and Control Groups of the Canadian National Breast Screening Studies I and II.

PubMed

Taghipour, Sharareh; Caudrelier, Laurent N; Miller, Anthony B; Harvey, Bart

2017-02-01

Modeling breast cancer progression and the effect of various risk is helpful in deciding when a woman should start and end screening, and how often the screening should be undertaken. We modeled the natural progression of breast cancer using a hidden Markov process, and incorporated the effects of covariates. Patients are women aged 50-59 (older) and 40-49 (younger) years from the Canadian National Breast Screening Studies. We included prevalent cancers, estimated the screening sensitivities and rates of over-diagnosis, and validated the models using simulation. We found that older women have a higher rate of transition from a healthy to preclinical state and other causes of death but a lower rate of transition from preclinical to clinical state. Reciprocally, younger women have a lower rate of transition from a healthy to preclinical state and other causes of death but a higher rate of transition from a preclinical to clinical state. Different risk factors were significant for the age groups. The mean sojourn times for older and younger women were 2.53 and 2.96 years, respectively. In the study group, the sensitivities of the initial physical examination and mammography for older and younger women were 0.87 and 0.81, respectively, and the sensitivity of the subsequent screens were 0.78 and 0.53, respectively. In the control groups, the sensitivities of the initial physical examination for older and younger women were 0.769 and 0.671, respectively, and the sensitivity of the subsequent physical examinations for the control group aged 50-59 years was 0.37. The upper-bounds for over-diagnosis in older and younger women were 25% and 27%, respectively. The present work offers a basis for the better modeling of cancer incidence for a population with the inclusion of prevalent cancers.

Gender, early alcohol use, and suicide ideation and attempts: findings from the 2005 youth risk behavior survey.

PubMed

Swahn, Monica H; Bossarte, Robert M

2007-08-01

To examine the cross-sectional associations between preteen alcohol use initiation and subsequent suicide ideation and attempts for boys and girls in a nationally representative sample of high school students. Analyses are computed using data from the 2005 national Youth Risk Behavior Survey, which includes a representative sample (n = 13,639) of high-school students in grades 9-12 in the United States. Cross-sectional logistic regression analyses were conducted to determine the associations between early alcohol use and reports of suicide ideation and suicide attempts for boys and girls while controlling for demographic characteristics, substance use, involvement in physical fights, weapon carrying, physical abuse by dating partner, sexual assault, and sadness. Among study participants, 25.4% reported drinking before age 13 years. Preteen alcohol use initiation was statistically significantly associated with suicidal ideation (adjusted OR = 1.89, 95% CI =1.46-2.44) and suicide attempts (adjusted OR = 2.71, 95% CI =1.82-4.02) relative to nondrinkers. Preteen alcohol use initiation was statistically significantly associated with suicidal ideation and attempts relative to nondrinkers for both boys and girls. Alcohol use among adolescents, particularly preteen alcohol use initiation, is an important risk factor for both suicide ideation and suicide attempts among boys and girls. Increased efforts to delay and reduce early alcohol use are needed, and may reduce suicide attempts.

Painless thyroiditis associated to thyroid carcinoma: role of initial ultrasonography evaluation.

PubMed

Valentini, Raisa Bressan; Macedo, Bruno Mussoi de; Izquierdo, Rogério Friedrich; Meyer, Erika Laurini Souza

2016-04-01

Even though it is a rare event, most associations of thyroid carcinoma with subacute thyroiditis described in the literature are related to its granulomatous form (Quervain's thyroiditis). We present a patient with subacute lymphocytic thyroiditis (painless thyroiditis) and papillary thyroid cancer that was first suspected in an initial ultrasound evaluation. A 30-year old female patient who was referred to the emergency room due to hyperthyroidism symptoms was diagnosed with painless thyroiditis established by physical examination and laboratory findings. With the presence of a palpable painless thyroid nodule an ultrasound was prescribed and the images revealed a suspicious thyroid nodule, microcalcification focus in the heterogeneous thyroid parenquima and cervical lymphadenopathy. Fine needle aspiration biopsy was taken from this nodule; cytology was assessed for compatibility with papillary thyroid carcinoma. Postsurgical pathology evaluation showed a multicentric papillary carcinoma and lymphocytic infiltration. Subacute thyroiditis, regardless of type, may produce transitory ultrasound changes that obscure the coexistence of papillary carcinoma. Due to this, initial thyroid ultrasound evaluation should be delayed until clinical recovery. We recommended a thyroid ultrasound exam for initial evaluation of painless thyroiditis, particularly in patients with palpable thyroid nodule. Further cytological examination is recommended in cases presenting with suspect thyroid nodule and/or non-nodular hypoechoic (> 1 cm) or heterogeneous areas with microcalcification focus.

Rf-assisted current startup in FED

DOE Office of Scientific and Technical Information (OSTI.GOV)

Borowski, S.K.; Peng, Y.K.M.; Kammash, T.

1981-01-01

Auxiliary rf heating of electrons before and during the current rise phase in FED is examined as a means of reducing both the initiation loop voltage and resistive flux expenditure during startup. Prior to current initiation, 1 to 2 MW of electron cyclotron resonance heating (ECRH) power at approximately 90 GHz is used to create a small volume of high conductivity plasma near the upper hybrid resonance (UHR) region. This plasma conditioning permits a small radius (a/sub o/ approximately 0.2-0.4 m) current channel to be established with a relatively low initial loop voltage (<25 V). During the subsequent plasma expansionmore » and current ramp phase, additional rf power is introduced to reduce volt-second consumption due to plasma resistance. The physics models used for analyzing the UHR heating and current rise phases are also discussed.« less

[Spontaneous splenic rupture as complication of infective mononucleosis: a clinical case].

PubMed

Delle Monache, Guido; Orlando, Dante; Frassanito, Salvatore; Sciarra, Roberto; Rinaldi, Manlio Tullio

2003-01-01

Spontaneous splenic rupture is a very rare complication of infectious mononucleosis, already described by other authors. In this case report we show the findings occurring in a young man who presented with sudden left thoracic pain and dyspnea. The initial work-up was oriented towards a suspected diagnosis of left spontaneous pneumothorax. Initially, little attention was paid to the clinical history that was characterized by flu-like symptoms during the previous 2 weeks; this, along with a rushed physical examination, could have had dramatic consequences, due to the unavoidable diagnostic delay. A thorough clinical evaluation by Internists, coupled with the essential ultrasonographic diagnostic support, allowed an earlier diagnosis followed by definitive cure, i.e. splenectomy.

Differentiating osteomyelitis from bone infarction in sickle cell disease.

PubMed

Wong, A L; Sakamoto, K M; Johnson, E E

2001-02-01

This brief review discusses one possible approach to evaluating the sickle cell patient with bone pain. The major differential diagnoses include osteomyelitis and bone infarction. Based on previous studies, we provide an approach to assessing and treating patients with the possible diagnosis of osteomyelitis. An algorithm has been provided, which emphasizes the importance of the initial history and physical examination. Specific radiographic studies are recommended to aid in making the initial assessment and to determine whether the patient has an infarct or osteomyelitis. Differentiating osteomyelitis from infarction in sickle cell patients remains a challenge for the pediatrician. This algorithm can be used as a guide for physicians who evaluate such patients in the acute care setting.

Design Mining Interacting Wind Turbines.

PubMed

Preen, Richard J; Bull, Larry

2016-01-01

An initial study has recently been presented of surrogate-assisted evolutionary algorithms used to design vertical-axis wind turbines wherein candidate prototypes are evaluated under fan-generated wind conditions after being physically instantiated by a 3D printer. Unlike other approaches, such as computational fluid dynamics simulations, no mathematical formulations were used and no model assumptions were made. This paper extends that work by exploring alternative surrogate modelling and evolutionary techniques. The accuracy of various modelling algorithms used to estimate the fitness of evaluated individuals from the initial experiments is compared. The effect of temporally windowing surrogate model training samples is explored. A surrogate-assisted approach based on an enhanced local search is introduced; and alternative coevolution collaboration schemes are examined.

Pre-K Physical Education: Universal Initiatives and Teacher Preparation Recommendations

ERIC Educational Resources Information Center

Ross, Susan M.

2013-01-01

The "National Physical Activity Plan", as well as professional and government agencies (NASPE, 2008a; US Department of Health and Human Services, 2000) acknowledge pre-kindergarten (pre-K) children should be part of comprehensive school physical activity initiatives anchored in quality physical education programming. These…

Physical dating violence victimization in college women in Chile.

PubMed

Lehrer, Jocelyn A; Lehrer, Evelyn L; Zhao, Zhenxiang

2010-05-01

There are no published studies on physical dating violence in college students in Chile, and campuses across the country currently lack systematized programs to prevent or respond to this public health problem. This is the first study to examine prevalence and predictors of physical dating violence victimization with a sample of female college students in Chile. A closed-ended questionnaire was administered to students enrolled in general education courses at a major public university. The prevalence of women's physical dating violence victimization was calculated, and generalized ordered logit models were used to estimate risk factors for such victimization (n = 441). Ancillary analyses examined associations of dating violence victimization with experiences of unwanted sexual contact and forced condom nonuse. Approximately 21% of subjects reported one or more incidents of physical dating violence not involving physical injury since age 14, and another 5% reported at least one incident resulting in physical injury during this time period. Risk factors identified in five sequential models were sexual abuse and witnessing of domestic violence in childhood, low parental education, residence away from the parental home, urban residence, and having had sexual intercourse. Maternal employment and religious participation had protective effects. Dating violence victimization was found to be significantly associated with experiences of unwanted sexual contact and forced condom nonuse. The study findings show a high prevalence of physical dating violence, strong associations between several sociodemographic factors and dating violence, and links between dating violence and sexual/reproductive risk. Our results indicate a need to expand attention to this public health problem in Chile as well as other developing countries, where research and prevention/response initiatives have generally been similarly limited. The findings also have important implications for the content of dating violence, HIV/sexually transmitted infection (STI), and pregnancy prevention programs for adolescents and young adults.

The BIG (brain injury guidelines) project: defining the management of traumatic brain injury by acute care surgeons.

PubMed

Joseph, Bellal; Friese, Randall S; Sadoun, Moutamn; Aziz, Hassan; Kulvatunyou, Narong; Pandit, Viraj; Wynne, Julie; Tang, Andrew; O'Keeffe, Terence; Rhee, Peter

2014-04-01

It is becoming a standard practice that any "positive" identification of a radiographic intracranial injury requires transfer of the patient to a trauma center for observation and repeat head computed tomography (RHCT). The purpose of this study was to define guidelines-based on each patient's history, physical examination, and initial head CT findings-regarding which patients require a period of observation, RHCT, or neurosurgical consultation. In our retrospective cohort analysis, we reviewed the records of 3,803 blunt traumatic brain injury patients during a 4-year period. We classified patients according to neurologic examination results, use of intoxicants, anticoagulation status, and initial head CT findings. We then developed brain injury guidelines (BIG) based on the individual patient's need for observation or hospitalization, RHCT, or neurosurgical consultation. A total of 1,232 patients had an abnormal head CT finding. In the BIG 1 category, no patients worsened clinically or radiographically or required any intervention. BIG 2 category had radiographic worsening in 2.6% of the patients. All patients who required neurosurgical intervention (13%) were in BIG 3. There was excellent agreement between assigned BIG and verified BIG. κ statistic is equal to 0.98. We have proposed BIG based on patient's history, neurologic examination, and findings of initial head CT scan. These guidelines must be used as supplement to good clinical examination while managing patients with traumatic brain injury. Prospective validation of the BIG is warranted before its widespread implementation. Epidemiologic study, level III.

The Characteristics of Fatigue Damage in the Fuselage Riveted Lap Splice Joint

NASA Technical Reports Server (NTRS)

Piascik, Robert S.; Willard, Scott A.

1997-01-01

An extensive data base has been developed to form the physical basis for new analytical methodology to predict the onset of widespread fatigue damage in the fuselage lap splice joint. The results of detailed destructive examinations have been cataloged to describe the physical nature of MSD in the lap splice joint. ne catalog includes a detailed description, e.g., crack initiation, growth rates, size, location, and fracture morphology, of fatigue damage in the fuselage lap splice joint structure. Detailed examinations were conducted on a lap splice joint panel removed from a full scale fuselage test article after completing a 60,000 cycle pressure test. The panel contained a four bay region that exhibited visible outer skin cracks and regions of crack link-up along the upper rivet row. Destructive examinations revealed undetected fatigue damage in the outer skin, inner skin, and tear strap regions. Outer skin fatigue cracks were found to initiate by fretting damage along the faying surface. The cracks grew along the faying surface to a length equivalent to two to three skin thicknesses before penetrating the outboard surface of the outer skin. Analysis of fracture surface marker bands produced during full scale testing revealed that all upper rivet row fatigue cracks contained in a dim bay region grow at similar rates; this important result suggests that fracture mechanics based methods can be used to predict the growth of outer skin fatigue cracks in lap splice structure. Results are presented showing the affects of MSD and out-of-plane pressure loads on outer skin crack link-up.

"We move kids"-the consensus report from the roundtable to examine strategies for promoting walking in the school environment.

PubMed

Chodzko-Zajko, Wojtek; Zhu, Weimo; Bazzarre, Terry; Castelli, Darla; Graber, Kim; Woods, Amelia

2008-07-01

In conjunction with the Walking for Health Conference, a Roundtable with 12 physical education teachers and 11 pedagogy researchers and public health professionals was organized to initiate a dialog between practicing school teachers and a group of researchers to identify practical and effective strategies for increasing physical activity, particularly walking, in the school setting. Discussions were organized on the following major themes: (1) promoting physical activity, (2) barriers for physical activity promotion in children, and (3) integrating physical activity with other health behaviors in the curriculum. There was a focus that came through on strategies to overcome barriers to allow opportunities for students to increase their physical activity levels. These strategies require the commitment not only of physical education teachers but also of their fellow teachers, school administrators, parents, local community members, and of course the students themselves. The issue of limited resources continually came up, thus realistically limiting strategies to those that could be implemented without additional cost. Any progress to be made with respect to the implementation of these strategies depends on the infrastructure of support that can be built on the excellent recommendations provided by the Roundtable focus groups.

Community development corporations could potentially improve research on causal associations between environmental features and physical activity.

PubMed

Suminski, Richard; Wasserman, Jason A; Mayfield, Carlene A; Kubic, Micah; Porter, Julie

2014-09-01

Community development corporations (CDC) are worldwide entities that create environments facilitating physical activity. At the same time, researchers face challenges conducting cost-effective, longitudinal studies on how environmental changes affect physical activity. To provide evidence suggesting that CDC initiatives could potentially be integrated into a research framework for examining the influence of environmental improvements on physical activity. Quality of Life Plans (QLP) developed by a CDC and stakeholders from 6 lower-income neighborhoods were systematically reviewed to obtain data about environmental features targeted for change and the strategies used to bring about those changes. Strategies were deemed pro-physical activity if previous studies suggested they have the potential to affect physical activity. A total of 348 strategies were proposed of which 164 were pro-physical activity. Six environmental features were targeted including crime (57 strategies), aesthetics (39), facilities (30), walkability (17), destinations (14), and programs (5). Strategies involved implementing (90 strategies), planning (33), assessing (26), and securing funding (13). Progress reports indicated that 37.4% of the pro-physical activity strategies were implemented 1 year following the development of the QLPs. These results suggest that activities of CDCs could potentially be systematically integrated into the scientific study of environmental influences on physical activity.

Evaluating the professional libraries of practicing physical therapists.

PubMed

Brown, Suzanne R; Roush, James R; Lamkin, Alyson R; Perrakis, Rena; Kronenfeld, Michael R

2007-01-01

The primary objective of this study was to explore the use of information resources by a sample of physical therapists. A qualitatively designed study using structured individual interviews, examination of professional libraries, and identification of information resources was initiated in three sites (Southern California, Arizona, and Georgia). Participants included forty physical therapists with between five and twenty years of experience. The Internet and continuing education activities appeared to be the primary information sources for the physical therapists surveyed. The personal professional libraries of participants were limited in scope and contained titles copyrighted more than ten years ago. Access to peer-reviewed journals in the sample was limited primarily to those received as a benefit of professional association membership. Participants did not maintain current print professional information resources. The majority of books in the personal and workplace professional libraries held copyrights dating from the time of the participants' enrollment in an entry-level physical therapy program. Medical librarians may play an important role in shifting physical therapy towards evidence-based practice by collaborating in professional development for this group. Physical therapy educators and professional leaders should support current public collections of physical therapy-related information resources to encourage the movement towards an evidence-based practice model in physical therapy.

Evaluating the professional libraries of practicing physical therapists

PubMed Central

Brown, Suzanne R.; Roush, James R.; Lamkin, Alyson R.; Perrakis, Rena; Kronenfeld, Michael R.

2007-01-01

Background and Purpose: The primary objective of this study was to explore the use of information resources by a sample of physical therapists. Methods: A qualitatively designed study using structured individual interviews, examination of professional libraries, and identification of information resources was initiated in three sites (Southern California, Arizona, and Georgia). Participants included forty physical therapists with between five and twenty years of experience. Results: The Internet and continuing education activities appeared to be the primary information sources for the physical therapists surveyed. The personal professional libraries of participants were limited in scope and contained titles copyrighted more than ten years ago. Access to peer-reviewed journals in the sample was limited primarily to those received as a benefit of professional association membership. Discussion and Conclusions: Participants did not maintain current print professional information resources. The majority of books in the personal and workplace professional libraries held copyrights dating from the time of the participants' enrollment in an entry-level physical therapy program. Medical librarians may play an important role in shifting physical therapy towards evidence-based practice by collaborating in professional development for this group. Physical therapy educators and professional leaders should support current public collections of physical therapy-related information resources to encourage the movement towards an evidence-based practice model in physical therapy. PMID:17252068

Validity evidence for the adaptation of the State Mindfulness Scale for Physical Activity (SMS-PA) in Spanish youth.

PubMed

Ullrich-French, Sarah; González Hernández, Juan; Hidalgo Montesinos, María D

2017-02-01

Mindfulness is an increasingly popular construct with promise in enhancing multiple positive health outcomes. Physical activity is an important behavior for enhancing overall health, but no Spanish language scale exists to test how mindfulness during physical activity may facilitate physical activity motivation or behavior. This study examined the validity of a Spanish adaption of a new scale, the State Mindfulness Scale for Physical Activity, to assess mindfulness during a specific experience of physical activity. Spanish youths (N = 502) completed a cross-sectional survey of state mindfulness during physical activity and physical activity motivation regulations based on Self-Determination Theory. A high-order model fit the data well and supports the use of one general state mindfulness factor or the use of separate subscales of mindfulness of mental (e.g., thoughts, emotions) and body (physical movement, muscles) aspects of the experience. Internal consistency reliability was good for the general scale and both sub-scales. The pattern of correlations with motivation regulations provides further support for construct validity with significant and positive correlations with self-determined forms of motivation and significant and negative correlations with external regulation and amotivation. Initial validity evidence is promising for the use of the adapted measure.

The Association between Physical Activity During the Day and Long-Term Memory Stability.

PubMed

Pontifex, Matthew B; Gwizdala, Kathryn L; Parks, Andrew C; Pfeiffer, Karin A; Fenn, Kimberly M

2016-12-02

Despite positive associations between chronic physical activity and memory; we have little understanding of how best to incorporate physical activity during the day to facilitate the consolidation of information into memory, nor even how time spent physically active during the day relates to memory processes. The purpose of this investigation was to examine the relation between physical activity during the day and long-term memory. Ninety-two young adults learned a list of paired-associate items and were tested on the items after a 12-hour interval during which heart rate was recorded continuously. Although the percentage of time spent active during the day was unrelated to memory, two critical physical activity periods were identified as relating to the maintenance of long-term memory. Engaging in physical activity during the period 1 to 2-hours following the encoding of information was observed to be detrimental to the maintenance of information in long-term memory. In contrast, physical activity during the period 1-hour prior to memory retrieval was associated with superior memory performance, likely due to enhanced retrieval processing. These findings provide initial evidence to suggest that long-term memory may be enhanced by more carefully attending to the relative timing of physical activity incorporated during the day.

Diabatic forcing and initialization with assimilation of cloud and rain water in a forecast model: Methodology

NASA Technical Reports Server (NTRS)

Raymond, William H.; Olson, William S.; Callan, Geary

1990-01-01

The focus of this part of the investigation is to find one or more general modeling techniques that will help reduce the time taken by numerical forecast models to initiate or spin-up precipitation processes and enhance storm intensity. If the conventional data base could explain the atmospheric mesoscale flow in detail, then much of our problem would be eliminated. But the data base is primarily synoptic scale, requiring that a solution must be sought either in nonconventional data, in methods to initialize mesoscale circulations, or in ways of retaining between forecasts the model generated mesoscale dynamics and precipitation fields. All three methods are investigated. The initialization and assimilation of explicit cloud and rainwater quantities computed from conservation equations in a mesoscale regional model are examined. The physical processes include condensation, evaporation, autoconversion, accretion, and the removal of rainwater by fallout. The question of how to initialize the explicit liquid water calculations in numerical models and how to retain information about precipitation processes during the 4-D assimilation cycle are important issues that are addressed. The explicit cloud calculations were purposely kept simple so that different initialization techniques can be easily and economically tested. Precipitation spin-up processes associated with three different types of weather phenomena are examined. Our findings show that diabatic initialization, or diabatic initialization in combination with a new diabatic forcing procedure, work effectively to enhance the spin-up of precipitation in a mesoscale numerical weather prediction forecast. Also, the retention of cloud and rain water during the analysis phase of the 4-D data assimilation procedure is shown to be valuable. Without detailed observations, the vertical placement of the diabatic heating remains a critical problem.

Costovertebral joint dysfunction: another misdiagnosed cause of atypical chest pain.

PubMed Central

Arroyo, J. F.; Jolliet, P.; Junod, A. F.

1992-01-01

The diagnostic work-up of atypical chest pain frequently leads to invasive procedures. However, this painful symptomatology can sometimes be of benign origin and respond to simple therapeutic manoeuvres. A number of musculoskeletal conditions such as costovertebral joint dysfunctions should be carefully considered. We report five cases in which patient discomfort and high costs could have been avoided if awareness of these conditions had led to a correct diagnosis upon initial physical examination. PMID:1448407

Cutaneous sarcoidosis evaluated by FDG PET.

PubMed

Li, Yuxin; Berenji, Gholam R

2011-07-01

A 50-year-old man presented with initial complaints of diffuse skin pain and pruritus. Physical examination revealed scattered skin plaques and subcutaneous nodules with mild tenderness throughout the body. Skin biopsy demonstrated noncaseating epithelioid granulomas. Patient soon developed cough, fever with hot flashes, and shortness of breath on exertion. FDG PET/CT demonstrated diffuse cutaneous involvement throughout the body. Follow-up FDG PET/CT after treatment revealed a decrease in FDG uptake suggesting a good response to therapy.

Process, cost, and clinical quality: the initial oral contraceptive visit.

PubMed

McMullen, Michael J; Woolford, Samuel W; Moore, Charles L; Berger, Barry M

2013-01-01

To demonstrate how the analysis of clinical process, cost, and outcomes can identify healthcare improvements that reduce cost without sacrificing quality, using the example of the initial visit associated with oral contraceptive pill use. Cross-sectional study using data collected by HealthMETRICS between 1996 and 2009. Using data collected from 106 sites in 24 states, the unintended pregnancy (UIP) rate, effectiveness of patient education, and unit visit cost were calculated. Staff type providing education and placement of education were recorded. Two-way analysis of variance models were created and tested for significance to identify differences between groups. Sites using nonclinical staff to provide education outside the exam were associated with lower cost, higher education scores, and a UIP rate no different from that of sites using clinical staff. Sites also providing patient education during the physical examination were associated with higher cost, lower education scores, and a UIP rate no lower than that of sites providing education outside of the exam. Through analyzing process, cost, and quality, lower-cost processes that did not reduce clinical quality were identified. This methodology is applicable to other clinical services for identifying low-cost processes that do not result in lower clinical quality. By using nonclinical staff educators to provide education outside of the physical examination, sites could save an average of 32% of the total cost of the visit.

Dating violence among urban, minority, middle school youth and associated sexual risk behaviors and substance use.

PubMed

Lormand, Donna K; Markham, Christine M; Peskin, Melissa F; Byrd, Theresa L; Addy, Robert C; Baumler, Elizabeth; Tortolero, Susan R

2013-06-01

Whereas dating violence among high school students has been linked with sexual risk-taking and substance use, this association has been understudied among early adolescents. We estimated the prevalence of physical and nonphysical dating violence in a sample of middle school students and examined associations between dating violence, sexual, and substance use behaviors. Logistic regression models for clustered data from 7th grade students attending 10 Texas urban middle schools were used to examine cross-sectional associations between dating violence victimization and risk behaviors. The sample (N = 950) was 48.5% African American, 36.0% Hispanic, 55.7% female, mean age 13.1 years (SD 0.64). About 1 in 5 reported physical dating violence victimization, 48.1% reported nonphysical victimization, and 52.6% reported any victimization. Adjusted logistic regression analyses indicated that physical, nonphysical, and any victimization was associated with ever having sex, ever using alcohol, and ever using drugs. Over 50% of sampled middle school students had experienced dating violence, which may be associated with early sexual initiation and substance use. Middle school interventions that prevent dating violence are needed. © 2013, American School Health Association.

Environmental Volunteering and Health Outcomes over a 20-Year Period

PubMed Central

Pillemer, Karl; Fuller-Rowell, Thomas E.; Reid, M. C.; Wells, Nancy M.

2010-01-01

Purpose: This study tested the hypothesis that volunteering in environmental organizations in midlife is associated with greater physical activity and improved mental and physical health over a 20-year period.  Design and Methods: The study used data from two waves (1974 and 1994) of the Alameda County Study, a longitudinal study of health and mortality that has followed a cohort of 6,928 adults since 1965. Using logistic and multiple regression models, we examined the prospective association between environmental and other volunteerism and three outcomes (physical activity, self-reported health, and depression), with 1974 volunteerism predicting 1994 outcomes, controlling for a number of relevant covariates.  Results: Midlife environmental volunteering was significantly associated with physical activity, self-reported health, and depressive symptoms.  Implications: This population-based study offers the first epidemiological evidence for a significant positive relationship between environmental volunteering and health and well-being outcomes. Further research, including intervention studies, is needed to confirm and shed additional light on these initial findings. PMID:20172902

Examining gender differences on FCI performance in algebra and calculus based physics courses

NASA Astrophysics Data System (ADS)

Kreutzer, Kimberley; Boudreaux, Andrew

2009-05-01

The Force Concept Inventory (FCI) has been widely used to asses student understanding of Newtonian principles. Studies have shown a marked difference in the performance of men and women on both pre- and post-tests [1,2] and also indicate that experiential based instruction may lead to a reduction in this gender gap [1,3]. This poster presents FCI data collected at Western Washington University. Initial analysis of gender differences are consistent with those reported nationally. We also discuss factors that may contribute to the differences in performance and propose instructional strategies that are designed to address the gender gap. [4pt] [1] M. Lorenzo, et. al., ``Reducing the gender gap in the physics classroom,'' AJP 74(2), 118-122 (2006) [0pt] [2] J. Docktor and K. Heller, ``Gender Differences in Both Force Concept Inventory and Introductory Physics Performance,'' Proceedings at the 2008 PERC [0pt] [3] S. Pollack, et. al., ``Reducing the gender gap in the physics classroom: How sufficient is interactive engagement?'' PRST-PER 3 (2007)

Initial Validation of the Physical Education Marginalization and Isolation Survey (PE-MAIS)

ERIC Educational Resources Information Center

Gaudreault, Karen Lux; Richards, K. Andrew R.; Mays Woods, Amelia

2017-01-01

Qualitative research conducted through occupational socialization theory has documented that physical educators feel marginalized and isolated in schools. We sought to propose and provide initial evidence of validity and reliability for the Physical Education Marginalization and Isolation Survey (PE-MAIS). Physical educators (n = 420) completed an…

Triceps brachii muscle reconstruction with a latissimus dorsi muscle flap in a dog.

PubMed

Pavletic, Michael M; Kalis, Russell; Tribou, Patricia; Mouser, Pam J

2015-01-15

A 6-year-old spayed female Border Collie was examined for a severe deformity of the right forelimb. Three months prior to examination, the patient awkwardly fell off the couch and became acutely lame in the right forelimb, progressing to non-weight bearing over the following 72 hours. On physical examination, the dog carried the limb caudally against the thoracic wall, with the shoulder flexed and elbow in extension. The right triceps brachii muscle was atrophied and contracted, resulting in a resistant tension band effect that precluded manipulation of the right elbow joint. The physical changes in the triceps muscle were considered the primary cause of the patient's loss of limb function. Surgical treatment by means of elevation and transposition of the ipsilateral latissimus dorsi muscle was performed. The exposed triceps brachii muscles were transected 3 cm proximal to the tendons of insertion. Via a separate incision, the right latissimus dorsi muscle was elevated and tunneled subcutaneously beneath the interposing skin between the 2 surgical incisions. The muscle was then positioned and sutured to the proximal and distal borders of the divided triceps muscle group. Two weeks later, physical therapy was initiated. After 2 months, the patient regularly walked on the limb most of the time (9/10 steps). The surgical procedure for elevation and transposition of the latissimus dorsi muscle was relatively simple to perform. Physical therapy was an essential component to achieving the successful functional outcome in this case. This technique may be considered for treatment of similar patients in which the triceps muscle group is severely compromised.

Engagement of young adult cancer survivors within a Facebook-based physical activity intervention.

PubMed

Valle, Carmina G; Tate, Deborah F

2017-12-01

Few studies have examined how young adult cancer survivors use online social media. The objective of this study was to characterize Facebook engagement by young adult cancer survivors in the context of a physical activity (PA) intervention program. Young adult cancer survivors participated in one of two Facebook groups as part of a 12-week randomized trial of a PA intervention (FITNET) compared to a self-help comparison (SC) condition. A moderator actively prompted group discussions in the FITNET Facebook group, while social interaction was unprompted in the SC group. We examined factors related to engagement, differences in engagement by group format and types of Facebook posts, and the relationship between Facebook engagement and PA outcomes. There were no group differences in the number of Facebook comments posted over 12 weeks (FITNET, 153 vs. SC, 188 p = 0.85) or the proportion of participants that reported engaging within Facebook group discussions at least 1-2 days/week. The proportion of participants that made any posts decreased over time in both groups. SC participants were more likely than FITNET participants to agree that group discussions caused them to become physically active (p = 0.040) and that group members were supportive (p = 0.028). Participant-initiated posts elicited significantly more comments and likes than moderator-initiated posts. Responses posted on Facebook were significantly associated with light PA at 12 weeks (β = 11.77, t(85) = 1.996, p = 0.049) across groups. Engagement within Facebook groups was variable and may be associated with PA among young adult cancer survivors. Future research should explore how to promote sustained engagement in online social networks. ClinicalTrials.gov identifier: NCT01349153.

Potentialities of ensemble strategies for flood forecasting over the Milano urban area

NASA Astrophysics Data System (ADS)

Ravazzani, Giovanni; Amengual, Arnau; Ceppi, Alessandro; Homar, Víctor; Romero, Romu; Lombardi, Gabriele; Mancini, Marco

2016-08-01

Analysis of ensemble forecasting strategies, which can provide a tangible backing for flood early warning procedures and mitigation measures over the Mediterranean region, is one of the fundamental motivations of the international HyMeX programme. Here, we examine two severe hydrometeorological episodes that affected the Milano urban area and for which the complex flood protection system of the city did not completely succeed. Indeed, flood damage have exponentially increased during the last 60 years, due to industrial and urban developments. Thus, the improvement of the Milano flood control system needs a synergism between structural and non-structural approaches. First, we examine how land-use changes due to urban development have altered the hydrological response to intense rainfalls. Second, we test a flood forecasting system which comprises the Flash-flood Event-based Spatially distributed rainfall-runoff Transformation, including Water Balance (FEST-WB) and the Weather Research and Forecasting (WRF) models. Accurate forecasts of deep moist convection and extreme precipitation are difficult to be predicted due to uncertainties arising from the numeric weather prediction (NWP) physical parameterizations and high sensitivity to misrepresentation of the atmospheric state; however, two hydrological ensemble prediction systems (HEPS) have been designed to explicitly cope with uncertainties in the initial and lateral boundary conditions (IC/LBCs) and physical parameterizations of the NWP model. No substantial differences in skill have been found between both ensemble strategies when considering an enhanced diversity of IC/LBCs for the perturbed initial conditions ensemble. Furthermore, no additional benefits have been found by considering more frequent LBCs in a mixed physics ensemble, as ensemble spread seems to be reduced. These findings could help to design the most appropriate ensemble strategies before these hydrometeorological extremes, given the computational cost of running such advanced HEPSs for operational purposes.

Anxiety sensitivity predicts increased perceived exertion during a 1-mile walk test among treatment-seeking smokers.

PubMed

Farris, Samantha G; Uebelacker, Lisa A; Brown, Richard A; Price, Lawrence H; Desaulniers, Julie; Abrantes, Ana M

2017-12-01

Smoking increases risk of early morbidity and mortality, and risk is compounded by physical inactivity. Anxiety sensitivity (fear of anxiety-relevant somatic sensations) is a cognitive factor that may amplify the subjective experience of exertion (effort) during exercise, subsequently resulting in lower engagement in physical activity. We examined the effect of anxiety sensitivity on ratings of perceived exertion (RPE) and physiological arousal (heart rate) during a bout of exercise among low-active treatment-seeking smokers. Adult daily smokers (n = 157; M age  = 44.9, SD = 11.13; 69.4% female) completed the Rockport 1.0 mile submaximal treadmill walk test. RPE and heart rate were assessed during the walk test. Multi-level modeling was used to examine the interactive effect of anxiety sensitivity × time on RPE and on heart rate at five time points during the walk test. There were significant linear and cubic time × anxiety sensitivity effects for RPE. High anxiety sensitivity was associated with greater initial increases in RPE during the walk test, with stabilized ratings towards the last 5 min, whereas low anxiety sensitivity was associated with lower initial increase in RPE which stabilized more quickly. The linear time × anxiety sensitivity effect for heart rate was not significant. Anxiety sensitivity is associated with increasing RPE during moderate-intensity exercise. Persistently rising RPE observed for smokers with high anxiety sensitivity may contribute to the negative experience of exercise, resulting in early termination of bouts of prolonged activity and/or decreased likelihood of future engagement in physical activity.

Racial/Ethnic Differences in Physical Activity Guideline Attainment among Participants in the Osteoarthritis Initiative

PubMed Central

Song, Jing; Hochberg, Marc C.; Chang, Rowland W.; Hootman, Jennifer M.; Manheim, Larry M.; Lee, Jungwha; Semanik, Pamela A.; Sharma, Leena; Dunlop, Dorothy D.

2012-01-01

Objective This cross-sectional study examined racial/ethnic differences in meeting the 2008 U.S. Department of Health and Human Services Physical Activity Guidelines aerobic component (≥ 150 moderate-to-vigorous (MV) minutes/week in bouts ≥ 10 minutes) among persons with or at risk for radiographic knee osteoarthritis (RKOA). Methods We evaluated African American versus White differences in Guideline attainment using multiple logistic regression adjusting for socio-demographic (age, gender, site, income, education) and health factors (comorbidity, depressive symptoms, overweight/obesity, knee pain). Our analyses included adults aged 49–84 who participated in accelerometer monitoring at the Osteoarthritis Initiative 48-month visit (1142 with and 747 at risk for RKOA). Results 2.0% of African Americans and 13.0% of Whites met Guidelines. For adults with and at risk for RKOA, significantly lower rates of Guideline attainment among African Americans compared to Whites were partially attenuated by health factor differences, particularly overweight/obesity and knee pain (RKOA: adjusted odds ratio [OR] = 0.24, 95% confidence interval [CI] = [0.08, 0.72]; at risk for RKOA: OR = 0.28, 95% CI = [0.07, 1.05]). Conclusion Despite known benefits from physical activity, attainment of Physical Activity Guidelines among persons with and at risk for RKOA was low. African Americans were 72–76% less likely than Whites to meet Guidelines. Culturally-relevant interventions and environmental strategies in the African American community targeting overweight/obesity and knee pain may reduce future racial/ethnic differences in physical activity and improve health outcomes. PMID:22807352

Current Government Actions and Potential Policy Options for Reducing Obesity in Queensland Schools.

PubMed

Alsharairi, Naser A

2018-01-29

School nutrition policies provide promising avenues towards the improvement of children's eating habits and the prevention of obesity. Childhood obesity rates and related chronic diseases are increasing in Queensland, in part as a result of unhealthy eating habits and lack of physical activity. There is a very high investment by the Queensland government in maintaining healthy weight and promoting nutrition and physical activity among schoolchildren through delivering a range of initiatives across the state. However, there is a lack of evidence concerning the effectiveness of nutrition/physical education and parental involvement programs addressing obesity delivered in Queensland schools. This paper can be used to guide government and policy-makers regarding the most effective policy options that will promote healthy eating and physical activity among Queensland schoolchildren. The aim of this paper is to: (i) summarize current evidence on Queensland government responses to obesity; and (ii) discuss potential policy options that could support healthy eating and regular physical activity, and examine the evidence base for each option and suggest new areas for future research.

The Martian: Examining Human Physical Judgments across Virtual Gravity Fields.

PubMed

Ye, Tian; Qi, Siyuan; Kubricht, James; Zhu, Yixin; Lu, Hongjing; Zhu, Song-Chun

2017-04-01

This paper examines how humans adapt to novel physical situations with unknown gravitational acceleration in immersive virtual environments. We designed four virtual reality experiments with different tasks for participants to complete: strike a ball to hit a target, trigger a ball to hit a target, predict the landing location of a projectile, and estimate the flight duration of a projectile. The first two experiments compared human behavior in the virtual environment with real-world performance reported in the literature. The last two experiments aimed to test the human ability to adapt to novel gravity fields by measuring their performance in trajectory prediction and time estimation tasks. The experiment results show that: 1) based on brief observation of a projectile's initial trajectory, humans are accurate at predicting the landing location even under novel gravity fields, and 2) humans' time estimation in a familiar earth environment fluctuates around the ground truth flight duration, although the time estimation in unknown gravity fields indicates a bias toward earth's gravity.

A longitudinal examination of mothers' and fathers' social information processing biases and harsh discipline in nine countries.

PubMed

Lansford, Jennifer E; Woodlief, Darren; Malone, Patrick S; Oburu, Paul; Pastorelli, Concetta; Skinner, Ann T; Sorbring, Emma; Tapanya, Sombat; Tirado, Liliana Maria Uribe; Zelli, Arnaldo; Al-Hassan, Suha M; Alampay, Liane Peña; Bacchini, Dario; Bombi, Anna Silvia; Bornstein, Marc H; Chang, Lei; Deater-Deckard, Kirby; Di Giunta, Laura; Dodge, Kenneth A

2014-08-01

This study examined whether parents' social information processing was related to their subsequent reports of their harsh discipline. Interviews were conducted with mothers (n = 1,277) and fathers (n = 1,030) of children in 1,297 families in nine countries (China, Colombia, Italy, Jordan, Kenya, the Philippines, Sweden, Thailand, and the United States), initially when children were 7 to 9 years old and again 1 year later. Structural equation models showed that parents' positive evaluations of aggressive responses to hypothetical childrearing vignettes at Time 1 predicted parents' self-reported harsh physical and nonphysical discipline at Time 2. This link was consistent across mothers and fathers, and across the nine countries, providing support for the universality of the link between positive evaluations of harsh discipline and parents' aggressive behavior toward children. The results suggest that international efforts to eliminate violence toward children could target parents' beliefs about the acceptability and advisability of using harsh physical and nonphysical forms of discipline.

Early Ambulation After Microsurgical Reconstruction of the Lower Extremity.

PubMed

Orseck, Michael J; Smith, Christopher Robert; Kirby, Sean; Trujillo, Manuel

2018-06-01

Successful outcomes after microsurgical reconstruction of the lower extremity include timely return to ambulation. Some combination of physical examination, ViOptix tissue oxygen saturation monitoring, and the implantable venous Doppler have shown promise in increasing sensitivity of current flap monitoring. We have incorporated this system into our postoperative monitoring protocol in an effort to initiate earlier dependency protocols. A prospective analysis of 36 anterolateral thigh free flap and radial forearm flaps for lower extremity reconstruction was performed. Indications for reconstruction were acute and chronic wounds, as well as oncologic resection. Twenty-three patients were able to ambulate and 3 were able to dangle their leg on the first postoperative day. One flap showed early mottling that improved immediately after elevation. After reelevation and return to baseline, the dependency protocol was successfully implemented on postoperative day 3. All flaps went on to successful healing. Physical examination, implantable venous Doppler, and ViOptix can be used reliably as an adjunct to increase the sensitivity of detecting poorly performing flaps during the postoperative progression of dependency.

A Longitudinal Examination of Mothers’ and Fathers’ Social Information Processing Biases and Harsh Discipline in Nine Countries

PubMed Central

Lansford, Jennifer E.; Woodlief, Darren; Malone, Patrick S.; Oburu, Paul; Pastorelli, Concetta; Skinner, Ann T.; Sorbring, Emma; Tapanya, Sombat; Uribe Tirado, Liliana Maria; Zelli, Arnaldo; Al-Hassan, Suha M.; Alampay, Liane Peña; Bacchini, Dario; Bombi, Anna Silvia; Bornstein, Marc H.; Chang, Lei; Deater-Deckard, Kirby; Di Giunta, Laura; Dodge, Kenneth A.

2014-01-01

This study examined whether parents’ social information processing was related to their subsequent reports of their harsh discipline. Interviews were conducted with mothers (n = 1277) and fathers (n = 1030) of children in 1297 families in nine countries (China, Colombia, Italy, Jordan, Kenya, Philippines, Sweden, Thailand, United States), initially when children were 7- to 9-years-old and again one year later. Structural equation models showed that parents’ positive evaluations of aggressive responses to hypothetical childrearing vignettes at Time 1 predicted parents’ self-reported harsh physical and nonphysical discipline at Time 2. This link was consistent across mothers and fathers and across the nine countries, providing support for the universality of the link between positive evaluations of harsh discipline and parents’ aggressive behavior toward children. The results suggest that international efforts to eliminate violence toward children could target parents’ beliefs about the acceptability and advisability of using harsh physical and nonphysical forms of discipline. PMID:24762321

Free-Aspire: A new device for the management of airways clearance in patient with ineffective cough

PubMed Central

Bertelli, Luca; Nardo, Giovanni Di; Cazzato, Salvatore; Ricci, Giampaolo; Pession, Andrea

2017-01-01

A 3-year-old girl with Spinal Muscular Atrophy type I presented with a right pneumonia. On physical examination pulmonary auscultation revealed an asymmetry of breath sounds between the 2 hemithoraces, owing to decreased breath sounds in the right hemithorax. Blood tests were normal. The initial working diagnosis was a suspected area of mucus accumulation. A treatment with Free Aspire was started. Within a few days, the girl was discharged with a normal physical examination and X-ray study result. Spinal Muscular Atrophy is a rare neuromuscular disorder characterized by loss of motor neurons and progressive muscle wasting. Cough in these patients result ineffective. Free-Aspire is an electromedical machine for removing bronchoalveolar secretions. The case show that Free Aspire in patients with ineffective cough and impaired removal of secretions is a safe and effective device for the removal of bronchial secretions and could be an another help in the management of airway clearance. PMID:29081932

Future Directions for the Early Detection of Colorectal Cancer Recurrence

PubMed Central

Walker, Avery S.; Johnson, Eric K.; Maykel, Justin A.; Stojadinovic, Alex; Nissan, Aviram; Brucher, Bjorn; Champagne, Bradley J.; Steele, Scott R.

2014-01-01

Surgical resection remains a mainstay of treatment and is highly effective for localized colorectal cancer. However, ~30-40% of patients develop recurrence following surgery and 40-50% of recurrences are apparent within the first few years after initial surgical resection. Several variables factor into the ultimate outcome of these patients, including the extent of disease, tumor biology, and patient co-morbidities. Additionally, the time from initial treatment to the development of recurrence is strongly associated with overall survival, particularly in patients who recur within one year of their surgical resection. Current post-resection surveillance strategies involve physical examination, laboratory, endoscopic and imaging studies utilizing various high and low-intensity protocols. Ultimately, the goal is to detect recurrence as early as possible, and ideally in the asymptomatic localized phase, to allow initiation of treatment that may still result in cure. While current strategies have been effective, several efforts are evolving to improve our ability to identify recurrent disease at its earliest phase. Our aim with this article is to briefly review the options available and, more importantly, examine emerging and future options to assist in the early detection of colon and rectal cancer recurrence. PMID:24790655

ATTRIBUTES AND THRESHOLDS IN MEASUREMENTS FOR TRANSPARENCY INITIATIVES

DOE Office of Scientific and Technical Information (OSTI.GOV)

M. W. JOHNSON

The collection of programs broadly termed Transparency Initiatives frequently involves physics measurements that are applied to items with sensitive or classified properties. The inability or reluctance to perform quantitative measurements, in the safeguards tradition, to such items, and then to expose the results to international examination, has impelled development of an attributes approach to measurements, following the philosophy if it looks like a duck, walks like a duck and quacks like a duck, call it a duck, This approach avoids certain of the classification issues that would otherwise be associated with such measurements. Use of the attributes approach, however, continuesmore » to pose problems of interpretation, in light of the need to establish numerical thresholds whereby data obtained from the measurements can be evaluated to determine whether the attribute is present. In this paper we examine the foundations of the attributes approach and the steps used to determine appropriate attributes and thresholds, using examples from contemporary threat-reduction initiatives where possible. Implications for the detector technologies used in the measurements will be discussed, as will the characteristics of so-called information barriers intended to prevent inadvertent release of sensitive information during attributes measurements.« less

Explaining Physical Activity Maintenance After a Theory-Based Intervention Among Patients With Rheumatoid Arthritis: Process Evaluation of a Randomized Controlled Trial.

PubMed

Knittle, Keegan; De Gucht, Véronique; Hurkmans, Emalie; Vlieland, Thea Vliet; Maes, Stan

2016-02-01

Regular physical activity (PA) benefits patients with rheumatoid arthritis (RA), particularly when maintained over time. Research in this area has largely focused on factors associated with initiating PA, while factors contributing to PA maintenance, particularly after lifestyle interventions, have received less attention. This study examined whether higher levels of autonomous motivation, self-efficacy for PA, and greater use of self-regulation skills mediated PA initiation and maintenance 6 months after a theory-based motivational interviewing and self-regulation coaching intervention. Seventy-eight individuals with RA were randomized to receive either a patient-education session (control group), or the patient-education session plus 1 motivational interview and 2 self-regulation coaching sessions (treatment group). Mediation analyses examined the effects of this intervention on PA initiation and maintenance through the intermediate variables autonomous motivation, self-efficacy for PA, and use of self-regulation skills. Analyses were controlled for age, sex, and previous levels of PA. The treatment group reported significantly higher autonomous motivation and greater use of self-regulation skills than controls at posttreatment. Increases in PA from baseline to posttreatment were not mediated by any intermediate variables. However, maintenance of PA from posttreatment to followup (6 months later) was mediated by greater autonomous motivation and use of self-regulation skills. Greater autonomous motivation and use of self-regulation skills predict maintenance of PA following a motivational interviewing and self-regulation coaching intervention. In promoting PA among patients with RA, supporting patient autonomy and teaching self-regulation skills, which focus attention on achieving PA goals, may improve long-term maintenance of PA. © 2016, American College of Rheumatology.

Factors Affecting Initial Intimate Partner Violence-Specific Health Care Seeking in the Tokyo Metropolitan Area, Japan.

PubMed

Kamimura, Akiko; Bybee, Deborah; Yoshihama, Mieko

2014-09-01

This study examined the factors affecting a women's initial intimate partner violence (IPV)-specific health care seeking event which refers to the first health care seeking as a result of IPV in a lifetime. Data were collected using the Life History Calendar method in the Tokyo metropolitan area from 101 women who had experienced IPV. Discrete-time survival analysis was used to assess the time to initial IPV-specific health care seeking. IPV-related injury was the most significant factor associated with increased likelihood of seeking IPV-specific health care seeking for the first time. In the presence of a strong effect of formal help seeking, physical and sexual IPV were no longer significantly related to initial IPV-specific health care seeking. The results suggest some victims of IPV may not seek health care unless they get injured. The timing of receiving health care would be important to ensure the health and safety of victims. © The Author(s) 2014.

Assessment of musculoskeletal physical examination skills and attitudes of orthopaedic residents.

PubMed

Beran, Matthew C; Awan, Hisham; Rowley, David; Samora, Julie Balch; Griesser, Michael J; Bishop, Julie Y

2012-03-21

Although the musculoskeletal physical examination is an essential part of patient encounters, we believe that it is underemphasized in residency education and that residents' physical examination skills may be lacking. We sought to assess attitudes regarding teaching of the physical examination in orthopaedic residencies, to assess physical examination knowledge and skills among residents, and to develop a method to track the skill level of residents in order to improve our physical examination curriculum. We created a thirty-question multiple-choice musculoskeletal physical examination test and administered it to our residents. We created a five-question survey assessing attitudes toward physical examination teaching in orthopaedic residencies and distributed it to U.S. orthopaedic department chairs We developed an Objective Structured Clinical Examination (OSCE), in which standardized patients enact four clinical scenarios, to observe and assess physical examination skills. The mean score on the multiple-choice physical examination test was 76% despite the fact that our residents consistently scored above 90% on the Orthopaedic In-Training Examination. Department chairs and residents agreed that, although learning to perform the physical examination is important, there is not enough time in the clinical setting to observe and critique a resident's patient examination. The overall score of our residents on the OSCE was 66%. We have exposed a deficiency in the physical examination knowledge and skills of our residents. Although the musculoskeletal physical examination is a vital practice component, our data indicate that it is likely underemphasized in training. Clinic time alone is likely insufficient for the teaching and learning of the musculoskeletal physical examination.

Perceived risks and benefits of cigarette smoking among Nepalese adolescents: a population-based cross-sectional study.

PubMed

Aryal, Umesh Raj; Petzold, Max; Krettek, Alexandra

2013-03-02

The perceived risks and benefits of smoking may play an important role in determining adolescents' susceptibility to initiating smoking. Our study examined the perceived risks and benefits of smoking among adolescents who demonstrated susceptibility or non susceptibility to smoking initiation. In October-November 2011, we conducted a population-based cross-sectional study in Jhaukhel and Duwakot Villages in Nepal. Located in the mid-hills of Bhaktapur District, 13 kilometers east of Kathmandu, Jhaukhel and Duwakot represent the prototypical urbanizing villages that surround Nepal's major urban centers, where young people have easy access to tobacco products and are influenced by advertising. Jhaukhel and Duwakot had a total population of 13,669, of which 15% were smokers. Trained enumerators used a semi-structured questionnaire to interview 352 randomly selected 14- to 16-year-old adolescents. The enumerators asked the adolescents to estimate their likelihood (0%-100%) of experiencing various smoking-related risks and benefits in a hypothetical scenario. Principal component analysis extracted four perceived risk and benefit components, excluding addiction risk: (i) physical risk I (lung cancer, heart disease, wrinkles, bad colds); (ii) physical risk II (bad cough, bad breath, trouble breathing); (iii) social risk (getting into trouble, smelling like an ashtray); and (iv) social benefit (looking cool, feeling relaxed, becoming popular, and feeling grown-up). The adjusted odds ratio of susceptibility increased 1.20-fold with each increased quartile in perception of physical Risk I. Susceptibility to smoking was 0.27- and 0.90-fold less among adolescents who provided the highest estimates of physical Risk II and social risk, respectively. Similarly, susceptibility was 2.16-fold greater among adolescents who provided the highest estimates of addiction risk. Physical risk I, addiction risk, and social benefits of cigarette smoking related positively, and physical risk II and social risk related negatively, with susceptibility to smoking. To discourage or prevent adolescents from initiating smoking, future intervention programs should focus on communicating not only the health risks but also the social and addiction risks as well as counteract the social benefits of smoking.

The Impact of Microphysics and Planetary Boundary Layer Physics on Model Simulation of U.S. Deep South Summer Convection

NASA Technical Reports Server (NTRS)

McCaul, Eugene W., Jr.; Case, Jonathan L.; Zavodsky, Bradley T.; Srikishen, Jayanthi; Medlin, Jeffrey M.; Wood, Lance

2014-01-01

Inspection of output from various configurations of high-resolution, explicit convection forecast models such as the Weather Research and Forecasting (WRF) model indicates significant sensitivity to the choices of model physics pararneterizations employed. Some of the largest apparent sensitivities are related to the specifications of the cloud microphysics and planetary boundary layer physics packages. In addition, these sensitivities appear to be especially pronounced for the weakly-sheared, multicell modes of deep convection characteristic of the Deep South of the United States during the boreal summer. Possible ocean-land sensitivities also argue for further examination of the impacts of using unique ocean-land surface initialization datasets provided by the NASA Short-term Prediction Research and Transition (SPoRn Center to select NOAAlNWS weather forecast offices. To obtain better quantitative understanding of these sensitivities and also to determine the utility of the ocean-land initialization data, we have executed matrices of regional WRF forecasts for selected convective events near Mobile, AL (MOB), and Houston, TX (HGX). The matrices consist of identically initialized WRF 24-h forecasts using any of eight microphysics choices and any of three planetary boWldary layer choices. The resulting 24 simulations performed for each event within either the MOB or HGX regions are then compared to identify the sensitivities of various convective storm metrics to the physics choices. Particular emphasis is placed on sensitivities of precipitation timing, intensity, and coverage, as well as amount and coverage oflightuing activity diagnosed from storm kinematics and graupel in the mixed phase layer. The results confirm impressions gleaned from study of the behavior of variously configured WRF runs contained in the ensembles produced each spring at the Center for the Analysis and Prediction of Storms, but with the benefit of more straightforward control of the physics package choices. The design of the experiments thus allows for more direct interpretation of the sensitivities to each possible physics combination. The results should assist forecasters in their efforts to anticipate and correct for possible biases in simulated WRF convection patterns, and help the modeling community refine their model parameterizations.

The Impacts of Microphysics and Planetary Boundary Layer Physics on Model Simulations of U. S. Deep South Summer Convection

NASA Technical Reports Server (NTRS)

McCaul, E. W., Jr.; Case, J. L.; Zavodsky, B. T.; Srikishen, J.; Medlin, J. M.; Wood, L.

2014-01-01

Inspection of output from various configurations of high-resolution, explicit convection forecast models such as the Weather Research and Forecasting (WRF) model indicates significant sensitivity to the choices of model physics parameterizations employed. Some of the largest apparent sensitivities are related to the specifications of the cloud microphysics and planetary boundary layer physics packages. In addition, these sensitivities appear to be especially pronounced for the weakly-sheared, multicell modes of deep convection characteristic of the Deep South of the United States during the boreal summer. Possible ocean-land sensitivities also argue for further examination of the impacts of using unique ocean-land surface initialization datasets provided by the NASA Short-term Prediction Research and Transition (SPoRT Center to select NOAA/NWS weather forecast offices. To obtain better quantitative understanding of these sensitivities and also to determine the utility of the ocean-land initialization data, we have executed matrices of regional WRF forecasts for selected convective events near Mobile, AL (MOB), and Houston, TX (HGX). The matrices consist of identically initialized WRF 24-h forecasts using any of eight microphysics choices and any of three planetary boundary layer choices. The resulting 24 simulations performed for each event within either the MOB or HGX regions are then compared to identify the sensitivities of various convective storm metrics to the physics choices. Particular emphasis is placed on sensitivities of precipitation timing, intensity, and coverage, as well as amount and coverage of lightning activity diagnosed from storm kinematics and graupel in the mixed phase layer. The results confirm impressions gleaned from study of the behavior of variously configured WRF runs contained in the ensembles produced each spring at the Center for the Analysis and Prediction of Storms, but with the benefit of more straightforward control of the physics package choices. The design of the experiments thus allows for more direct interpretation of the sensitivities to each possible physics combination. The results should assist forecasters in their efforts to anticipate and correct for possible biases in simulated WRF convection patterns, and help the modeling community refine their model parameterizations.

Physical and psychosocial function in residential aged-care elders: effect of Nintendo Wii Sports games.

PubMed

Keogh, Justin W L; Power, Nicola; Wooller, Leslie; Lucas, Patricia; Whatman, Chris

2014-04-01

This mixed-methods, quasi-experimental pilot study examined whether the Nintendo Wii Sports (NWS) active video game (exergame) system could significantly improve the functional ability, physical activity levels, and quality of life of 34 older adults (4 men and 30 women, 83 ± 8 yr) living in 2 residential aged-care (RAC) centers. Change score analyses indicated the intervention group had significantly greater increases in bicep curl muscular endurance, physical activity levels, and psychological quality of life than the control group (p < .05). Analysis of the quotes underlying the 3 themes (feeling silly, feeling good; having fun; and something to look forward to) suggested that intervention group participants developed a sense of empowerment and achievement after some initial reluctance and anxiousness. They felt that the games were fun and provided an avenue for greater socialization. These results add some further support to the utilization of NWS exergames in the RAC context.

Resisting Unwanted Sexual and Social Advances: Perspectives of College Women and Men.

PubMed

Orchowski, Lindsay M; Gidycz, Christine A; Kraft, Kathryn

2018-06-01

This study examines college men's ( N = 635) and women's ( N = 650) reports of women's resistance against unwanted sexual and social advances. Men completed surveys to assess (a) initiation of unwanted sexual contact with a female partner, (b) initiation of unwanted sexual intercourse with a female partner, (c) sexual situations where a female partner decided she did not want to proceed, (d) encouraging a woman to drink when they were aware that the woman did not want to, and (e) attempting to take a woman to an isolated location against her will. Women completed corresponding questionnaires regarding the receipt of such unwanted advances, the outcome of the situation, and the resistance tactics utilized. Many men (5%-46%) and women (15%-38%) initiated or experienced, respectively, at least one of the five unwanted sexual or social advances. Unwanted sexual and social advances most often stopped as a result of women's verbal and physical resistance. Few advances (0%-8%) stopped as a result of bystander intervention. In addition to decreasing men's likelihood of engaging in unwanted sexual and social advances, these data highlight the importance of educating women on the effectiveness of verbal and physical resistance tactics, and increasing the frequency of prosocial bystander action on college campuses.

Successful treatment of a guitarist with a finger joint injury using instrument-assisted soft tissue mobilization: a case report

PubMed Central

Terry Loghmani, M.; Bayliss, Amy J.; Clayton, Greg; Gundeck, Evelina

2015-01-01

Finger injuries are common and can greatly affect a musician’s quality of life. A 55-year-old man, who had injured the proximal interphalangeal joint of the left index finger 6 months prior to any intervention, was treated with a manual therapy approach incorporating instrument-assisted soft tissue mobilization (IASTM). Initial examination findings included self-reported pain and functional limitations and physical impairments that significantly impeded his ability to play the acoustic guitar. He was treated once a week for 6 weeks with IASTM, joint mobilization, therapeutic exercise, and ice massage. Additionally, a home exercise program and self-care instructions were provided. The patient gained positive outcomes with improvements in pain (Numerical Pain Rating Scale while playing the guitar: initial 5/10, discharge 1/10) and function (Disability Arm Shoulder Hand Sports-Performing Arts Optional Module: initial 75; discharge 6·25), each reaching a minimum clinically important difference. Importantly, he was able to play the guitar with minimal to no pain as desired. Physical measures also improved, including an immediate gain in finger range of motion with IASTM alone. Manual therapy approaches integrating IASTM may provide an effective conservative treatment strategy for patients with finger/hand conditions in the performing arts and other patient populations. PMID:26952165

Diagnosis and initial management of cerebellar infarction.

PubMed

Edlow, Jonathan A; Newman-Toker, David E; Savitz, Sean I

2008-10-01

Cerebellar infarction is an important cause of stroke that often presents with common and non-specific symptoms such as dizziness, nausea and vomiting, unsteady gait, and headache. Accurate diagnosis frequently relies on careful attention to patients' coordination, gait, and eye movements--components of the neurological physical examination that are sometimes omitted or abridged if cerebellar stroke is not specifically being considered. The differential diagnosis is broad, and includes many common and benign causes. Furthermore, early-stage posterior fossa ischaemia is rarely seen with brain CT--the most commonly available initial imaging test that is used for stroke. Insufficient examination and imaging can result in misdiagnosis. However, early correct diagnosis is crucial to help prevent treatable but potentially fatal complications, such as brainstem compression and obstructive hydrocephalus. The identification and treatment of the underlying vascular lesions at an early stage can also prevent subsequent occurrences of stroke and improve patients' outcomes. Here, we review the clinical presentation of cerebellar infarction, from diagnosis and misdiagnosis to patients' monitoring, treatment, and potential complications.

Nonspecific verbal cues alleviate forgetting by young children.

PubMed

Morgan, Kirstie; Hayne, Harlene

2007-11-01

Verbal reminders play a pervasive role in memory retrieval by human adults. In fact, relatively nonspecific verbal information (e.g. 'Remember the last time we ate at that restaurant?') will often cue vivid recollections of a past event even when presented outside the original encoding context. Although research has shown that memory retrieval by young children can be initiated by physical cues and by highly specific verbal cues, the effect of less specific verbal cues is not known. Using a Visual Recognition Memory (VRM) procedure, we examined the effect of nonspecific verbal cues on memory retrieval by 4-year-old children. Our findings showed that nonspecific verbal cues were as effective as highly specific nonverbal cues in facilitating memory retrieval after a 2-week delay. We conclude that, at least by 4 years of age, children are able to use nonspecific verbal reminders to cue memory retrieval, and that the VRM paradigm may be particularly valuable in examining the age at which this initially occurs.

Osteolytic bone lesions, severe hypercalcemia without circulating blasts: unusual presentation of childhood acute lymphoblastic leukemia

PubMed Central

Bechir, Achour; Haifa, Regaieg; Atef, Ben Abdelkader; Emna, Bouslema; Asma, Achour; Nesrine, Ben Sayed; Yosra, Ben Youssef; Abdrrahim, Khelif

2017-01-01

Hypercalcemia and severe osteolytic lesions are rare complications of acute lymphoblastic leukemia (ALL) in childhood. We report a case of a 3 years old boy who presented with prolonged fever, nausea, vomiting and increasing lower limbs pain. Skeletal X-rays and CT scan showed severe osteolytic lesions of the skull and extremities. Her physical examination showed multiple cervical lymph nodes. In laboratory tests, he had severe hypercalcemia. Parathyroid hormone (PTH) was not elevated. Despite the absence of circulating blasts, bone marrow biopsy revealed B-precursor (ALL). Hypercalcemia was initially treated with intravenous isotonic sodium chloride solution and diuretics but the serum calcium level normalized only after the beginning of corticosteroids and chemotherapy. The child responded initially to chemotherapy and eventually relapsed and died of septic shock. Acute leukemia must be considered in differential diagnosis in patients with hypercalcemia. A detailed examination even when there no circulating blasts in their peripheral blood smear, and if in doubt bone marrow aspiration should must be taken into consideration. PMID:28690758

Ecological Immunology through the Lens of Exercise Immunology: New Perspective on the Links between Physical Activity and Immune Function and Disease Susceptibility in Wild Animals.

PubMed

van Dijk, Jacintha G B; Matson, Kevin D

2016-08-01

Locomotion and other physical activities by free-living animals may influence immune function and disease susceptibility. This influence may be a consequence of energetic trade-offs or other mechanisms that are often, but not always, inseparably linked to an animal's life history (e.g., flight and migration). Ecological immunology has mainly focused on these life-history trade-offs, overlooking the possible effects of physical activity per se on immune function and disease susceptibility. In this review, we explore the field of exercise immunology, which examines the impact of exercise on immune function and disease susceptibility in humans, with the aim of presenting new perspectives that might be transferable to ecological immunology. First, we explore key concepts in exercise immunology that could be extended to animals. Next, we investigate the concept "exercise" in animals, and propose the use of "physical activity" instead. We briefly discuss methods used in animals to quantify physical activity in terms of energy expenditure and summarize several examples of animals engaging in physical activity. Then, we highlight potential consequences of physical activity on immune function and disease susceptibility in animals, together with an overview of animal studies that examine these links. Finally, we explore and discuss the potential for incorporating perspectives from exercise immunology into ecological immunology. Such integration could help advance our understanding of human and animal health and contribute new ideas to budding "One Health" initiatives. © The Author 2016. Published by Oxford University Press on behalf of the Society for Integrative and Comparative Biology. All rights reserved. For permissions please email: journals.permissions@oup.com.

A Mokken scale analysis of the peer physical examination questionnaire.

PubMed

Vaughan, Brett; Grace, Sandra

2018-01-01

Peer physical examination (PPE) is a teaching and learning strategy utilised in most health profession education programs. Perceptions of participating in PPE have been described in the literature, focusing on areas of the body students are willing, or unwilling, to examine. A small number of questionnaires exist to evaluate these perceptions, however none have described the measurement properties that may allow them to be used longitudinally. The present study undertook a Mokken scale analysis of the Peer Physical Examination Questionnaire (PPEQ) to evaluate its dimensionality and structure when used with Australian osteopathy students. Students enrolled in Year 1 of the osteopathy programs at Victoria University (Melbourne, Australia) and Southern Cross University (Lismore, Australia) were invited to complete the PPEQ prior to their first practical skills examination class. R, an open-source statistics program, was used to generate the descriptive statistics and perform a Mokken scale analysis. Mokken scale analysis is a non-parametric item response theory approach that is used to cluster items measuring a latent construct. Initial analysis suggested the PPEQ did not form a single scale. Further analysis identified three subscales: 'comfort', 'concern', and 'professionalism and education'. The properties of each subscale suggested they were unidimensional with variable internal structures. The 'comfort' subscale was the strongest of the three identified. All subscales demonstrated acceptable reliability estimation statistics (McDonald's omega > 0.75) supporting the calculation of a sum score for each subscale. The subscales identified are consistent with the literature. The 'comfort' subscale may be useful to longitudinally evaluate student perceptions of PPE. Further research is required to evaluate changes with PPE and the utility of the questionnaire with other health profession education programs.

Survivors of childhood cancer and comparison peers: the influence of early family factors on distress in emerging adulthood.

PubMed

Robinson, Kristen E; Gerhardt, Cynthia A; Vannatta, Kathryn; Noll, Robert B

2009-02-01

This prospective study examines family predictors of distress among survivors of childhood cancer and comparison peers during the transition to emerging adulthood. Children with cancer (n = 55), comparison peers (n = 60), and parents completed measures of distress, family environment, social support, and demographic characteristics during initial treatment, as well as follow-up measures of young adult distress and demographic characteristics soon after participants turned 18 years old. Severity of initial treatment and late effects were rated by healthcare providers for participants with cancer. For all participants, mother and father report of initial parent distress was associated with their report of young adult distress at follow-up. Young adult gender moderated this association. For survivors of childhood cancer, severity of initial treatment and late effects also moderated the association between parent and young adult distress. Improving parent distress may help reduce child distress in general. For survivors specifically, ameliorating the impact of initial treatment and long-term physical problems may be beneficial. Copyright 2009 APA, all rights reserved.

Synthesis and testing of ZnO nanoparticles for photo-initiation: experimental observation of two different non-migration initiators for bulk polymerization

NASA Astrophysics Data System (ADS)

Schmitt, M.

2015-05-01

The migration and transport of polymerization initiators are problematic for commercially used polymerization procedures. For example, UV printing of packaging generates products with potentially harmful components that come in contact with food. Enlarging the size of the initiator is the only way to prevent contamination, e.g., by gas phase transport. In this manuscript, the synthesis and advanced and full analyses of novel nanoparticle-based types of non-migration, fragmenting and non-fragmenting photo-initiators will be presented in detail. This study introduces non-fragmenting/``Norrish type II'' and fragmenting/``Norrish type I'' ZnO nanoparticle-based initiators and compares them with two commercial products, a ``Norrish type I'' initiator and a ``Norrish type II'' initiator. Therefore, inter alia, the recently developed analysis involves examining the solidification by UV-vis and the double bond content by Raman. Irradiation is performed using absolute and spectrally calibrated xenon flash lights. A novel procedure for absolute and spectral calibration of such light sources is also presented. The non-optimized ``Norrish type II'' particle-based initiator is already many times faster than benzophenone, which is a molecular initiator of the same non-fragmenting type. This experimentally observed difference in reactive particle-based systems without co-initiators is unexpected. Co-initiators are normally an additional molecular species, which leads to migration problems. The discovery of significant initiation potential resulting in a very well-dispersed organic-inorganic hybrid material suggests a new field of research opportunities at the interface of physical chemistry, polymer chemistry and engineering science, with enormous value for human health.The migration and transport of polymerization initiators are problematic for commercially used polymerization procedures. For example, UV printing of packaging generates products with potentially harmful components that come in contact with food. Enlarging the size of the initiator is the only way to prevent contamination, e.g., by gas phase transport. In this manuscript, the synthesis and advanced and full analyses of novel nanoparticle-based types of non-migration, fragmenting and non-fragmenting photo-initiators will be presented in detail. This study introduces non-fragmenting/``Norrish type II'' and fragmenting/``Norrish type I'' ZnO nanoparticle-based initiators and compares them with two commercial products, a ``Norrish type I'' initiator and a ``Norrish type II'' initiator. Therefore, inter alia, the recently developed analysis involves examining the solidification by UV-vis and the double bond content by Raman. Irradiation is performed using absolute and spectrally calibrated xenon flash lights. A novel procedure for absolute and spectral calibration of such light sources is also presented. The non-optimized ``Norrish type II'' particle-based initiator is already many times faster than benzophenone, which is a molecular initiator of the same non-fragmenting type. This experimentally observed difference in reactive particle-based systems without co-initiators is unexpected. Co-initiators are normally an additional molecular species, which leads to migration problems. The discovery of significant initiation potential resulting in a very well-dispersed organic-inorganic hybrid material suggests a new field of research opportunities at the interface of physical chemistry, polymer chemistry and engineering science, with enormous value for human health. Electronic supplementary information (ESI) available: Multiple additional figures and images concerning the synthesis, characterization, data evaluation, TEMs and ESR spectra are available free of charge. See DOI: 10.1039/c5nr00850f

Providing a Virtual Initiation for Epsilon Pi Tau

ERIC Educational Resources Information Center

Sanders, Craig S.; Griffin, Kathryn M.

2005-01-01

One of the requirements of the Epsilon Pi Tau (EPT) initiation is the apprentice has to physically be at the initiation (EPT, 2004). Since the majority of nontraditional students and working professionals are physically removed from an initiation site, they have missed the opportunity to join EPT. On 8 April, 2005, the Beta Mu Chapter of The…

Cardiac rehabilitation and the therapeutic environment: the importance of physical, social, and symbolic safety for programme participation among women.

PubMed

Sutton, Erica J; Rolfe, Danielle E; Landry, Mireille; Sternberg, Leonard; Price, Jennifer A D

2012-08-01

To report an exploration of the multidimensionality of safety in cardiac rehabilitation programmes as perceived by women who were enrolled in the Women's Cardiovascular Health Initiative in Toronto, Canada. Cardiovascular disease is the leading cause of death among women. Although cardiac rehabilitation is clinically effective, significantly fewer women than men participate in available programmes. The literature identifies factors affecting women's cardiac rehabilitation participation, and provides possible explanations for this gender disparity. Although safety is mentioned among the barriers to women's cardiac rehabilitation participation, the extent to which safety contributes to programme participation, completion, and maintenance remains under-explored in the cardiac rehabilitation literature. We conducted an exploratory qualitative study to examine the role safety and place play for women engaged in cardiac prevention and rehabilitation at the Women's Cardiovascular Health Initiative. Methods.  From 2005-2006, 14 participants engaged in semi-structured, qualitative interviews lasting 30-90 minutes. Discussions addressed women's experiences at the Women's Cardiovascular Health Initiative. Interview transcripts were analysed using thematic analysis. Three themes were developed: 'Safety', which was sub-categorized according to physical, social, and symbolic interpretations of safety, 'searching for a sense of place', and 'confidence and empowerment'. Feeling physically, socially, and symbolically safe in one's cardiac rehabilitation environment may contribute to programme adherence and exercise maintenance for women. Focusing on comprehensive notions of safety in future cardiac rehabilitation research could offer insight into why many women do not maintain an exercise regimen in currently structured cardiac rehabilitation and community programmes. © 2012 Blackwell Publishing Ltd.

Child, family, and neighborhood associations with parent and peer interactive play during early childhood.

PubMed

Kenney, Mary Kay

2012-04-01

To examine national patterns of peer and parent interactive play opportunities that enhance early learning/socialization. Bivariate and multivariable analyses of cross-sectional data on 22,797 children aged 1-5 years from the National Survey of Children's Health 2007 were performed to determine the child, family, and neighborhood factors associated with four parent-initiated activities. Outcomes measures included time (days/week) children spent: participating in peer play; being read to; sung to/told stories; and taken on family outings. Covariates included race/ethnicity, poverty, TV watching, childcare, child and maternal physical and mental health, family factors (structure, size, language, stress, education), and neighborhood factors (amenities, support, physical condition, safety). According to adjusted regression models, minority children from lower income, non-English-speaking households with limited education, poorer maternal health and greater parenting stress were read to/told stories less than children without these characteristics, while neighborhood factors exerted less influence. In contrast, significant reductions in days/week of peer play were associated with unsupportive neighborhoods and those with the poorest physical conditions and limited amenities. Likewise, reductions in outings were associated with fewer neighborhood amenities. The findings of this study indicate that a variety of child, family, and neighborhood factors are associated with parent-initiated behaviors such as reading, storytelling, peer interactive play, and family outings. Appropriate evidence-based home visiting interventions targeting child health, parenting skills, early childhood education, and social services in at-risk communities would appear to be appropriate vehicles for addressing such parent-initiated play activities that have the potential to enhance development.

Physically-Derived Dynamical Cores in Atmospheric General Circulation Models

NASA Technical Reports Server (NTRS)

Rood, Richard B.; Lin, Shian-Jiann

1999-01-01

The algorithm chosen to represent the advection in atmospheric models is often used as the primary attribute to classify the model. Meteorological models are generally classified as spectral or grid point, with the term grid point implying discretization using finite differences. These traditional approaches have a number of shortcomings that render them non-physical. That is, they provide approximate solutions to the conservation equations that do not obey the fundamental laws of physics. The most commonly discussed shortcomings are overshoots and undershoots which manifest themselves most overtly in the constituent continuity equation. For this reason many climate models have special algorithms to model water vapor advection. This talk focuses on the development of an atmospheric general circulation model which uses a consistent physically-based advection algorithm in all aspects of the model formulation. The shallow-water model is generalized to three dimensions and combined with the physics parameterizations of NCAR's Community Climate Model. The scientific motivation for the development is to increase the integrity of the underlying fluid dynamics so that the physics terms can be more effectively isolated, examined, and improved. The expected benefits of the new model are discussed and results from the initial integrations will be presented.

Physically-Derived Dynamical Cores in Atmospheric General Circulation Models

NASA Technical Reports Server (NTRS)

Rood, Richard B.; Lin, Shian-Kiann

1999-01-01

The algorithm chosen to represent the advection in atmospheric models is often used as the primary attribute to classify the model. Meteorological models are generally classified as spectral or grid point, with the term grid point implying discretization using finite differences. These traditional approaches have a number of shortcomings that render them non-physical. That is, they provide approximate solutions to the conservation equations that do not obey the fundamental laws of physics. The most commonly discussed shortcomings are overshoots and undershoots which manifest themselves most overtly in the constituent continuity equation. For this reason many climate models have special algorithms to model water vapor advection. This talk focuses on the development of an atmospheric general circulation model which uses a consistent physically-based advection algorithm in all aspects of the model formulation. The shallow-water model of Lin and Rood (QJRMS, 1997) is generalized to three dimensions and combined with the physics parameterizations of NCAR's Community Climate Model. The scientific motivation for the development is to increase the integrity of the underlying fluid dynamics so that the physics terms can be more effectively isolated, examined, and improved. The expected benefits of the new model are discussed and results from the initial integrations will be presented.

Adolescents' perspectives on the barriers and facilitators of physical activity: a systematic review of qualitative studies.

PubMed

Martins, João; Marques, Adilson; Sarmento, Hugo; Carreiro da Costa, Francisco

2015-10-01

This article examined qualitative studies of adolescents' perspectives about the facilitators and barriers of physical activity, published from 2007 to 2014. A systematic review of 'Web of Science', 'EBSCO', 'Psychinfo' and 'ERIC' databases was performed according to Preferred Reporting Items for Systematic reviews and Meta-analyses guidelines. The following keywords were used: 'physical activity' and 'physical education', each one individually associated with 'correlate', 'determinant', 'facilitator', 'barrier', 'factor influen*', and with 'qualitative', 'focus group', 'interview', "narrative'. Out of 3815 studies initially identified, due to inclusion and quality criteria, only 12 were fully reviewed. Studies' outcomes were analyzed through thematic analysis. The majority of these reported research with young adolescent girls. Few studies have considered the socioeconomic status influence. According to young people's perspectives, the main facilitators and hampering factors to their participation in physical activity were the following: attitude toward physical activity; motivation; perceptions of competence and body image; fun; influence of friends, family and physical education teachers and environmental physical activity opportunities. Specific life transition periods were referred only as a barrier to physical activity. Strategies of pedagogical actions and for developing physical activity intervention programs were discussed, in order to effectively promote the adoption of active lifestyles among youth. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Early Socioeconomic Adversity and Young Adult Physical Illness: The Role of Body Mass Index and Depressive Symptoms

PubMed Central

Wickrama, K. A. S.; Kwon, Josephine A.; Oshri, Assaf; Lee, Tae Kyoung

2014-01-01

Purpose The present study investigated the psycho-physiological inter and intra-individual processes that mediate the linkage between childhood/adolescent socioeconomic adversities and adult health outcomes. Specifically, the proposed model examined the roles of youth depressive symptoms and BMI trajectories as mediators that explain the link between early adversity and young adults’ general health and physical illnesses after controlling for gender, race/ethnicity, and earlier general health reports. Methods Using a nationally representative sample of 12,424 from National Longitudinal Study of Adolescent Health (Add Health), this study used growth curve modeling to consider both the severity (initial level) as well as the change over time (deterioration or elevation) as psycho-physiological mediators, thereby acknowledging multiple facets of depressive symptoms and BMI trajectories as psych-physiological mediators of early adversity to adult health. Results Results provide evidence for (a) the influence of early childhood and early adolescent cumulative socioeconomic adversity on both the initial levels and changes over time of depressive symptoms and BMI and (b) the independent influences depressive symptoms and BMI trajectories on the general health and the physical illnesses of young adults Conclusions These findings contribute valuable knowledge to existing research by elucidating how early adversity exerts an enduring long-term influence on physical health problems in young adulthood; further, this information suggests effective intervention and prevention programs should incorporate multiple facets (severity and change over time) of multiple mechanisms (psychological and physiological). PMID:24856408

Effectiveness of the Pasos Adelante chronic disease prevention and control program in a US-Mexico border community, 2005-2008.

PubMed

Staten, Lisa K; Cutshaw, Christina A; Davidson, Christopher; Reinschmidt, Kerstin; Stewart, Rosie; Roe, Denise J

2012-01-01

Pasos Adelante is a lifestyle intervention program facilitated by community health workers (promotores) targeting chronic disease prevention and control in Mexican Americans. Initial studies of Pasos Adelante indicated significant improvements in self-reported nutrition and physical activity. This study examined whether Pasos Adelante participants living in a US border community showed improvements in selected physiological measures after participating in the program and whether changes were maintained at 3-month follow-up. The program took place in 12-week sessions from January 2005 to May 2008 and included walking groups and education targeting nutrition and physical activity. Questionnaires, anthropometric measures, and laboratory tests were conducted at baseline (n = 305), conclusion of program (n = 254), and 3-month follow-up (n = 221). Participants demonstrated decreases in body mass index (P = .04), waist and hip circumference (P < .001), diastolic and systolic blood pressure (P < .001), and total cholesterol (P = .008) from baseline to program conclusion. No values worsened significantly between program conclusion and follow-up, except systolic blood pressure. Glucose levels improved between conclusion and follow-up (P = .01). These results support the initial findings of improvements in participants' self-reported physical activity and nutrition patterns through changes in objective measures. This evidence-based program demonstrates the potential for a promotores-facilitated chronic disease prevention and control program to improve physical health and targets both primary and secondary prevention in Hispanic communities and organizations.

Characteristics of difficult-to-place youth in state custody: a profile of the Exceptional Care Pilot Project population.

PubMed

Armour, Marilyn P; Schwab, James

2007-01-01

This study examines the characteristics of Texas youth designated as 'most difficult to place' recipients of service under the "Exceptional Care Pilot Project" (N = 46). Findings include, among others, high levels of comorbid psychiatric disturbance (> 3 diagnostic groupings), physical (78.3%) and sexual (88%) maltreatment, and placement breakdowns (m = 4.8 therapeutic placements). This initial profile of the population provides a base for helping other states identify and plan for the needs of their most troubled youth.

Wound management in rodents.

PubMed

Langlois, Isabelle

2004-01-01

Successful wound management requires appropriate evaluation of the wound at the time of initial physical examination, an all throughout the healing process. Factors affecting wound healing need to be identified though a complete patient history and addressed to ensure proper healing. The clinician must have current knowledge of topical medications and bandages available and their clinical applications according to the stage of healing. It is essential to remember that wounds are painful; therefore, analgesics should be administered to render the animal pain-free during wound cleaning, debridement, bandaging, and surgical procedures.

Human Trafficking, Sexual Assault, or Something Else? A Complicated Case With an Unexpected Outcome.

PubMed

Scott-Tilley, Donna; Crites, Heather

This case report presents a patient who presented multiple times with vaginal injuries and bleeding, reporting sexual assault with a foreign object. Findings from her history and physical examination were consistent with sexual assault and human trafficking. The outcome of this case was not what we initially expected when the patient first presented for care. However, the patient ultimately received the care she needed. This case illuminates the need for excellent continuing education, interdisciplinary communication, and continuity of care.

Physical and social environmental characteristics of physical activity for Mexican-origin children: examining differences between school year and summer perceptions.

PubMed

Umstattd Meyer, M Renée; Walsh, Shana M; Sharkey, Joseph R; Morgan, Grant B; Nalty, Courtney C

2014-09-16

Colonias are substandard residential areas along the U.S.-Mexico border. Families of Mexican-origin living in colonias face health burdens characterized by environmental and socioeconomic hardships. Mexican Americans and low-income families, including colonias children, do not frequently participate in physical activity despite the known link to disease risk reduction. For colonias children, schools are the most commonly reported location for physical activity. School closures and extreme temperatures during summer months create a need to explore seasonal differences in environmental supports and barriers in this population. The purpose of this study was to examine the effect of seasonality on perceived environmental barriers, opportunities, and social support for physical activity among colonias children. As a secondary aim, mother-child discordance for each factor was analyzed. Promotora-researchers recruited mother-child dyads (n=101 dyads, n=202 participants) from colonias in Hidalgo County, Texas. Mothers and children were separately administered surveys at two time points to capture perceived barriers, opportunities, and social support for physical activity (school-year: February-May; summertime: July-August). Summative scores for each outcome were calculated and three multilevel longitudinal models for continuous outcomes were examined; children were nested within households. Mother-child discordance was measured using Cohen's Kappa statistic. Physical activity barriers and environmental opportunities (household and neighborhood) increased from school-year to summer by 1.16 and 2.83 points respectively (p≤0.01), after adjusting for covariates. Significant predictors of increased barriers included household income of >$900/month and having more household members. Children of mothers with significant others who were employed part-time or full-time saw significant decreases in barriers. Mother-child agreement of barriers, environmental opportunities, and social support across seasons was slight to fair (range: median κ=0.047 to κ=0.262). These results suggest a complex relationship between dimensions of economic hardship (employment status, household income, etc…) and perceived opportunities and barriers of children's physical activity engagement during the school-year and summer. In this study, both barriers and opportunities increased from school-year to summer, further demonstrating that interactions among these characteristics need to be better understood and addressed when considering physical activity initiatives for colonias and other Mexican-American children, specifically during summer when school-based physical activity resources are unavailable.

46 CFR 11.709 - Annual physical examination requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 1 2010-10-01 2010-10-01 false Annual physical examination requirements. 11.709 Section... REQUIREMENTS FOR OFFICER ENDORSEMENTS Professional Requirements for Pilots § 11.709 Annual physical examination... physical examination each year. (c) Each annual physical examination must meet the requirements specified...

46 CFR 11.709 - Annual physical examination requirements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 1 2011-10-01 2011-10-01 false Annual physical examination requirements. 11.709 Section... REQUIREMENTS FOR OFFICER ENDORSEMENTS Professional Requirements for Pilots § 11.709 Annual physical examination... physical examination each year. (c) Each annual physical examination must meet the requirements specified...

46 CFR 11.709 - Annual physical examination requirements.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 1 2012-10-01 2012-10-01 false Annual physical examination requirements. 11.709 Section... REQUIREMENTS FOR OFFICER ENDORSEMENTS Professional Requirements for Pilots § 11.709 Annual physical examination... physical examination each year. (c) Each annual physical examination must meet the requirements specified...

46 CFR 11.709 - Annual physical examination requirements.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 1 2013-10-01 2013-10-01 false Annual physical examination requirements. 11.709 Section... REQUIREMENTS FOR OFFICER ENDORSEMENTS Professional Requirements for Pilots § 11.709 Annual physical examination... physical examination each year. (c) Each annual physical examination must meet the requirements specified...

[Factors influencing the effectiveness of physical rehabilitation after myocardial infarction].

PubMed

Sumin, A N; Beresneva, V L; Enina, T N; Verkhoshapova, T N; Kabova, E A; Valeeva, V I; Shapaurina, N V

2007-01-01

The aim of the study was to compare initial clinical, hemodynamic, and vegetative parameters in patients with myocardial infarction (MI) who had undergone physical rehabilitation with different results. The subjects were 106 male patients aged 48.6 +/- 0.95 years undergoing sanatorium rehabilitation after MI. According to the dynamics of exercise tolerance (ET) during the course of treatment, the subjects were divided into three groups: group one consisted of 39 patients with a significant ET growth of more than 10W, group two consisted of 47 patients with no changes in ET or its insignificant growth of less than 10W, and group three consisted of 20 patients with a decrease in ET revealed during a repeated test. In group three patients, the initial EchoCG examination revealed a higher degree of myocardial lesion, which was manifested by lowered ejection fraction and sphericity index, increased end-diastolic volume, and increased degree of left ventricular (LV) asynergy. Furthermore, day-time ventricular extrasystoles were more frequent in these patients; the number of patients with large-focal MI, LV aneurysm, and post-infarction stenocardia was also higher in group three. Correlation and multiple step regression analysis revealed that both initial parameters of vegetative nervous system, data from initial load test, and the EchoCG measurements of the right atrium were associated with the degree of ET growth according to VEM results. The data from the study are able to help individualize rehabilitation of MI patients, especially those with severe myocardial lesion.

Initiation of traditional birth attendants and their traditional and spiritual practices during pregnancy and childbirth in Ghana.

PubMed

Aziato, Lydia; Omenyo, Cephas N

2018-03-07

Prior to the advent of modern obstetric services, traditional birth attendants (TBAs) have rendered services to pregnant women and women in labour for a long time. Although it is anticipated that women in contemporary societies will give birth in hospitals and clinics, some women still patronize the services of TBAs. The study therefore sought to gain an in-depth understanding of the initiation of TBAs and their traditional and spiritual practices employed during pregnancy and childbirth in Ghana. The design was an exploratory qualitative one using in-depth individual interviews. Data saturation was reached with 16 participants who were all of Christian faith. Interviews were conducted with a semi-structured interview guide, audiotaped and transcribed verbatim. Content analysis was employed to generate findings. The findings showed that TBAs were initiated through apprenticeship from family members who were TBAs and other non-family TBAs as well as through dreams and revelations. They practice using both spiritual and physical methods and their work was founded on spiritual directions, use of spiritual artefacts, herbs and physical examination. TBAs delay cutting of the cord and disposal of the placenta was associated with beliefs which indicated that when not properly disposed, it will have negative consequences on the child during adulthood. Although, TBAs like maternal health professionals operate to improve maternal health care, some of their spiritual practices and beliefs may pose threats to their clients. Nonetheless, with appropriate initiation and training, they can become useful.

Long-term prognosis of acute lateral ankle ligamentous sprains: high incidence of recurrences and residual symptoms.

PubMed

Kemler, Ellen; Thijs, Karin M; Badenbroek, Ilse; van de Port, Ingrid G L; Hoes, Arno W; Backx, Frank J G

2016-12-01

Acute lateral ankle ligamentous sprains (ALALS) are common injuries. This injury does not always have a favourable long-term outcome. Studies reporting the prognosis of ALALS after functional treatment are scarce. To determine the prognosis of functionally treated ALALS, in terms of recurrent ALALS and residual symptoms. Retrospective cohort study. Patients were recruited from 20 family practices, nine physical therapy practices, the emergency departments of a regional hospital and a university hospital. Adult patients with an ALALS caused by an inversion trauma were invited to participate in this study 2.5-5 years after their initial injury. Functional treatment of the initial ALALS. Acute lateral ankle ligamentous sprain recurrences and residual symptoms. A total of 44 patients were included, with an average follow-up period after the initial ankle sprain of 204 weeks (range 150-274 weeks). Eight patients (18.1%) had reinjured their ankle. Explicit pain around the ankle joint at physical examination was experienced by 45.5%. Clinical symptoms of anterior ankle impingement were present in 25% (all athletes), with radiologically confirmed tibiotalar osteophyte bone formation in 82% of them. A large proportion of patients with ALALS experience recurrences and persistent symptoms after their initial ankle injury. The high percentage of patients with anterior ankle impingement syndromes illustrates the need for early assessment of this impairment in patients with persistent complaints. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Childhood maltreatment and early alcohol use among high-risk adolescents.

PubMed

Hamburger, Merle E; Leeb, Rebecca T; Swahn, Monica H

2008-03-01

Child maltreatment (CM) is prevalent among U.S. youth and has been associated with subsequent maladaptive behaviors, including substance use. The current study examines the associations between early child maltreatment and (1) preteen alcohol-use initiation and (2) heavy episodic drinking among students in a large study of adolescents. The Youth Violence Survey is a cross-sectional survey of public school students enrolled in Grades 7,9, 11, and 12 in a school district in a high-risk community. The analysis sample was limited to students who provided complete data on all relevant variables (N= 3,559). Fifty-two percent of the analysis sample was female. Early child maltreatment was defined as witnessing domestic violence and experiencing physical and/or sexual abuse before the age of 10 years. Outcome variables include ever drinking alcohol, preteen alcohol-use initiation, and heavy episodic drinking. Witnessing domestic violence, experiencing physical abuse, and experiencing sexual abuse were significantly associated with preteen alcohol-use initiation (adjusted odds ratio [AOR] = 1.55, 95% confidence interval [CI]: 1.26-1.91; AOR = 2.10, 95% CI: 1.69-2.63; AOR = 1.57, 95% CI: 1.16-2.14, respectively). Students who experienced one or more types of maltreatment were 1.5-3 times more likely to report preteen alcohol-use initiation. Heavy episodic drinking was associated only with childhood sexual abuse in boys (AOR = 2.62, 95% CI: 1.52-4.50). Prevention and treatment of the negative impact of early child maltreatment may delay and reduce alcohol use.

Major initiatives related to childhood obesity and physical inactivity in Canada: the year in review.

PubMed

Tremblay, Mark S

2012-01-01

This manuscript briefly reviews 15 significant initiatives related to childhood obesity and physical inactivity in Canada between September 2010 and September 2011. These include the: announcement of a Federal-Provincial-Territorial framework for action to promote healthy weights; implementation of the nutrition labeling initiative; launch of the CBC "Live Right Now" campaign; announcement of the Public Health Agency of Canada's innovation strategy funding related to obesity; publication of the Canadian Health Measures Survey physical activity findings; release of new Canadian physical activity and sedentary behaviour guidelines; launch of ParticipACTION's "Think Again" campaign; workshop on building trust to address the epidemic of obesity; start of the Canadian Pediatric Weight Management Registry; initiation of "Our Health Our Future: A National Dialogue on Healthy Weights"; release of the Active Healthy Kids Canada Report Card on Physical Activity for Children and Youth; National Obesity Summit; Nature Play Day and Sports Day in Canada; development of the Canadian Assessment of Physical Literacy; and the creation of Active Canada 20/20--A National Physical Activity Plan. The diversity and intensity of activity addressing the childhood obesity and physical inactivity "epidemic" in Canada is encouraging and must be maintained and enhanced.

Occult Breast Cancer: Scintimammography with High-Resolution Breast-specific Gamma Camera in Women at High Risk for Breast Cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rachel F. Brem; Jocelyn A. Rapelyea; , Gilat Zisman

2005-08-01

To prospectively evaluate a high-resolution breast-specific gamma camera for depicting occult breast cancer in women at high risk for breast cancer but with normal mammographic and physical examination findings. MATERIALS AND METHODS: Institutional Review Board approval and informed consent were obtained. The study was HIPAA compliant. Ninety-four high-risk women (age range, 36-78 years; mean, 55 years) with normal mammographic (Breast Imaging Reporting and Data System [BI-RADS] 1 or 2) and physical examination findings were evaluated with scintimammography. After injection with 25-30 mCi (925-1110 MBq) of technetium 99m sestamibi, patients were imaged with a high-resolution small-field-of-view breast-specific gamma camera in craniocaudalmore » and mediolateral oblique projections. Scintimammograms were prospectively classified according to focal radiotracer uptake as normal (score of 1), with no focal or diffuse uptake; benign (score of 2), with minimal patchy uptake; probably benign (score of 3), with scattered patchy uptake; probably abnormal (score of 4), with mild focal radiotracer uptake; and abnormal (score of 5), with marked focal radiotracer uptake. Mammographic breast density was categorized according to BI-RADS criteria. Patients with normal scintimammograms (scores of 1, 2, or 3) were followed up for 1 year with an annual mammogram, physical examination, and repeat scintimammography. Patients with abnormal scintimammograms (scores of 4 or 5) underwent ultrasonography (US), and those with focal hypoechoic lesions underwent biopsy. If no lesion was found during US, patients were followed up with scintimammography. Specific pathologic findings were compared with scintimammographic findings. RESULTS: Of 94 women, 78 (83%) had normal scintimammograms (score of 1, 2, or 3) at initial examination and 16 (17%) had abnormal scintimammograms (score of 4 or 5). Fourteen (88%) of the 16 patients had either benign findings at biopsy or no focal abnormality at US; in two (12%) patients, invasive carcinoma was diagnosed at US-guided biopsy (9 mm each at pathologic examination). CONCLUSION: High-resolution breast-specific scintimammography can depict small (<1-cm), mammographically occult, nonpalpable lesions in women at increased risk for breast cancer not otherwise identified at mammography or physical examination.« less

Physical Activity as a Vital Sign: A Systematic Review

PubMed Central

Allen, Kelli D.; Ambrose, Kirsten R.; Stiller, Jamie L.; Evenson, Kelly R.; Voisin, Christiane; Hootman, Jennifer M.; Callahan, Leigh F.

2017-01-01

Introduction Physical activity (PA) is strongly endorsed for managing chronic conditions, and a vital sign tool (indicator of general physical condition) could alert providers of inadequate PA to prompt counseling or referral. This systematic review examined the use, definitions, psychometric properties, and outcomes of brief PA instruments as vital sign measures, with attention primarily to studies focused on arthritis. Methods Electronic databases were searched for English-language literature from 1985 through 2016 using the terms PA, exercise, vital sign, exercise referral scheme, and exercise counseling. Of the 838 articles identified for title and abstract review, 9 articles qualified for full text review and data extraction. Results Five brief PA measures were identified: Exercise Vital Sign (EVS), Physical Activity Vital Sign (PAVS), Speedy Nutrition and Physical Activity Assessment (SNAP), General Practice Physical Activity Questionnaire (GPPAQ), and Stanford Brief Activity Survey (SBAS). Studies focusing on arthritis were not found. Over 1.5 years of using EVS in a large hospital system, improvements occurred in relative weight loss among overweight patients and reduction in glycosylated hemoglobin among diabetic patients. On PAVS, moderate physical activity of 5 or more days per week versus fewer than 5 days per week was associated with a lower body mass index (−2.90 kg/m2). Compared with accelerometer-defined physical activity, EVS was weakly correlated (r = 0.27), had low sensitivity (27%–59%), and high specificity (74%–89%); SNAP showed weak agreement (κ = 0.12); GPPAQ had moderate sensitivity (46%) and specificity (50%), and SBAS was weakly correlated (r = 0.10–0.28), had poor to moderate sensitivity (18%–67%), and had moderate specificity (58%–79%). Conclusion Few studies have examined a brief physical activity tool as a vital sign measure. Initial investigations suggest the promise of these simple and quick assessment tools, and research is needed to test the effects of their use on chronic disease outcomes. PMID:29191260

20 CFR 718.104 - Report of physical examinations.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 4 2012-04-01 2012-04-01 false Report of physical examinations. 718.104... of physical examinations. (a) A report of any physical examination conducted in connection with a... report of physical examination may be based on any other procedures such as electrocardiogram, blood-gas...

A retrospective evaluation of coral snake envenomation in dogs and cats: 20 cases (1996-2011).

PubMed

Pérez, Mayrim L; Fox, Karlie; Schaer, Michael

2012-12-01

To describe the clinical signs, treatment, and outcomes of dogs and cats following envenomation by the eastern coral snake and to report our clinical experience with the use of Coralmyn. Retrospective study (1996-2011). University teaching hospital. Sixteen dogs and 4 cats with eastern coral snake envenomation. Medical records meeting the study inclusion criteria were reviewed and evaluated for signalment, date and time of the snake encounter, elapsed time between encounter and hospital examination, initial physical examination findings, antivenom type, length of hospitalization, and outcome. Initial physical examination findings included: quiet mentation, tetraparesis, ptyalism, tachypnea, abdominal breathing, shallow breathing, decreased to absent gag reflex, ataxia, muscle fasciculations, and decreased spinal reflexes. Laboratory findings in dogs included proteinuria, bilirubinuria, hemeproteinuria, increased aspartate aminotransferase activity, increased alanine aminotransferase activity, and hemolysis. Four dogs and 2 cats received Coralmyn and 4 dogs received North American Coral Snake Antivenom. Adverse reaction to antivenom was suspected in 1 dog that received North American Coral Snake Antivenom. Eight of 11 envenomated dogs survived with a median length of hospitalization of 4.5 days. Two of 3 envenomated cats survived with a median length of hospitalization of 4 days. Two dogs were euthanized, 1 dog suffered acute respiratory arrest, and 1 cat developed tachycardia that progressed to pulseless electrical activity. Five dogs and 1 cat in the encounter group survived to discharge. Diagnosis of eastern coral snake envenomation is likely in the dog that has concomitant lower motor neuron neuropathy, bulbar palsy, and hemolysis. Early diagnosis is crucial as antivenom administration can reduce morbidity. Prognosis is considered good with 71% of the envenomated patients in this study surviving to discharge. Supportive care that may include ventilator assistance and antivenom administration are the mainstays of therapy. © Veterinary Emergency and Critical Care Society 2012.

Student performance of the general physical examination in internal medicine: an observational study.

PubMed

Haring, Catharina M; Cools, Bernadette M; van der Meer, Jos Wm; Postma, Cornelis T

2014-04-08

Many practicing physicians lack skills in physical examination. It is not known whether physical examination skills already show deficiencies after an early phase of clinical training. At the end of the internal medicine clerkship students are expected to be able to perform a general physical examination in every new patient encounter. In a previous study, the basic physical examination items that should standardly be performed were set by consensus. The aim of the current observational study was to assess whether medical students were able to correctly perform a general physical examination regarding completeness as well as technique at the end of the clerkship internal medicine. One hundred students who had just finished their clerkship internal medicine were asked to perform a general physical examination on a standardized patient as they had learned during the clerkship. They were recorded on camera. Frequency of performance of each component of the physical examination was counted. Adequacy of performance was determined as either correct or incorrect or not assessable using a checklist of short descriptions of each physical examination component. A reliability analysis was performed by calculation of the intra class correlation coefficient for total scores of five physical examinations rated by three trained physicians and for their agreement on performance of all items. Approximately 40% of the agreed standard physical examination items were not performed by the students. Students put the most emphasis on examination of general parameters, heart, lungs and abdomen. Many components of the physical examination were not performed as was taught during precourses. Intra-class correlation was high for total scores of the physical examinations 0.91 (p <0.001) and for agreement on performance of the five physical examinations (0.79-0.92 p <0.001). In conclusion, performance of the general physical examination was already below expectation at the end of the internal medicine clerkship. Possible causes and suggestions for improvement are discussed.

Student performance of the general physical examination in internal medicine: an observational study

PubMed Central

2014-01-01

Background Many practicing physicians lack skills in physical examination. It is not known whether physical examination skills already show deficiencies after an early phase of clinical training. At the end of the internal medicine clerkship students are expected to be able to perform a general physical examination in every new patient encounter. In a previous study, the basic physical examination items that should standardly be performed were set by consensus. The aim of the current observational study was to assess whether medical students were able to correctly perform a general physical examination regarding completeness as well as technique at the end of the clerkship internal medicine. Methods One hundred students who had just finished their clerkship internal medicine were asked to perform a general physical examination on a standardized patient as they had learned during the clerkship. They were recorded on camera. Frequency of performance of each component of the physical examination was counted. Adequacy of performance was determined as either correct or incorrect or not assessable using a checklist of short descriptions of each physical examination component. A reliability analysis was performed by calculation of the intra class correlation coefficient for total scores of five physical examinations rated by three trained physicians and for their agreement on performance of all items. Results Approximately 40% of the agreed standard physical examination items were not performed by the students. Students put the most emphasis on examination of general parameters, heart, lungs and abdomen. Many components of the physical examination were not performed as was taught during precourses. Intra-class correlation was high for total scores of the physical examinations 0.91 (p <0.001) and for agreement on performance of the five physical examinations (0.79-0.92 p <0.001). Conclusions In conclusion, performance of the general physical examination was already below expectation at the end of the internal medicine clerkship. Possible causes and suggestions for improvement are discussed. PMID:24712683

Neighborhoods on the move: a community-based participatory research approach to promoting physical activity.

PubMed

Suminski, Richard R; Petosa, Rick L; Jones, Larry; Hall, Lisa; Poston, Carlos W

2009-01-01

There is a scientific and practical need for high-quality effectiveness studies of physical activity interventions in "real-world" settings. To use a community-based participatory research (CBPR) approach to develop, implement, operate, and evaluate an intervention for promoting physical activity called Neighborhoods on the Move. Two communities with similar physical and social characteristics participated in this study. One community was involved in Neighborhoods on the Move; the other (comparison community) participated only in the assessments. Academic personnel and residents/organizations in the Neighborhoods on the Move community worked together to create a community environment that was more conducive for physical activity. Pre- and posttest data on new initiatives promoting physical activity, existing physical activity initiatives, and business policies supporting physical activity were collected simultaneously in both communities. The success of the CBPR approach was evidenced by several developments, including substantial resident involvement and the formation of a leadership committee, marketing campaign, and numerous community partnerships. The number of businesses with policies promoting physical activity and breadth of existing physical activity initiatives (participants, activities, hours) increased substantially more in the Neighborhoods on the Move community than in the comparison community. A total of sixty new initiatives promoting physical activity were implemented in the Neighborhoods on the Move community during the intervention. The CBPR approach is an effective strategy for inducing environmental changes that promote physical activity. Additional research is needed to assess the portability and sustainability of Neighborhoods on the Move.

Predictors for Physical Activity in Adolescent Girls Using Statistical Shrinkage Techniques for Hierarchical Longitudinal Mixed Effects Models

PubMed Central

Grant, Edward M.; Young, Deborah Rohm; Wu, Tong Tong

2015-01-01

We examined associations among longitudinal, multilevel variables and girls’ physical activity to determine the important predictors for physical activity change at different adolescent ages. The Trial of Activity for Adolescent Girls 2 study (Maryland) contributed participants from 8th (2009) to 11th grade (2011) (n=561). Questionnaires were used to obtain demographic, and psychosocial information (individual- and social-level variables); height, weight, and triceps skinfold to assess body composition; interviews and surveys for school-level data; and self-report for neighborhood-level variables. Moderate to vigorous physical activity minutes were assessed from accelerometers. A doubly regularized linear mixed effects model was used for the longitudinal multilevel data to identify the most important covariates for physical activity. Three fixed effects at the individual level and one random effect at the school level were chosen from an initial total of 66 variables, consisting of 47 fixed effects and 19 random effects variables, in additional to the time effect. Self-management strategies, perceived barriers, and social support from friends were the three selected fixed effects, and whether intramural or interscholastic programs were offered in middle school was the selected random effect. Psychosocial factors and friend support, plus a school’s physical activity environment, affect adolescent girl’s moderate to vigorous physical activity longitudinally. PMID:25928064

The physical challenges of early breastfeeding.

PubMed

Kelleher, Christa M

2006-11-01

Breastfeeding rates have recently increased in the United States and Canada and a majority of women now initiate breastfeeding. Feminist scholarship on breastfeeding has addressed a variety of issues related to women's breastfeeding experiences but has tended to ignore or downplay the potentially physically challenging aspects of early breastfeeding. This study, based on semi-structured, in-depth interviews with 52 women from Canada and the United States conducted at approximately one month postpartum, examines women's experiences of pain and discomfort associated with breastfeeding. The findings demonstrate that many women experienced pain and discomfort and that they were generally surprised by the extent, intensity and duration of discomfort and pain, which ranged from mild to severe. Several women indicated that the physical impact of breastfeeding affected their relationship with their baby; others indicated that they became hesitant to continue the practice due to feelings of physical vulnerability, pain and/or discomfort. Lastly, women's experiences of the physical implications of breastfeeding were influenced in part by assistance provided by health care practitioners, in both positive and negative ways. The practice of breastfeeding has the potential to challenge women's physicality. Feminist scholars addressing the topic of breastfeeding, women's postpartum health, and embodiment must more directly and comprehensively account for the potentially negative physical implications and demands associated with early breastfeeding.

CSPAP Professional Preparation and Research Initiatives at the University of South Carolina

ERIC Educational Resources Information Center

Webster, Collin

2017-01-01

Several comprehensive school physical activity program (CSPAP) professional preparation and research initiatives are underway in the Department of Physical Education and Athletic Training at the University of South Carolina. The CSPAP learning experiences have been mostly integrated into existing courses to help candidates in physical education…

76 FR 25329 - Torofino Physical Trading LLC; Supplemental Notice That Initial Market-Based Rate Filing Includes...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-04

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. ER11-3432-000] Torofino Physical Trading LLC; Supplemental Notice That Initial Market-Based Rate Filing Includes Request for... Torofino Physical Trading LLC's application for market-based rate authority, with an accompanying rate...

77 FR 9226 - Physical Systems Integration, LLC; Supplemental Notice That Initial Market-Based Rate Filing...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-16

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. ER12-1013-000] Physical Systems Integration, LLC; Supplemental Notice That Initial Market-Based Rate Filing Includes Request for... Physical Systems Integration, LLC's application for market-based rate authority, with an accompanying rate...

Moms in motion: a group-mediated cognitive-behavioral physical activity intervention.

PubMed

Cramp, Anita G; Brawley, Lawrence R

2006-08-22

When examining the prevalence of physical inactivity by gender and age, women over the age of 25 are at an increased risk for sedentary behavior. Childbearing and motherhood have been explored as one possible explanation for this increased risk. Post natal exercise studies to date demonstrate promising physical and psychological outcomes, however few physical activity interventions have been theory-driven and tailored to post natal exercise initiates. The purpose of this study was to compare the effects of a group-mediated cognitive behavioral intervention based upon social-cognitive theory and group dynamics (GMCB) to a standard care postnatal exercise program (SE). A randomized, two-arm intervention design was used. Fifty-seven post natal women were randomized to one of two conditions: (1) a standard exercise treatment (SE) and (2) a standard exercise treatment plus group-mediated cognitive behavioral intervention (GMCB). Participants in both conditions participated in a four-week intensive phase where participants received standard exercise training. In addition, GMCB participants received self-regulatory behavioral skills training via six group-mediated counseling sessions. Following the intensive phase, participants engaged in a four-week home-based phase of self-structured exercise. Measures of physical activity, barrier efficacy, and proximal outcome expectations were administered and data were analyzed using ANCOVA procedures. ANCOVA of change scores for frequency, minutes, and volume of physical activity revealed significant treatment effects over the intensive and home-based phases (p's < 0.01). In addition, ANCOVA of change in mean barrier efficacy and proximal outcome expectations at the conclusion of the intensive phase demonstrated that GMCB participants increased their initial level of barrier efficacy and outcome expectations while SE participants decreased (p < 0.05). While both exercise programs resulted in improvements to exercise participation, the GMCB intervention produced greater improvement in overall physical activity, barrier efficacy and proximal outcome expectations.

Social determinants of health in Canada: Are healthy living initiatives there yet? A policy analysis

PubMed Central

2012-01-01

Introduction Preventative strategies that focus on addressing the social determinants of health to improve healthy eating and physical activity have become an important strategy in British Columbia and Ontario for combating chronic diseases. What has not yet been examined is the extent to which healthy living initiatives implemented under these new policy frameworks successfully engage with and change the social determinants of health. Methods Initiatives active between January 1, 2006 and September 1, 2011 were found using provincial policy documents, web searches, health organization and government websites, and databases of initiatives that attempted to influence to nutrition and physical activity in order to prevent chronic diseases or improve overall health. Initiatives were reviewed, analyzed and grouped using the descriptive codes: lifestyle-based, environment-based or structure-based. Initiatives were also classified according to the mechanism by which they were administered: as direct programs (e.g. directly delivered), blueprints (or frameworks to tailor developed programs), and building blocks (resources to develop programs). Results 60 initiatives were identified in Ontario and 61 were identified in British Columbia. In British Columbia, 11.5% of initiatives were structure-based. In Ontario, of 60 provincial initiatives identified, 15% were structure-based. Ontario had a higher proportion of direct interventions than British Columbia for all intervention types. However, in both provinces, as the intervention became more upstream and attempted to target the social determinants of health more directly, the level of direct support for the intervention lessened. Conclusions The paucity of initiatives in British Columbia and Ontario that address healthy eating and active living through action on the social determinants of health is problematic. In the context of Canada's increasingly neoliberal political and economic policy, the public health sector may face significant barriers to addressing upstream determinants in a meaningful way. If public health cannot directly affect broader societal conditions, interventions should be focused around advocacy and education about the social determinants of health. It is necessary that health be seen for what it is: a political matter. As such, the health sector needs to take a more political approach in finding solutions for health inequities. PMID:22889402

The relationship between physical activity, fitness, physical complaints and BMI in German adults - results of a longitudinal study.

PubMed

Tittlbach, Susanne A; Jekauc, Darko; Schmidt, Steffen C E; Woll, Alexander; Bös, Klaus

2017-09-01

This study's aims were to describe the development of physical activity, physical fitness (PF), subjective (physical complaints (PC)) and objective (Body mass index (BMI)) health measures and to examine the relationship between the development trajectories. In addition, the study also aimed to assess the influence of sociodemographic determinants (age, sex, socioeconomic status (SES)) in German adults over a period of 18 years. The longitudinal study population comprises of 721 men and women, aged 33-76 years over the study period. There was self-report of physical activity and PC and testing of physical fitness and BMI in each study year (1992, 1997, 2002 and 2010). Latent growth curve models were used to analyse the development. Physical activity slightly increased while fitness, PC and BMI worsened over the course of 18 years. Sex, age and SES play important roles concerning physical activity, fitness and health. Several integrative associations could be detected between physical activity, fitness, PC and BMI as well as their trajectories. In particular, high initial levels of physical activity and fitness protect from high PC and BMI.The slope of physical activity was not significantly associated with slopes of fitness, PC and BMI. However, increase of fitness resulted in decrease of PC. A general positive development regarding the amount of physical activity could be detected. However, if it is only an unsystematic increase of physical activity, this is not in itself enough to achieve health benefits. The strengthening of fitness should be focused when increasing physical activity, since only then a health benefit is possible.

Examining problem solving in physics-intensive Ph.D. research

NASA Astrophysics Data System (ADS)

Leak, Anne E.; Rothwell, Susan L.; Olivera, Javier; Zwickl, Benjamin; Vosburg, Jarrett; Martin, Kelly Norris

2017-12-01

Problem-solving strategies learned by physics undergraduates should prepare them for real-world contexts as they transition from students to professionals. Yet, graduate students in physics-intensive research face problems that go beyond problem sets they experienced as undergraduates and are solved by different strategies than are typically learned in undergraduate coursework. This paper expands the notion of problem solving by characterizing the breadth of problems and problem-solving processes carried out by graduate students in physics-intensive research. We conducted semi-structured interviews with ten graduate students to determine the routine, difficult, and important problems they engage in and problem-solving strategies they found useful in their research. A qualitative typological analysis resulted in the creation of a three-dimensional framework: context, activity, and feature (that made the problem challenging). Problem contexts extended beyond theory and mathematics to include interactions with lab equipment, data, software, and people. Important and difficult contexts blended social and technical skills. Routine problem activities were typically well defined (e.g., troubleshooting), while difficult and important ones were more open ended and had multiple solution paths (e.g., evaluating options). In addition to broadening our understanding of problems faced by graduate students, our findings explore problem-solving strategies (e.g., breaking down problems, evaluating options, using test cases or approximations) and characteristics of successful problem solvers (e.g., initiative, persistence, and motivation). Our research provides evidence of the influence that problems students are exposed to have on the strategies they use and learn. Using this evidence, we have developed a preliminary framework for exploring problems from the solver's perspective. This framework will be examined and refined in future work. Understanding problems graduate students face and the strategies they use has implications for improving how we approach problem solving in undergraduate physics and physics education research.

WHO European Childhood Obesity Surveillance Initiative: health-risk behaviours on nutrition and physical activity in 6-9-year-old schoolchildren.

PubMed

Wijnhoven, Trudy M A; van Raaij, Joop M A; Yngve, Agneta; Sjöberg, Agneta; Kunešová, Marie; Duleva, Vesselka; Petrauskiene, Ausra; Rito, Ana I; Breda, João

2015-12-01

To assess to what extent eight behavioural health risks related to breakfast and food consumption and five behavioural health risks related to physical activity, screen time and sleep duration are present among schoolchildren, and to examine whether health-risk behaviours are associated with obesity. Cross-sectional design as part of the WHO European Childhood Obesity Surveillance Initiative (school year 2007/2008). Children's behavioural data were reported by their parents and children's weight and height measured by trained fieldworkers. Descriptive statistics and logistic regression analyses were performed. Primary schools in Bulgaria, Lithuania, Portugal and Sweden; paediatric clinics in the Czech Republic. Nationally representative samples of 6-9-year-olds (n 15 643). All thirteen risk behaviours differed statistically significantly across countries. Highest prevalence estimates of risk behaviours were observed in Bulgaria and lowest in Sweden. Not having breakfast daily and spending screen time ≥2 h/d were clearly positively associated with obesity. The same was true for eating 'foods like pizza, French fries, hamburgers, sausages or meat pies' >3 d/week and playing outside <1 h/d. Surprisingly, other individual unhealthy eating or less favourable physical activity behaviours showed either no or significant negative associations with obesity. A combination of multiple less favourable physical activity behaviours showed positive associations with obesity, whereas multiple unhealthy eating behaviours combined did not lead to higher odds of obesity. Despite a categorization based on international health recommendations, individual associations of the thirteen health-risk behaviours with obesity were not consistent, whereas presence of multiple physical activity-related risk behaviours was clearly associated with higher odds of obesity.

Physical impairment and body weight history in postmenopausal women: The Women's Health Initiative

PubMed Central

Wanigatunga, Amal A.; Sourdet, Sandrine S.; LaMonte, Michael J.; Waring, Molly E.; Nassir, Rami; Garcia, Lorena; Bea, Jennifer W.; Seguin, Rebecca A.; Ockene, Judith K.; Sarto, Gloria E.; Stefanick, Marcia L.; Limacher, Marian; Manini, Todd M.

2016-01-01

OBJECTIVE To examine whether weight history and weight transitions over adult lifespan contribute to physical impairment among postmenopausal women. DESIGN Body mass index (BMI; kg/m2) categories were calculated among postmenopausal women who reported their weight and height at age 18. Multiple-variable logistic regression was used to determine the association between BMI at age 18 and BMI transitions over adulthood on severe physical impairment (SPI), defined as scoring < 60 on the Physical Functioning Subscale of the Random 36-Item Healthy Survey. SETTING Participants were part of the Women's Health Initiative Observational study (WHI OS), where participants’ health were followed over time via questionnaires and clinical assessments. SUBJECTS Postmenopausal women (n=76,016; 63.5 ± 7.3 years) RESULTS Women with overweight (BMI=25.0-29.9) or obesity (BMI≥30) at 18 years had greater odds of SPI [odds ratio (OR) = 1.51, 95% confidence interval (CI): 1.35-1.69 and 2.14, 95% CI: 1.72-2.65, respectively] than normal weight (BMI=18.5-24.9) counterparts. Transitions from normal weight to overweight/obese or to underweight (BMI <18.5) were associated with greater odds of SPI (1.97 [1.84-2.11] and 1.35 [1.06-1.71], respectively) compared to weight stability. Shifting from underweight to overweight/obese also had increased odds of SPI (1.52 [1.11-2.09]). Overweight/obese to normal BMI transitions resulted in a reduced SPI odds (0.52 [0.39-0.71]). CONCLUSIONS Higher weight history and transitions into higher weight classes were associated with higher likelihood of severe physical impairment, while transitioning into lower weight classes for those with overweight/obesity was protective among postmenopausal women. PMID:27269298

Predictors of perceived asthma control among patients managed in primary care clinics.

PubMed

Eilayyan, Owis; Gogovor, Amede; Mayo, Nancy; Ernst, Pierre; Ahmed, Sara

2015-01-01

To estimate the extent to which symptom status, physical activity, beliefs about medications, self-efficacy, emotional status, and healthcare utilization predict perceived asthma control over a period of 16 months among a primary care population. The current study is a secondary analysis of data from a longitudinal study that examined health outcomes of asthma among participants recruited from primary care clinics. Path analysis, based on the Wilson and Cleary and International Classification of Functioning, Disability and Health frameworks, was used to estimate the predictors of perceived asthma control. The path analysis identified initial perceived asthma control asthma (β = 0.43, p < 0.0001), symptoms (β = 0.35, p < 0.0001), physical activity (β = 0.27, p < 0.0001), and self-efficacy (β = 0.29, p < 0.0001) as significant predictors of perceived asthma control (total effects, i.e., direct and indirect), while emotional status (β = 0.08, p = 0.03) was a significant indirect predictor through physical activity. The model explained 24 % of the variance of perceived asthma control. Overall, the model fits the data well (χ (2) = 6.65, df = 6, p value = 0.35, root-mean-square error of approximation = 0.02, Comparative Fit Index = 0.999, and weighted root-mean-square residual = 0.27). Initial perceived asthma control, current symptoms status, physical activity, and self-efficacy can be used to identify individuals likely to have good perceived asthma control in the future. Emotional status also has an impact on perceived asthma control mediated through physical activity and should be considered when planning patient management. Identifying these predictors is important to help the care team tailor interventions that will allow individuals to optimally manage their asthma, to prevent exacerbations, to prevent other respiratory-related chronic disease, and to maximize quality of life.

Preoperative predictors of adherence to dietary and physical activity recommendations and weight loss one year after surgery.

PubMed

Bergh, Irmelin; Lundin Kvalem, Ingela; Risstad, Hilde; Sniehotta, Falko F

2016-05-01

Weight loss and weight loss maintenance vary considerably between patients after bariatric surgery. Postoperative weight gain has partially been explained by lack of adherence to postoperative dietary and physical activity recommendations. However, little is known about factors related to postoperative adherence. The aim of this study was to examine psychological, behavioral, and demographic predictors of adherence to behavior recommendations and weight loss 1 year after bariatric surgery. Oslo University Hospital. In a prospective cohort study, 230 patients who underwent Roux-en-Y gastric bypass were recruited from Oslo University hospital from 2011 to 2013. They completed a comprehensive questionnaire before and 1 year after surgery. Weight was measured preoperatively, on the day of surgery, and 1-year postoperatively. Mean body mass index was 44.9 kg/m(2) (standard deviation [SD] = 6.0) preoperatively and 30.6 kg/m(2) (SD = 5.2) 1 year after surgery. Patients lost on average 29.2 % (SD = 8.2) of their initial weight. Predictors of dietary adherence were years with dieting experience, readiness to limit food intake, and night eating tendency. Preoperative physical activity and planning predicted postoperative physical activity whereas predictors of weight loss were higher frequency of snacking preoperatively, greater past weight loss, and lower age. Several preoperative psychological predictors were related to postoperative adherence to dietary and physical activity recommendations but were not associated with weight loss. Interventions targeting psychological factors facilitating behavior change during the initial postoperative phase are recommended as this might improve long-term outcomes. Copyright © 2016 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

A sampling strategy for promoting and assessing medical student retention of physical examination skills.

PubMed

Williams, Reed G; Klamen, Debra L; Mayer, David; Valaski, Maureen; Roberts, Nicole K

2007-10-01

Skill acquisition and maintenance requires spaced deliberate practice. Assessing medical students' physical examination performance ability is resource intensive. The authors assessed the nature and size of physical examination performance samples necessary to accurately estimate total physical examination skill. Physical examination assessment data were analyzed from second year students at the University of Illinois College of Medicine at Chicago in 2002, 2003, and 2004 (N = 548). Scores on subgroups of physical exam maneuvers were compared with scores on the total physical exam, to identify sound predictors of total test performance. Five exam subcomponents were sufficiently correlated to overall test performance and provided adequate sensitivity and specificity to serve as a means to prompt continued student review and rehearsal of physical examination technical skills. Selection and administration of samples of the total physical exam provide a resource-saving approach for promoting and estimating overall physical examination skills retention.

Long-term outcomes of adolescents with juvenile-onset fibromyalgia in early adulthood.

PubMed

Kashikar-Zuck, Susmita; Cunningham, Natoshia; Sil, Soumitri; Bromberg, Maggie H; Lynch-Jordan, Anne M; Strotman, Daniel; Peugh, James; Noll, Jennie; Ting, Tracy V; Powers, Scott W; Lovell, Daniel J; Arnold, Lesley M

2014-03-01

This prospective longitudinal study examined the long-term physical and psychosocial outcomes of adolescents with juvenile-onset fibromyalgia (JFM), compared with healthy control subjects, into early adulthood. Adolescent patients with JFM initially seen at a pediatric rheumatology clinic (n = 94) and age- and gender-matched healthy control subjects (n = 33) completed online measures of demographic characteristics, pain, physical functioning, mood symptoms, and health care utilization at ∼6 years' follow-up (mean age: 21 years). A standard in-person tender-point examination was conducted. Patients with JFM had significantly higher pain (P < .001), poorer physical function (P < .001), greater anxiety (P < .001) and depressive symptoms (P < .001), and more medical visits (P < .001)than control subjects. The majority (>80%) of JFM patients continued to experience fibromyalgia symptoms into early adulthood, and 51.1% of the JFM sample met American College of Rheumatology criteria for adult fibromyalgia at follow-up. Patients with JFM were more likely than control subjects to be married and less likely to obtain a college education. Adolescent patients with JFM have a high likelihood of continued fibromyalgia symptoms into young adulthood. Those who met criteria for fibromyalgia in adulthood exhibited the highest levels of physical and emotional impairment. Emerging differences in educational attainment and marital status were also found in the JFM group. JFM is likely to be a long-term condition for many patients, and this study for the first time describes the wide-ranging impact of JFM on a variety of physical and psychosocial outcomes that seem to diverge from their same-age peers.

Disparities in dietary habits and physical activity in Denmark and trends from 1995 to 2008.

PubMed

Groth, Margit Velsing; Sørensen, Mette Rosenlund; Matthiessen, Jeppe; Fagt, Sisse; Landvad, Niels; Knudsen, Vibeke Kildegaard

2014-11-01

To examine social disparities in dietary-, alcohol- and leisure-time physical activity habits in Danish adults from 1995 to 2008 and to test the hypothesis of widening disparities. Four cross-sectional surveys of representative samples of the Danish population aged 20-75 years were analysed, a total of 7900 respondents. Dietary and alcohol habits were measured by a 7-day pre-coded food diary and physical activity and education by a face-to-face interview. Multivariate analyses were used to test associations between explanatory variables and response variables and the hypothesis of widening disparities. In all analyses, both diet quality and physical inactivity differed systematically with educational group and with healthier habits for the group with long education. Only for alcohol habits was an opposite social gradient seen. Disparities persisted over all time periods. The analyses using "The Concentration Index" did not change any of the conclusions. Gender also influenced diet quality. Men had dietary and alcohol habits furthest away from the guidelines. A trend of healthier habits was also found over the time period. Social disparities in diet quality and leisure-time physical activity were seen for all examined time periods and with no significant change therefore, there is no support to the hypothesis of widening social disparities in all educational groups some improvement of dietary habits was found, especially for those foods where comprehensive initiatives had taken place however, social disparities still exist there is an ongoing need to address these disparities in order to reduce social inequality in health. © 2014 the Nordic Societies of Public Health.

Social Support for Exercise as a Predictor of Weight and Physical Activity Status Among Puerto Rican and Mexican Men: Results From the Latino Men's Health Initiative.

PubMed

Craven, Meredith R; Keefer, Laurie; Rademaker, Alfred; Dykema-Engblade, Amanda; Sanchez-Johnsen, Lisa

2018-07-01

Social support is an important factor in increasing positive health outcomes and positive health behaviors across a variety of disease states including obesity. However, research examining the relationship between social support for exercise and weight and physical activity status, particularly among Latino men, is lacking. This paper examined whether social support for exercise predicted weight and physical activity status and whether the direction of these relationships differ as a function of Hispanic/Latino background (Puerto Rican/Mexican). Participants were 203 men who participated in a National Institutes of Health (NIH)-funded study addressing culture- and obesity-related variables. Both family participation social support and f amily rewards and punishment social support predicted higher weight status ( p < .005 and p < .05, respectively). Friend participation social support did not predict weight status. The direction of the relationship between weight status and family participation social support, family rewards and punishment social support, and friend participation social support did not significantly differ as a function of Hispanic/Latino background. The direction of the relationship between physical activity status and family participation social support, family rewards and punishment social support, and friend participation social support did not significantly differ as a function of Hispanic/Latino background. Findings suggest that increased social support for exercise from family members may be focused on those who need it most-overweight and obese participants. Additional research is needed to explore sociocultural factors that may promote social support, physical activity, and weight loss and maintenance in Puerto Rican and Mexican men.

Family practitioners' diagnostic decision-making processes regarding patients with respiratory tract infections: an observational study.

PubMed

Fischer, Thomas; Fischer, Susanne; Himmel, Wolfgang; Kochen, Michael M; Hummers-Pradier, Eva

2008-01-01

The influence of patient characteristics on family practitioners' (FPs') diagnostic decision making has mainly been investigated using indirect methods such as vignettes or questionnaires. Direct observation-borrowed from social and cultural anthropology-may be an alternative method for describing FPs' real-life behavior and may help in gaining insight into how FPs diagnose respiratory tract infections, which are frequent in primary care. To clarify FPs' diagnostic processes when treating patients suffering from symptoms of respiratory tract infection. This direct observation study was performed in 30 family practices using a checklist for patient complaints, history taking, physical examination, and diagnoses. The influence of patients' symptoms and complaints on the FPs' physical examination and diagnosis was calculated by logistic regression analyses. Dummy variables based on combinations of symptoms and complaints were constructed and tested against saturated (full) and backward regression models. In total, 273 patients (median age 37 years, 51% women) were included. The median number of symptoms described was 4 per patient, and most information was provided at the patients' own initiative. Multiple logistic regression analysis showed a strong association between patients' complaints and the physical examination. Frequent diagnoses were upper respiratory tract infection (URTI)/common cold (43%), bronchitis (26%), sinusitis (12%), and tonsillitis (11%). There were no significant statistical differences between "simple heuristic'' models and saturated regression models in the diagnoses of bronchitis, sinusitis, and tonsillitis, indicating that simple heuristics are probably used by the FPs, whereas "URTI/common cold'' was better explained by the full model. FPs tended to make their diagnosis based on a few patient symptoms and a limited physical examination. Simple heuristic models were almost as powerful in explaining most diagnoses as saturated models. Direct observation allowed for the study of decision making under real conditions, yielding both quantitative data and "qualitative'' information about the FPs' performance. It is important for investigators to be aware of the specific disadvantages of the method (e.g., a possible observer effect).

Re-audit of physical examination on admission.

PubMed

Drury, Andrew; Eriksson, Erik; Marriott, Rebecca; Symeon, Christopher; Chan, Jeni

2011-09-01

Re-audit of the physical examination of older adults admitted to one of two inpatient Older Adult wards at the Maudsley Hospital found that on admission, only 58% of patients had a brief physical examination and 43% had a full physical examination, and after 72 hours only 65% had a full physical examination. This is a slight improvement on the previous audit but still falls short of the target of 90% of patients having a full physical examination within 72 hours of admission. Recommendations include education of junior and senior doctors of the need for physical examination via presentation of audit and distribution of results, consideration of the use of a proforma to gather information on physical examination which may have been done in an acute hospital and a further re-audit to see if outcomes have improved.

Effect of Physical Attractiveness on Therapists' Initial Judgments of a Person's Self-concept

ERIC Educational Resources Information Center

Hobfoll, Stevan E.; Penner, Louis A.

1978-01-01

Investigated effect of a person's physical attractiveness on a therapist's initial judgment of that person's self-concept. Videotapes and audiotapes were made of interviews with attractive and unattractive males and females. Physically attractive persons of both sexes were rated as having better self-concepts than unattractive persons. (Author)

Development and Initial Validation of the Psychological Needs Satisfaction Scale in Physical Education

ERIC Educational Resources Information Center

Liu, Jing Dong; Chung, Pak Kwong

2014-01-01

The current study presents the development process and initial validation of a measure designed for assessing psychological needs satisfaction in a secondary school physical education context (Psychological Needs Satisfaction Scale in Physical Education, PNSSPE). Junior secondary school (grades 7 to 9) students (N?=?1,258) were invited to…

Implications of early and guideline adherent physical therapy for low back pain on utilization and costs.

PubMed

Childs, John D; Fritz, Julie M; Wu, Samuel S; Flynn, Timothy W; Wainner, Robert S; Robertson, Eric K; Kim, Forest S; George, Steven Z

2015-04-09

Initial management decisions following a new episode of low back pain (LBP) are thought to have profound implications for health care utilization and costs. The purpose of this study was to evaluate the impact of early and guideline adherent physical therapy for low back pain on utilization and costs within the Military Health System (MHS). Patients presenting to a primary care setting with a new complaint of LBP from January 1, 2007 to December 31, 2009 were identified from the MHS Management Analysis and Reporting Tool. Descriptive statistics, utilization, and costs were examined on the basis of timing of referral to physical therapy and adherence to practice guidelines over a 2-year period. Utilization outcomes (advanced imaging, lumbar injections or surgery, and opioid use) were compared using adjusted odds ratios with 99% confidence intervals. Total LBP-related health care costs over the 2-year follow-up were compared using linear regression models. 753,450 eligible patients with a primary care visit for LBP between 18-60 years of age were considered. Physical therapy was utilized by 16.3% (n = 122,723) of patients, with 24.0% (n = 17,175) of those receiving early physical therapy that was adherent to recommendations for active treatment. Early referral to guideline adherent physical therapy was associated with significantly lower utilization for all outcomes and 60% lower total LBP-related costs. The potential for cost savings in the MHS from early guideline adherent physical therapy may be substantial. These results also extend the findings from similar studies in civilian settings by demonstrating an association between early guideline adherent care and utilization and costs in a single payer health system. Future research is necessary to examine which patients with LBP benefit early physical therapy and determine strategies for providing early guideline adherent care.

A test of cognitive mediation in a 12-month physical activity workplace intervention: does it explain behaviour change in women?

PubMed

Plotnikoff, Ronald C; Pickering, Michael A; Rhodes, Ryan E; Courneya, Kerry S; Spence, John C

2010-05-03

Attempts to demonstrate the efficacy of interventions aimed at increasing physical activity (PA) have been mixed. Further, studies are seldom designed in a manner that facilitates the understanding of how or why a treatment is effective or ineffective and PA intervention designs should be guided by a heavier reliance upon behavioral theory. The use of a mediating variable framework offers a systematic methodological approach to testing the role of theory, and could also identify the effectiveness of specific intervention components. The primary purpose of this paper was to test the mediating role that cognitive constructs may have played in regards to the positive effect that a workplace behavioral intervention had on leisure-time PA for women. A subsidiary purpose was to examine the cross-sectional relationships of these cognitive constructs with PA behavior. The Physical Activity Workplace Study was a randomized controlled trial which compared the effects of stage-matched and standard print materials upon self-reported leisure-time PA, within a workplace sample at 6 and 12-months. In this secondary analysis we examined the mediation effects of 14 psychosocial constructs across 3 major social-cognitive theories which were operationalized for the intervention materials and measured at baseline, 6 and 12-months. We examined change in PA and change in the psychological constructs employing a mediation strategy proposed by Baron and Kenny for: (1) the first 6-months (i.e., initial change), (2) the second 6-months (i.e., delayed change), and (3) the entire 12-months (overall change) of the study on 323 women (n = 213 control/standard materials group; n = 110 stage-matched materials group). Of the 14 constructs and 42 tests (including initial, delayed and overall change) two positive results were identified (i.e., overall change in pros, initial change in experiential powerful intervention approaches processes), with very small effect sizes. However, these mediating results were eliminated after adjusting for the multiple statistical tests. The intervention did not change these mediators in any substantive way, and show a similar pattern to prior research where interventions generally do not result in a change in mediation of behavior change. It is important to report mediation results in randomized controlled trials whether the findings are null or positive. Future studies may wish to focus on more detailed dose-response issues between mediators and behavior, the inclusion of moderators that could affect individual change, or different mediator constructs at higher levels of measurement specificity. Continued work on innovative and more powerful PA intervention approaches are needed.

Interpreting Assessments of Student Learning in the Introductory Physics Classroom and Laboratory

NASA Astrophysics Data System (ADS)

Dowd, Jason Edward

Assessment is the primary means of feedback between students and instructors. However, to effectively use assessment, the ability to interpret collected information is essential. We present insights into three unique, important avenues of assessment in the physics classroom and laboratory. First, we examine students' performance on conceptual surveys. The goal of this research project is to better utilize the information collected by instructors when they administer the Force Concept Inventory (FCI) to students as a pre-test and post-test of their conceptual understanding of Newtonian mechanics. We find that ambiguities in the use of the normalized gain, g, may influence comparisons among individual classes. Therefore, we propose using stratagrams, graphical summaries of the fraction of students who exhibit "Newtonian thinking," as a clearer, more informative method of both assessing a single class and comparing performance among classes. Next, we examine students' expressions of confusion when they initially encounter new material. The goal of this research project is to better understand what such confusion actually conveys to instructors about students' performance and engagement. We investigate the relationship between students' self-assessment of their confusion over material and their performance, confidence in reasoning, pre-course self-efficacy and several other measurable characteristics of engagement. We find that students' expressions of confusion are negatively related to initial performance, confidence and self-efficacy, but positively related to final performance when all factors are considered together. Finally, we examine students' exhibition of scientific reasoning abilities in the instructional laboratory. The goal of this research project is to explore two inquiry-based curricula, each of which proposes a different degree of scaffolding. Students engage in sequences of these laboratory activities during one semester of an introductory physics course. We find that students who participate in the less scaffolded activities exhibit marginally stronger scientific reasoning abilities in distinct exercises throughout the semester, but exhibit no differences in the final, common exercises. Overall, we find that, although students demonstrate some enhanced scientific reasoning skills, they fail to exhibit or retain even some of the most strongly emphasized skills.

Heterogeneity Within Domestic Violence Exposure: Young Adults' Retrospective Experiences.

PubMed

Haselschwerdt, Megan L; Hlavaty, Kathleen; Carlson, Camille; Schneider, Mallory; Maddox, Lauren; Skipper, Megan

2016-06-01

Using Holden's taxonomy of domestic violence (DV) exposure as a guiding framework, the current study examined young adults' diverse DV exposure experiences. Twenty-five young adults (ages 19-25) exposed to father-perpetrated DV during their childhood and adolescence were interviewed using a qualitative descriptive design. Data analyses focused on coercive control exposure through reports of non-physical abuse tactics, types of exposure (e.g., direct, indirect), physical violence exposure (e.g., severity, frequency), and child abuse and harsh parenting practices. DV-exposed young adults were directly and indirectly exposed to physical violence and an array of non-physical abuse tactics toward their mothers. Young adults categorized as having been exposed to coercive controlling violence reported exposure to ongoing, non-physical abuse tactics and more frequent and severe physical violence. These young adults were also more likely to intervene and become victimized during physical violence and reported repeated episodes of child abuse and harsh parenting. Although coercive control appeared to be associated with physical violence and child abuse, generalizations should be made with caution as a few participants exposed to situational conflict were exposed to frequent and severe DV. The findings suggest that DV exposure should be measured in methodologically sophisticated ways to capture the heterogeneity in experiences, with the goal of promoting empirically driven intervention and prevention initiatives that are tailored to individual and family needs. © The Author(s) 2016.

Sex Differences in the Implications of Partner Physical Attractiveness for the Trajectory of Marital Satisfaction

PubMed Central

Meltzer, Andrea L.; McNulty, James K.; Jackson, Grace; Karney, Benjamin R.

2014-01-01

Do men value physical attractiveness in a mate more than women? Scientists in numerous disciplines believe that they do, but recent research using speed-dating paradigms suggests that males and females are equally influenced by physical attractiveness when choosing potential mates. Nevertheless, the premise of the current work is that sex differences in the importance of physical attractiveness are most likely to emerge in research on long-term relationships. Accordingly, the current work drew from four independent, longitudinal studies to examine sex differences in the implications of partner physical attractiveness for trajectories of marital satisfaction. In all four studies, both partners’ physical attractiveness was objectively rated at baseline and both partners reported their marital satisfaction up to eight times over the first four years of marriage. Whereas husbands were more satisfied at the beginning of the marriage and remained more satisfied over the next four years to the extent that they had an attractive wife, wives were no more or less satisfied initially or over the next four years to the extent that they had an attractive husband. Most importantly, a direct test indicated that partner physical attractiveness played a larger role in predicting husbands’ satisfaction than predicting wives’ satisfaction. These findings strengthen support for the idea that gender differences in self-reported preferences for physical attractiveness do have implications for long-term relationship outcomes. PMID:24128188

42 CFR 21.24 - Physical examinations.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 1 2013-10-01 2013-10-01 false Physical examinations. 21.24 Section 21.24 Public... Appointment § 21.24 Physical examinations. Every candidate for appointment as an officer shall undergo such physical examination as the Surgeon General may direct, and no candidate who is not found to be physically...

42 CFR 21.24 - Physical examinations.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Physical examinations. 21.24 Section 21.24 Public... Appointment § 21.24 Physical examinations. Every candidate for appointment as an officer shall undergo such physical examination as the Surgeon General may direct, and no candidate who is not found to be physically...

42 CFR 21.24 - Physical examinations.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 1 2012-10-01 2012-10-01 false Physical examinations. 21.24 Section 21.24 Public... Appointment § 21.24 Physical examinations. Every candidate for appointment as an officer shall undergo such physical examination as the Surgeon General may direct, and no candidate who is not found to be physically...

42 CFR 21.24 - Physical examinations.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 1 2014-10-01 2014-10-01 false Physical examinations. 21.24 Section 21.24 Public... Appointment § 21.24 Physical examinations. Every candidate for appointment as an officer shall undergo such physical examination as the Surgeon General may direct, and no candidate who is not found to be physically...

42 CFR 21.24 - Physical examinations.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 1 2011-10-01 2011-10-01 false Physical examinations. 21.24 Section 21.24 Public... Appointment § 21.24 Physical examinations. Every candidate for appointment as an officer shall undergo such physical examination as the Surgeon General may direct, and no candidate who is not found to be physically...

The PILI@Work Program: a translation of the diabetes prevention program to Native Hawaiian-serving worksites in Hawai'i.

PubMed

Townsend, Claire K M; Miyamoto, Robin E S; Antonio, Mapuana; Zhang, Guangxing; Paloma, Diane; Basques, DeAnna; Braun, Kathryn L; Kaholokula, Joseph Keawe'aimoku

2016-06-01

A previously translated Diabetes Prevention Program Lifestyle Intervention (DPP-LI) was adapted for delivery as a worksite-based intervention, called PILI@Work, to address obesity disparities in Native Hawaiians/Pacific Islanders. This study examined the effectiveness of PILI@Work and factors associated with weight loss at post-intervention. Overweight/obese employees of 15 Native Hawaiian-serving organizations received the 3-month component of PILI@Work. Assessments included weight, systolic/diastolic blood pressure, physical activity and functioning, fat intake, locus of weight control, social support, and self-efficacy. Weight, systolic/diastolic blood pressure, physical functioning, physical activity frequency, fat intake, family support, and eating self-efficacy improved from pre- to post-intervention. Regression analysis indicated that worksite type, decreased diastolic blood pressure, increased physical activity, and more internalized locus of weight control were significantly associated with 3-month weight loss. PILI@Work initiated weight loss in Native Hawaiians/Pacific Islanders. DPP-LI translated to worksite settings and tailored for specific populations can be effective for addressing obesity.

Caring for mom and neglecting yourself? The health effects of caring for an elderly parent.

PubMed

Coe, Norma B; Van Houtven, Courtney Harold

2009-09-01

We examine the physical and mental health effects of providing care to an elderly mother on the adult child caregiver. We address the endogeneity of the selection in and out of caregiving using an instrumental variable approach, using the death of the care recipient and sibling characteristics. We also carefully control for baseline health and work status of the adult child. We explore flexible specifications, such as Arellano-Bond estimation techniques. Continued caregiving over time increases depressive symptoms and decreases self-rated health for married women and married men. In addition, the increase in depressive symptoms is persistent for married women. While depressive symptoms for single men and women are not affected by continued caregiving, there is evidence of increased incidence of heart conditions for single men, and that these effects are persistent. Robustness checks indicate that these health changes can be directly attributable to caregiving behavior, and not due to a direct effect of the death of the mother. The initial onset of caregiving has modest immediate negative effects on depressive symptoms for married women and no immediate effects on physical health. Negative physical health effects emerge 2 years later, however, suggesting that there are delayed effects on health that would be missed with a short recall period. Initial caregiving does not affect health of married men.

The role of popularity goal in early adolescents' behaviors and popularity status.

PubMed

Dawes, Molly; Xie, Hongling

2014-02-01

The effect of popularity goal on the use of 3 popularity-related behaviors and later popularity status was examined in a diverse sample of 314 6th-grade students (176 girls and 138 boys) in both fall (Time 1) and spring (Time 2) semesters. Popularity goal and the use of popularity-driven behaviors (e.g., "I change the way I dress in order to be more popular") were assessed by self-report survey items (Time 1). Physical aggression, social aggression (Time 1), and perceived popularity (Times 1 and 2) were assessed by peer nominations. Popularity goal was positively associated with popularity-driven behaviors, social aggression, and physical aggression. There was a significant interaction effect between popularity goal and popularity status on the use of concurrent social aggression at Time 1; a higher popularity goal was associated with greater usage of social aggression for high-popular adolescents. Popularity goal alone did not predict popularity status change at Time 2; rather, greater use of social aggression at Time 1 was associated with higher Time 2 popularity status for initially high-popular adolescents who had a high-popularity goal and for initially low-popular adolescents who had a low-popularity goal. A similar 3-way interaction effect was found for physical aggression. Results suggest that the adolescents' goal for popularity may help us better understand the functions of aggressive and popularity-driven behaviors in peer social networks.

Perspective on Physical Therapist Management of Functional Constipation.

PubMed

George, Susan E; Borello-France, Diane F

2017-04-01

Functional constipation is a common bowel disorder leading to activity restrictions and reduced health-related quality of life. Typically, this condition is initially managed with prescription of laxatives or fiber supplementation, or both. However, these interventions are often ineffective and fail to address the underlying pathophysiology and impairments contributing to this condition. Physical therapists possess the knowledge and skills to diagnose and manage a wide range of musculoskeletal and motor coordination impairments that may contribute to functional constipation. Relevant anatomic, physiologic, and behavioral contributors to functional constipation are discussed with regard to specific constipation diagnoses. A framework for physical therapist examination of impairments that can affect gastrointestinal function, including postural, respiratory, musculoskeletal, neuromuscular, and behavioral impairments, is offered. Within the context of diagnosis-specific patient cases, multifaceted interventions are described as they relate to impairments underlying functional constipation type. The current state of evidence to support these interventions and patient recommendations is summarized. This perspective article aims not only to heighten physical therapists' awareness and management of this condition, but also to stimulate clinical questioning that will open avenues for future research to improve patient care. © 2016 American Physical Therapy Association.

Voluntary medical male circumcision: a cross-sectional study comparing circumcision self-report and physical examination findings in Lesotho.

PubMed

Thomas, Anne Goldzier; Tran, Bonnie Robin; Cranston, Marcus; Brown, Malerato Cecilia; Kumar, Rajiv; Tlelai, Matsotetsi

2011-01-01

Overwhelming evidence, including three clinical trials, shows that male circumcision (MC) reduces the risk of HIV infection among men. However, data from recent Lesotho Demographic and Health Surveys do not demonstrate MC to be protective against HIV. These contradictory findings could partially be due to inaccurate self-reported MC status used to estimate MC prevalence. This study describes MC characteristics among men applying for Lesotho Defence Force recruitment and seeks to assess MC self-reported accuracy through comparison with physical-examination-based data. During Lesotho Defence Force applicant screening in 2009, 241 (77%) of 312 men, aged 18-25 y, consented to a self-administered demographic and MC characteristic survey and physician-performed genital examination. The extent of foreskin removal was graded on a scale of 1 (no evidence of MC) to 4 (complete MC). MC was self-reported by 27% (n = 64/239) of participants. Of the 64 men self-reporting being circumcised, physical exam showed that 23% had no evidence of circumcision, 27% had partial circumcision, and 50% had complete circumcision. Of the MCs reportedly performed by a medical provider, 3% were Grade 1 and 73% were Grade 4. Of the MCs reportedly performed by traditional circumcisers, 41% were Grade 1, while 28% were Grade 4. Among participants self-reporting being circumcised, the odds of MC status misclassification were seven times higher among those reportedly circumcised by initiation school personnel (odds ratio = 7.22; 95% CI = 2.29-22.75). Approximately 27% of participants self-reported being circumcised. However, only 50% of these men had complete MC as determined by a physical exam. Given this low MC self-report accuracy, countries scaling up voluntary medical MC (VMMC) should obtain physical-exam-based MC data to guide service delivery and cost estimates. HIV prevention messages promoting VMMC should provide comprehensive education regarding the definition of VMMC.

Tunnelling in asymmetric double-well potentials: varying initial states

NASA Astrophysics Data System (ADS)

Cordes, J. G.; Das, A. K.

2001-02-01

Tunnelling in a double-well potential has features which are not derivable through a mere extension of the concepts used in the context of a single potential barrier with no confining walls on either side. Furthermore, an asymmetric double-well potential, relevant in many contemporary areas of physics and chemistry, possesses certain distinctive aspects in contrast to the relatively simple case of a symmetric double-well potential. In this paper a self-contained numerical and analytical study of these features is reported, and a theoretical model is presented with special attention being given to a unified treatment of both the symmetric and asymmetric cases. The popularly used pair-state model is critically examined, and the important role of the initial state (which is rarely discussed in the literature) is highlighted with specific examples.

Geomorphological control on variably saturated hillslope hydrology and slope instability

USGS Publications Warehouse

Giuseppe, Formetta; Simoni, Silvia; Godt, Jonathan W.; Lu, Ning; Rigon, Riccardo

2016-01-01

In steep topography, the processes governing variably saturated subsurface hydrologic response and the interparticle stresses leading to shallow landslide initiation are physically linked. However, these processes are usually analyzed separately. Here, we take a combined approach, simultaneously analyzing the influence of topography on both hillslope hydrology and the effective stress fields within the hillslope itself. Clearly, runoff and saturated groundwater flow are dominated by gravity and, ultimately, by topography. Less clear is how landscape morphology influences flows in the vadose zone, where transient fluxes are usually taken to be vertical. We aim to assess and quantify the impact of topography on both saturated and unsaturated hillslope hydrology and its effects on shallow slope stability. Three real hillslope morphologies (concave, convex, and planar) are analyzed using a 3-D, physically based, distributed model coupled with a module for computation of the probability of failure, based on the infinite slope assumption. The results of the analyses, which included parameter uncertainty analysis of the results themselves, show that convex and planar slopes are more stable than concave slopes. Specifically, under the same initial, boundary, and infiltration conditions, the percentage of unstable areas ranges from 1.3% for the planar hillslope, 21% for convex, to a maximum value of 33% for the concave morphology. The results are supported by a sensitivity analysis carried out to examine the effect of initial conditions and rainfall intensity.

Improving High School Physics Through An Outreach Initiative

NASA Astrophysics Data System (ADS)

Zettili, Nouredine

2006-04-01

We want to discuss our outreach initiative at Jacksonville State University designed to help improve the teaching of physics at a number of high schools in Northeast Alabama. This initiative is part of Project IMPACTSEED (IMproving Physics And Chemistry Teaching in SEcondary Education), a No-Child Left Behind grant funded by the Alabama Commission on Higher Education. This project is motivated by a major pressing local need: A large number of high school physics teachers teach out of field. IMPACTSEED is designed to achieve a double aim: (a) to make physics and chemistry understandable and fun to learn within a hands-on, inquiry-based setting; (b) to overcome the fear-factor for physics and chemistry among students. Through a two-week long summer institute, a series of weekend workshops designed to help bring technology into physics classrooms, onsite support, and a hotline, we have been providing year-round support to the physics/chemistry teachers in this area. IMPACTSEED aims at providing our students with a physics/chemistry education that enjoys a great deal of continuity and consistency from high school to college.

Statin use and incident frailty in women aged 65 years or older: prospective findings from the Women's Health Initiative Observational Study.

PubMed

LaCroix, Andrea Z; Gray, Shelly L; Aragaki, Aaron; Cochrane, Barbara B; Newman, Anne B; Kooperberg, Charles L; Black, Henry; Curb, J David; Greenland, Philip; Woods, Nancy F

2008-04-01

Inflammatory biomarkers have shown consistent associations with disability and frailty in older adults. Statin medications may reduce the incidence the frailty because of their anti-inflammatory effects. This study examines associations between current use, duration, and potency of statin medications and incident frailty in initially nonfrail women 65 years old or older. The authors conducted a prospective analysis of data from the Women's Health Initiative Observational Study (WHI-OS) conducted at 40 clinical centers in the United States. Eligible women were nonfrail and 65-79 years old at baseline (n = 25,378). Current statin use at baseline was ascertained through direct inspection of medicine containers during clinic visits. Frailty was ascertained through self-reported indicators and physical measurements at baseline and 3-year clinic contacts. Components of frailty included self-reported low physical function, exhaustion, low physical activity, and unintended weight loss. Multinomial logistic regression models were used to adjust for covariates predicting incident frailty. Among the 25,378 eligible women, 3453 (13.6%) developed frailty by the 3-year follow-up contact. Current statin use had no association with incident frailty (multivariate-adjusted odds ratio [OR] = 1.00; 95% confidence interval [CI], 0.85-1.16). Duration and potency of statin use were also not significantly associated with incident frailty. Among low potency statin users, longer duration of use was associated with reduced risk of frailty (p for trend =.02). A similar pattern of results was observed when frailty was studied in the absence of intervening, incident cardiovascular events. Overall, incidence of frailty was similar in current statin users and nonusers.

Association of vascular physical examination findings and arteriographic lesions in large vessel vasculitis.

PubMed

Grayson, Peter C; Tomasson, Gunnar; Cuthbertson, David; Carette, Simon; Hoffman, Gary S; Khalidi, Nader A; Langford, Carol A; McAlear, Carol A; Monach, Paul A; Seo, Philip; Warrington, Kenneth J; Ytterberg, Steven R; Merkel, Peter A

2012-02-01

To assess the utility of the vascular physical examination to detect arteriographic lesions in patients with established large vessel vasculitis (LVV), including Takayasu's arteritis (TAK) and giant cell arteritis (GCA). In total, 100 patients (TAK = 68, GCA = 32) underwent standardized physical examination and angiography of the carotid, subclavian, and axillary arteries. Sensitivity and specificity were calculated for the association between findings on physical examination focusing on the vascular system (absent pulse, bruit, and blood pressure difference) and arteriographic lesions defined as stenosis, occlusion, or aneurysm. We found 67% of patients had at least 1 abnormality on physical examination (74% TAK, 53% GCA). Arteriographic lesions were seen in 76% of patients (82% TAK, 63% GCA). Individual physical examination findings had poor sensitivity (range 14%-50%) and good-excellent specificity (range 71%-98%) to detect arteriographic lesions. Even when considering physical examination findings in combination, at least 30% of arteriographic lesions were missed. Specificity improved (range 88%-100%) if individual physical examination findings were compared to a broader region of vessels rather than specific anatomically correlated vessels and if ≥ 1 physical examination findings were combined. In patients with established LVV, physical examination alone is worthwhile to detect arterial disease but does not always localize or reveal the full extent of arteriographic lesions. Abnormal vascular system findings on physical examination are highly associated with the presence of arterial lesions, but normal findings on physical examination do not exclude the possibility of arterial disease. Serial angiographic assessment is advisable to monitor arterial disease in patients with established LVV.

Association of Vascular Physical Examination Findings and Arteriographic Lesions in Large Vessel Vasculitis

PubMed Central

GRAYSON, PETER C.; TOMASSON, GUNNAR; CUTHBERTSON, DAVID; CARETTE, SIMON; HOFFMAN, GARY S.; KHALIDI, NADER A.; LANGFORD, CAROL A.; McALEAR, CAROL A.; MONACH, PAUL A.; SEO, PHILIP; WARRINGTON, KENNETH J.; YTTERBERG, STEVEN R.; MERKEL, PETER A.

2013-01-01

Objective To assess the utility of the vascular physical examination to detect arteriographic lesions in patients with established large vessel vasculitis (LVV), including Takayasu’s arteritis (TAK) and giant cell arteritis (GCA). Methods In total, 100 patients (TAK = 68, GCA = 32) underwent standardized physical examination and angiography of the carotid, subclavian, and axillary arteries. Sensitivity and specificity were calculated for the association between findings on physical examination focusing on the vascular system (absent pulse, bruit, and blood pressure difference) and arteriographic lesions defined as stenosis, occlusion, or aneurysm. Results We found 67% of patients had at least 1 abnormality on physical examination (74% TAK, 53% GCA). Arteriographic lesions were seen in 76% of patients (82% TAK, 63% GCA). Individual physical examination findings had poor sensitivity (range 14%–50%) and good-excellent specificity (range 71%–98%) to detect arteriographic lesions. Even when considering physical examination findings in combination, at least 30% of arteriographic lesions were missed. Specificity improved (range 88%–100%) if individual physical examination findings were compared to a broader region of vessels rather than specific anatomically correlated vessels and if ≥ 1 physical examination findings were combined. Conclusion In patients with established LVV, physical examination alone is worthwhile to detect arterial disease but does not always localize or reveal the full extent of arteriographic lesions. Abnormal vascular system findings on physical examination are highly associated with the presence of arterial lesions, but normal findings on physical examination do not exclude the possibility of arterial disease. Serial angiographic assessment is advisable to monitor arterial disease in patients with established LVV. PMID:22174204

Association of leisure-time physical activity with cognition by apolipoprotein-E genotype in persons aged 60 years and over: the National Health and Nutrition Examination Survey (NHANES-III).

PubMed

Obisesan, Thomas O; Umar, Nisser; Paluvoi, Nivedh; Gillum, Richard F

2012-01-01

To test the hypothesis that aerobic-related leisure-time physical activity (PA) is associated with better cognitive function and that the effect varies among apolipoprotein E (APOE) genotype groups. Cross-sectional study of persons examined in the Third National Health and Nutrition Examination Survey (NHANES-III; 1988-1994). US noninstitutionalized population. From a sample of 7159, aged ≥60 years, we analyzed data for 1799 older American men and women who had information on PA, a short mental status examination (SMSE), and were genotyped at the apolipoprotein E gene locus. In the initial bivariate analysis, non-ɛ4 carriers and ɛ4-heterozygotes performed better than ɛ4-homozygotes in the 60-69 age group. After controlling for multiple confounders including mobility limitation, PA correlated with a higher SMSE score in non-ɛ4 carriers (P = 0.014), but not in ɛ4 carriers (P = 0.887). At ≥70 years, PA also correlated with higher adjusted SMSE scores in non-ɛ4 carriers (P = 0.02); but this association became nonsignificant after controlling for mobility limitation (P = 0.12). In a nationally representative sample, PA was associated with enhanced cognition, an effect that was differentially influenced by apolipoprotein E genotype. Experimental studies are needed to determine whether or not PA can attenuate cognitive decline.

Manual Khalifa Therapy Improves Functional and Morphological Outcome of Patients with Anterior Cruciate Ligament Rupture in the Knee: A Randomized Controlled Trial

PubMed Central

Kastner, Andreas; Wallenboeck, Engelbert; Pehn, Robert; Schneider, Frank; Groell, Reinhard; Szolar, Dieter; Walach, Harald; Sandner-Kiesling, Andreas

2014-01-01

Rupture of the anterior cruciate ligament (ACL) is a high incidence injury usually treated surgically. According to common knowledge, it does not heal spontaneously, although some claim the opposite. Regeneration therapy by Khalifa was developed for injuries of the musculoskeletal system by using specific pressure to the skin. This randomized, controlled, observer-blinded, multicentre study was performed to validate this assumption. Thirty patients with complete ACL rupture, magnetic resonance imaging (MRI) verified, were included. Study examinations (e.g., international knee documentation committee (IKDC) score) were performed at inclusion (t 0). Patients were randomized to receive either standardised physiotherapy (ST) or additionally 1 hour of Khalifa therapy at the first session (STK). Twenty-four hours later, study examinations were performed again (t 1). Three months later control MRI and follow-up examinations were performed (t 2). Initial status was comparable between both groups. There was a highly significant difference of mean IKDC score results at t 1 and t 2. After 3 months, 47% of the STK patients, but no ST patient, demonstrated an end-to-end homogeneous ACL in MRI. Clinical and physical examinations were significantly different in t 1 and t 2. ACL healing can be improved with manual therapy. Physical activity can be performed without pain and nearly normal range of motion after one treatment of specific pressure. PMID:24600477

Anal Health Care Basics

PubMed Central

Chang, Jason; McLemore, Elisabeth; Tejirian, Talar

2016-01-01

Despite the fact that countless patients suffer from anal problems, there tends to be a lack of understanding of anal health care. Unfortunately, this leads to incorrect diagnoses and treatments. When treating a patient with an anal complaint, the primary goals are to first diagnose the etiology of the symptoms correctly, then to provide an effective and appropriate treatment strategy. The first step in this process is to take an accurate history and physical examination. Specific questions include details about bowel habits, anal hygiene, and fiber supplementation. Specific components of the physical examination include an external anal examination, a digital rectal examination, and anoscopy if appropriate. Common diagnoses include pruritus ani, anal fissures, hemorrhoids, anal abscess or fistula, fecal incontinence, and anal skin tags. However, each problem presents differently and requires a different approach for management. It is of paramount importance that the correct diagnosis is reached. Common errors include an inaccurate diagnosis of hemorrhoids when other pathology is present and subsequent treatment with a steroid product, which is harmful to the anal area. Most of these problems can be avoided by improving bowel habits. Adequate fiber intake with 30 g to 40 g daily is important for many reasons, including improving the quality of stool and preventing colorectal and anal diseases. In this Special Report, we provide an overview of commonly encountered anal problems, their presentation, initial treatment options, and recommendations for referral to specialists. PMID:27723447

Advancing Sustainability through Urban Green Space: Cultural Ecosystem Services, Equity, and Social Determinants of Health

PubMed Central

Jennings, Viniece; Larson, Lincoln; Yun, Jessica

2016-01-01

Urban green spaces provide an array of benefits, or ecosystem services, that support our physical, psychological, and social health. In many cases, however, these benefits are not equitably distributed across diverse urban populations. In this paper, we explore relationships between cultural ecosystem services provided by urban green space and the social determinants of health outlined in the United States Healthy People 2020 initiative. Specifically, we: (1) explore connections between cultural ecosystem services and social determinants of health; (2) examine cultural ecosystem services as nature-based health amenities to promote social equity; and (3) recommend areas for future research examining links between urban green space and public health within the context of environmental justice. PMID:26861365

Advancing Sustainability through Urban Green Space: Cultural Ecosystem Services, Equity, and Social Determinants of Health.

PubMed

Jennings, Viniece; Larson, Lincoln; Yun, Jessica

2016-02-05

Urban green spaces provide an array of benefits, or ecosystem services, that support our physical, psychological, and social health. In many cases, however, these benefits are not equitably distributed across diverse urban populations. In this paper, we explore relationships between cultural ecosystem services provided by urban green space and the social determinants of health outlined in the United States Healthy People 2020 initiative. Specifically, we: (1) explore connections between cultural ecosystem services and social determinants of health; (2) examine cultural ecosystem services as nature-based health amenities to promote social equity; and (3) recommend areas for future research examining links between urban green space and public health within the context of environmental justice.

21 CFR 1210.12 - Physical examination of cows.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Physical examination of cows. 1210.12 Section 1210... FEDERAL IMPORT MILK ACT Inspection and Testing § 1210.12 Physical examination of cows. (a) Physical.... (b) The result of the physical examination shall be set forth in the form prescribed by the Secretary. ...

21 CFR 1210.12 - Physical examination of cows.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Physical examination of cows. 1210.12 Section 1210... FEDERAL IMPORT MILK ACT Inspection and Testing § 1210.12 Physical examination of cows. (a) Physical.... (b) The result of the physical examination shall be set forth in the form prescribed by the Secretary. ...

21 CFR 1210.12 - Physical examination of cows.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Physical examination of cows. 1210.12 Section 1210... FEDERAL IMPORT MILK ACT Inspection and Testing § 1210.12 Physical examination of cows. (a) Physical.... (b) The result of the physical examination shall be set forth in the form prescribed by the Secretary. ...

21 CFR 1210.12 - Physical examination of cows.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Physical examination of cows. 1210.12 Section 1210... FEDERAL IMPORT MILK ACT Inspection and Testing § 1210.12 Physical examination of cows. (a) Physical.... (b) The result of the physical examination shall be set forth in the form prescribed by the Secretary. ...

Coupling of a distributed stakeholder-built system dynamics socio-economic model with SAHYSMOD for sustainable soil salinity management. Part 2: Model coupling and application

NASA Astrophysics Data System (ADS)

Inam, Azhar; Adamowski, Jan; Prasher, Shiv; Halbe, Johannes; Malard, Julien; Albano, Raffaele

2017-08-01

Many simulation models focus on simulating a single physical process and do not constitute balanced representations of the physical, social and economic components of a system. The present study addresses this challenge by integrating a physical (P) model (SAHYSMOD) with a group (stakeholder) built system dynamics model (GBSDM) through a component modeling approach based on widely applied tools such as MS Excel, Python and Visual Basic for Applications (VBA). The coupled model (P-GBSDM) was applied to test soil salinity management scenarios (proposed by stakeholders) for the Haveli region of the Rechna Doab Basin in Pakistan. Scenarios such as water banking, vertical drainage, canal lining, and irrigation water reallocation were simulated with the integrated model. Spatiotemporal maps and economic and environmental trade-off criteria were used to examine the effectiveness of the selected management scenarios. After 20 years of simulation, canal lining reduced soil salinity by 22% but caused an initial reduction of 18% in farm income, which requires an initial investment from the government. The government-sponsored Salinity Control and Reclamation Project (SCARP) is a short-term policy that resulted in a 37% increase in water availability with a 12% increase in farmer income. However, it showed detrimental effects on soil salinity in the long term, with a 21% increase in soil salinity due to secondary salinization. The new P-GBSDM was shown to be an effective platform for engaging stakeholders and simulating their proposed management policies while taking into account socioeconomic considerations. This was not possible using the physically based SAHYSMOD model alone.

Development and Initial Validation of the Chinese Version of Psychological Needs Thwarting Scale in Physical Education

ERIC Educational Resources Information Center

Liu, Jing Dong; Chung, Pak-Kwong

2015-01-01

The current study presents the development process and initial validation of a measure designed for assessing psychological needs thwarting (frustration) in a secondary school physical education context (Psychological Needs Thwarting Scale in Physical Education, PNTSPE). Secondary school students (grades 7-9) from Hong Kong (N = 1258) were invited…

Walking impairment in patients with multiple sclerosis: exercise training as a treatment option.

PubMed

Motl, Robert W; Goldman, Myla D; Benedict, Ralph H B

2010-11-16

Multiple sclerosis (MS) is a chronic disease of the central nervous system that culminates in the progression of physical and cognitive disability over time. Walking impairment is a ubiquitous feature of MS and a sentinel characteristic of the later or advanced stages of the disease. This paper presents a conceptual rationale along with empirical evidence for exercise training as a rehabilitation approach for managing walking impairment and improving walking function in persons with MS. Conceptually, MS is associated with a decrease in physical activity, which, in turn, can result in deconditioning across multiple domains of physiological functioning. The resulting deconditioning feeds back and further drives physical inactivity until a threshold is reached that likely initiates the progression of walking impairment in MS. Empirically, physical activity and exercise training have been associated with beneficial effects on walking function in persons with MS. This is based on cross-sectional, longitudinal, and experimental research that included diversity in the breadth of measures of walking, persons with MS, and exercise/physical activity characteristics. Of particular importance, future researchers might consider examining the combinatory effects of exercise training plus pharmacological agents on walking mobility in MS. Collectively, exercise training and physical activity might hold significant potential for the management of progressive mobility disability in MS.

[A series about the value of physical examination].

PubMed

de Jongh, T O H; Zaat, J O M

2010-01-01

This article is the introduction to a new series in the Nederlands Tijdschrift voor Geneeskunde about the value of physical examination. Associated with this series, on the website (www.ntvg.nl) there are chapters of the new textbook on physical examination and films about carrying out physical examinations. Although physical examination is an essential part of the diagnostic process, often little attention is paid to the correct execution of the examination and there is insufficient knowledge of the value of the findings. The diagnostic process usually involves analysing all the information from the patient's history and a physical examination. However, research has only been done on the value of specific tests and even that is very limited. The most important measure we use for the results of a physical examination is the likelihood ratio, which shows how the likelihood of presence or absence of a disease changes depending on the examination results.

Beyond initial attraction: physical attractiveness in newlywed marriage.

PubMed

McNulty, James K; Neff, Lisa A; Karney, Benjamin R

2008-02-01

Physical appearance plays a crucial role in shaping new relationships, but does it continue to affect established relationships, such as marriage? In the current study, the authors examined how observer ratings of each spouse's facial attractiveness and the difference between those ratings were associated with (a) observations of social support behavior and (b) reports of marital satisfaction. In contrast to the robust and almost universally positive effects of levels of attractiveness on new relationships, the only association between levels of attractiveness and the outcomes of these marriages was that attractive husbands were less satisfied. Further, in contrast to the importance of matched attractiveness to new relationships, similarity in attractiveness was unrelated to spouses' satisfaction and behavior. Instead, the relative difference between partners' levels of attractiveness appeared to be most important in predicting marital behavior, such that both spouses behaved more positively in relationships in which wives were more attractive than their husbands, but they behaved more negatively in relationships in which husbands were more attractive than their wives. These results highlight the importance of dyadic examinations of the effects of spouses' qualities on their marriages.

A 3-month-old infant with atypical Kawasaki disease.

PubMed

Lertamornkitti, Nichkamol; Wangjirapan, Anchalee

2018-05-30

We report a 3-month-old girl who presented with high-grade fever for 3 days. Her initial physical examination was normal. Investigation showed abnormal white cells in her urine. She was diagnosed with a urinary tract infection and received an antibiotic for 1 day. After that, she developed a generalised maculopapular rash over her body. An adverse drug reaction from the antibiotic was suspected, and the patient was referred to our hospital. On admission, she still had fever and was irritable. She was diagnosed with sepsis and given another broad-spectrum antibiotic for 2 days. However, her fever still persisted. An additional thorough physical examination showed redness of her BCG inoculation scar. Consequently, a diagnosis of Kawasaki disease (KD) was made. After she received intravenous immunoglobulin, her fever diminished straight away. This case highlights an unusual manifestation of KD in an uncommonly young age group. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Initiative Games in Physical Education: A Practical Approach for Teaching Critical Thinking Skills--Part 1

ERIC Educational Resources Information Center

Maina, Michael P.; Maina, Julie Schlegel; Hunt, Kevin

2016-01-01

As teachers prepare children for the future, the need for developing critical thinking skills in students becomes clearly evident. One way to promote this process is through initiative games. Initiative games are clearly defined problems that a group must find a solution to through cooperation, physical effort and cognitive functioning. The…

Alcohol Advertising on Social Media: Examining the Content of Popular Alcohol Brands on Instagram.

PubMed

Barry, Adam E; Padon, Alisa A; Whiteman, Shawn D; Hicks, Kristen K; Carreon, Amie K; Crowell, Jarrett R; Willingham, Kristen L; Merianos, Ashley L

2018-06-11

There is considerable evidence that exposure to alcohol marketing increases the likelihood of adolescents initiating and engaging in alcohol consumption. There is a paucity of research, however, specifically examining industry generated alcohol marketing occurring on social media/networking platforms. The purpose of this investigation was to analyze the content of promotional advertisements by alcohol brands on Instagram. For a 30-day period, Instagram profiles of 15 distinct alcohol brands were examined. Pictorial posts/updates from each profile were screen captured and individually documented. Approximately 184 distinct posts constituted our final sample. The Content Appealing to Youth Index was independently employed by two raters to assess each post. For each characteristic, Cohen's Kappa measures, and associated 95% confidence intervals, were calculated. Descriptive statistics were performed. Posts increased throughout the week and peaked on Thursday and Friday. The production value of the posts examined was generally high, frequently featuring color, texture, shine, contrast, faces, and action. Character appeals and use of youth-oriented genres were uncommon. Many of the posts used product appeals and physical benefits to consumption. The posts also emphasized the following rewarding appeal characteristics: positive emotional experiences, achievement, individuality, and camaraderie. The most commonly coded risk-related feature was inappropriate use. Conclusions/Importance: This investigation represents an initial attempt to provide insights into the content alcohol brands are including in their promotional materials on social networking sites.

The Outpatient Physical Examination.

PubMed

Artandi, Maja K; Stewart, Rosalyn W

2018-05-01

The physical examination in the outpatient setting is a valuable tool. Even in settings where there is lack of evidence, such as the annual physical examination of an asymptomatic adult, the physical examination is beneficial for the physician-patient relationship. When a patient has specific symptoms, the physical examination-in addition to a thorough history-can help narrow down, or in many cases establish, a diagnosis. In a time where imaging and laboratory tests are easily available, but are expensive and can be invasive, a skilled physical examination remains an important component of patient evaluation. Copyright © 2018 Elsevier Inc. All rights reserved.

Parents and Young Children with Disabilities: The Effects of a Home-Based Music Therapy Program on Parent-Child Interactions.

PubMed

Yang, Yen-Hsuan

2016-01-01

Responsive parenting style and synchronous parent-child interactions have a positive impact on children in terms of language, cognitive, and social-emotional development. Despite widely documented benefits of music therapy on parent-child interactions, empirical evidence for the effects of music therapy on parent-child synchrony is lacking. To examine effects of parent-child dyads' participation in a six-week home-based music therapy program on parent response, child initiation, and parent-child synchrony, as well as parents' daily use of musical activities with their child. Twenty-six parent-child dyads participated in this pretest-posttest within-subject single-group design study. Participating dyads included parents and their child with disabilities or developmental delays (ages 1-3 years inclusive). Parent-child dyads participated in a home-based music therapy program that included six weekly 40-minute sessions, and incorporated five responsive teaching strategies (i.e., affect, match, reciprocity, shared control, and contingency). Observational data were recorded for parent-child interactions and parent-child synchrony. Parents' positive physical and verbal responses, as well as children's positive verbal initiations, increased significantly pre- to post-intervention; however, children's positive physical initiations did not increase significantly. Parent-child synchrony also improved significantly pre- to post-intervention. Findings support the use of home-based music therapy programs to facilitate parent-child interactions in the areas of parental responsiveness and child-initiated communication, as well as parent-child synchrony. © the American Music Therapy Association 2015. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

A core physical examination in internal medicine: what should students do and how about their supervisors?

PubMed

Haring, Catharina M; van der Meer, Jos W M; Postma, Cornelis T

2013-09-01

Performance of a focused physical examination will induce a high cognitive load for medical students in the early phase of the clinical clerkships. To come to a workable and clinically applicable standard physical examination for medical students to be used in every new patient in the daily clinical practice of internal medicine. A questionnaire held among physicians that supervise students during the clerkship of internal medicine in one Dutch training region. Of the complete list of physical examination 55 items were considered to be an integral part of the standard general physical examination for medical students. Most emphasized were elements of the physical examination aimed at general parameters, thorax and abdomen, vascular status, lymph nodes, spinal column, skin and some parts of the neurological examination. The standard physical examinations performed by supervisors themselves contain fewer items than they expected from the students. The expectations a supervisor has towards the student correlates with the frequency with which they apply the various components in their own physical examination. This study provides us with a 'core' physical examination for medical students that can be applied in the early phase of the clinical clerkships.

Insight and other predictors of physical examination refusal in psychotic illness.

PubMed

Iwata, Kazuya; Strydom, Andre; Osborn, David

2011-08-01

Poor physical health in psychiatric patients is well recognized, yet factors contributing to physical examination noncompliance in psychotic illness have not been previously studied. To examine whether insight or any other variables were independent predictors of physical examination noncompliance. A case-note study (N = 200) of inpatient psychiatric patients in four hospitals in London, UK was conducted to examine the relationship between insight and physical examination noncompliance within 24  h of admission and over 2 weeks. Clinical variables including illness severity were also examined. Patients who were noncompliant with physical examinations offered within 24  h and over 2 weeks were associated with lack of insight, higher illness severity, female gender, longer history of illness, current compulsory admission, and previous history of detention. After adjusting for confounding factors, lack of insight, female gender, and previous history of detention were found to be independent predictors of physical examination noncompliance for 24  h and 2 weeks. Lack of insight is highly predictive of physical examination noncompliance for up to 2 weeks, indicating that mental incapacity to consenting to medical care may be common and that more proactive physical screening may be required for these patients.

Women in physics in the Netherlands: Progress and developments

NASA Astrophysics Data System (ADS)

Rudolf, Petra; de Graaf, Noortje; Koornstra, Renée-Andrée; van Tijn, Paula; Kool, Dorien

2015-12-01

The visibility of women and the awareness of a healthy gender balance in physics in the Netherlands have clearly improved over the last few years. Initiatives to promote women and their possibilities to pursue a career in physics are plentiful and commendable. Nevertheless, the numbers do not yet show the desired impact of all these initiatives. Although student numbers have increased, the percentage of female first-year student remains at approximately 13% of the total students in physics. Similarly, the relative numbers of female PhD candidates and postdocs have been stable over the last years at (both) approximately 20% to 25%. Despite the number of women obtaining a PhD in physics and continuing a scientific career as postdoc, the presence of women further up on the scientific ladder in physics remains strikingly low. We will here focus on the current status, ambitions, and initiatives in the Netherlands to promote women, and especially to keep them, in physics.

The Cost-Effective Evaluation of Syncope.

PubMed

Angus, Steven

2016-09-01

Syncope is a common clinical problem that carries a high socioeconomic burden. A structured approach in the evaluation of syncope with special emphasis on a detailed history, comprehensive physical examination that includes orthostatic vital signs, and an electrocardiogram, proves to be the most cost-effective approach. The need for additional testing and hospital admission should be based on the results of the initial evaluation and use of risk-stratification tools that help identify those syncope patients at highest risk for poor outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

Wound botulism.

PubMed

Burningham, M D; Walter, F G; Mechem, C; Haber, J; Ekins, B R

1994-12-01

Wound botulism is a rare infectious and toxicologic complication of trauma and i.v. drug abuse. Only 39 cases have been reported in detail in the English literature. This case report describes a patient with wound botulism who presented to four medical facilities before receiving definitive diagnosis and treatment. Although his history and physical examination were consistent with wound botulism, diagnosis and therapy were delayed because this rare disease was not considered initially in the differential diagnosis. Wound botulism should be considered in trauma patients and i.v. drug abusers who present with cranial nerve palsies and descending paresis.

Damage assessment in multilayered MEMS structures under thermal fatigue

NASA Astrophysics Data System (ADS)

Maligno, A. R.; Whalley, D. C.; Silberschmidt, V. V.

2011-07-01

This paper reports on the application of a Physics of Failure (PoF) methodology to assessing the reliability of a micro electro mechanical system (MEMS). Numerical simulations, based on the finite element method (FEM) using a sub-domain approach was used to examine the damage onset due to temperature variations (e.g. yielding of metals which may lead to thermal fatigue). In this work remeshing techniques were employed in order to develop a damage tolerance approach based on the assumption that initial flaws exist in the multi-layered.

Concentrating on beauty: sexual selection and sociospatial memory.

PubMed

Becker, D Vaughn; Kenrick, Douglas T; Guerin, Stephen; Maner, Jon K

2005-12-01

In three experiments, location memory for faces was examined using a computer version of the matching game Concentration. Findings suggested that physical attractiveness led to more efficient matching for female faces but not for male faces. Study 3 revealed this interaction despite allowing participants to initially see, attend to, and match the attractive male faces in the first few turns. Analysis of matching errors suggested that, compared to other targets, attractive women were less confusable with one another. Results are discussed in terms of the different functions that attractiveness serves for men and women.

Comment on ;Evaluation of a physically based quasi-linear and a conceptually based nonlinear Muskingum methods; [J. Hydrol., 546, 437-449, 10.1016/j.jhydrol.2017.01.025

NASA Astrophysics Data System (ADS)

Barati, Reza

2017-07-01

Perumal et al. (2017) compared the performances of the variable parameter McCarthy-Muskingum (VPMM) model of Perumal and Price (2013) and the nonlinear Muskingum (NLM) model of Gill (1978) using hypothetical inflow hydrographs in an artificial channel. As input parameters, first model needs the initial condition, upstream boundary condition, Manning's roughness coefficient, length of the routing reach, cross-sections of the river reach and the bed slope, while the latter one requires the initial condition, upstream boundary condition and the hydrologic parameters (three parameters which can be calibrated using flood hydrographs of the upstream and downstream sections). The VPMM model was examined by available Manning's roughness values, whereas the NLM model was tested in both calibration and validation steps. As final conclusion, Perumal et al. (2017) claimed that the NLM model should be retired from the literature of the Muskingum model. While the author's intention is laudable, this comment examines some important issues in the subject matter of the original study.

Premarital mental disorders and physical violence in marriage: cross-national study of married couples

PubMed Central

Miller, Elizabeth; Breslau, Joshua; Petukhova, Maria; Fayyad, John; Green, Jennifer Greif; Kola, Lola; Seedat, Soraya; Stein, Dan J.; Tsang, Adley; Viana, Maria Carmen; Andrade, Laura Helena; Demyttenaere, Koen; de Girolamo, Giovanni; Haro, Josep Maria; Hu, Chiyi; Karam, Elie G.; Kovess-Masfety, Viviane; Tomov, Toma; Kessler, Ronald C.

2011-01-01

Background Mental disorders may increase the risk of physical violence among married couples. Aims To estimate associations between premarital mental disorders and marital violence in a cross-national sample of married couples. Method A total of 1821 married couples (3642 individuals) from 11 countries were interviewed as part of the World Health Organization's World Mental Health Survey Initiative. Sixteen mental disorders with onset prior to marriage were examined as predictors of marital violence reported by either spouse. Results Any physical violence was reported by one or both spouses in 20% of couples, and was associated with husbands' externalising disorders (OR = 1.7, 95% CI 1.2-2.3). Overall, the population attributable risk for marital violence related to premarital mental disorders was estimated to be 17.2%. Conclusions Husbands' externalising disorders had a modest but consistent association with marital violence across diverse countries. This finding has implications for the development of targeted interventions to reduce risk of marital violence. PMID:21778172

Maximizing the Adjacent Possible in Automata Chemistries.

PubMed

Hickinbotham, Simon; Clark, Edward; Nellis, Adam; Stepney, Susan; Clarke, Tim; Young, Peter

2016-01-01

Automata chemistries are good vehicles for experimentation in open-ended evolution, but they are by necessity complex systems whose low-level properties require careful design. To aid the process of designing automata chemistries, we develop an abstract model that classifies the features of a chemistry from a physical (bottom up) perspective and from a biological (top down) perspective. There are two levels: things that can evolve, and things that cannot. We equate the evolving level with biology and the non-evolving level with physics. We design our initial organisms in the biology, so they can evolve. We design the physics to facilitate evolvable biologies. This architecture leads to a set of design principles that should be observed when creating an instantiation of the architecture. These principles are Everything Evolves, Everything's Soft, and Everything Dies. To evaluate these ideas, we present experiments in the recently developed Stringmol automata chemistry. We examine the properties of Stringmol with respect to the principles, and so demonstrate the usefulness of the principles in designing automata chemistries.

Advanced physical assessment skills: implementation of a module.

PubMed

Aldridge-Bent, Sharon

2011-02-01

This article aims to explore and examine advanced physical assessment skills and the role of the district nurse. It will particularly highlight district nurses' perceptions of how they may implement skills learnt on a new module introduced into the Community Health Care Nursing degree at a university in London. Physical assessment skills have traditionally been viewed as part of a doctor's role; however, with the advancement of nursing roles, it is argued that it has become a key nursing skill. As Government policy continues to expect health professionals to keep patients in the community who have complex health and social care needs, the role of the district nurse presents as 'best placed' to take on this challenge (Department of Health (DH), 2005a; 2005b). Evaluation of the district nurses' perceptions of their practice is shared here, highlighting some of the challenges that they face. The article will address the complexity of developing a curriculum in response to the DH initiatives and the importance of listening to students on courses.

Psychiatric and Cognitive Functioning in Adolescent Inpatients with Histories of Dating Violence Victimization

PubMed Central

Rizzo, Christie J.; Esposito-Smythers, Christianne; Spirito, Anthony; Thompson, Ariel

2010-01-01

The presence of dating violence victimization as well as its relation to psychiatric diagnosis and cognitive processes was examined in a sample of 155 adolescents hospitalized in a psychiatric facility. Participants and their parents completed semi-structured diagnostic interviews. Participants also completed self-report measures of dating violence victimization and cognitive functioning. Seventy-seven percent of adolescents who had initiated dating reported psychological, physical, and/or sexual abuse by a dating partner over the past year. Victims of psychological abuse alone as well as physical and/or sexual violence endorsed higher rates of major depressive disorder compared to non-victims. Physical/sexual dating violence victims also endorsed significantly higher rates of PTSD and alcohol use disorders, more frequent co-occurrence of externalizing and internalizing disorders, and more frequent negative cognitive biases, relative to non-victimized adolescents. Findings suggest that psychiatrically hospitalized adolescents with dating violence histories represent a subgroup of adolescent inpatients with a particularly serious clinical picture. PMID:20824193

Fatigue: an overview.

PubMed

Rosenthal, Thomas C; Majeroni, Barbara A; Pretorius, Richard; Malik, Khalid

2008-11-15

Fatigue, a common presenting symptom in primary care, negatively impacts work performance, family life, and social relationships. The differential diagnosis of fatigue includes lifestyle issues, physical conditions, mental disorders, and treatment side effects. Fatigue can be classified as secondary to other medical conditions, physiologic, or chronic. The history and physical examination should focus on identifying common secondary causes (e.g., medications, anemia, pregnancy) and life-threatening problems, such as cancer. Results of laboratory studies affect management in only 5 percent of patients, and if initial results are normal, repeat testing is generally not indicated. Treatment of all types of fatigue should include a structured plan for regular physical activity that consists of stretching and aerobic exercise, such as walking. Caffeine and modafinil may be useful for episodic situations requiring alertness. Short naps are proven performance enhancers. Selective serotonin reuptake inhibitors, such as fluoxetine, paroxetine, or sertraline, may improve energy in patients with depression. Patients with chronic fatigue may respond to cognitive behavior therapy. Scheduling regular follow-up visits, rather than sporadic urgent appointments, is recommended for effective long-term management.

Physical examination performed by psychiatrists.

PubMed

Hodgson, Richard; Adeyemo, Olubukola

2004-01-01

Too little, too late? Physical examinations performed by trainee psychiatrists on newly admitted psychiatric patients. To assess the comprehensiveness of the physical examination carried out by psychiatric trainees on acute in-patient units. To quantify delays in undertaking physical examination on psychiatric inpatients. A prospective case note study of 60 consecutive admissions to acute psychiatric wards in North Staffordshire. Information regarding demography, details of physical examination and routine blood investigations was collected. The case notes of 60 inpatients were studied. Mean age was 38.7 years and the sex ratio equal. A delay in performing a physical occurred in 17 (28.8%) patients. No explanation for a delay was given in six (10.0%) cases. The mean time to physical examination from admission was 61.8 h (range 0-612 h). The standard of physical examination was variable. The central nervous system (CNS) was reported as 'grossly intact' in six (10.2%) cases with only 34 (57.6%) of patients having a comprehensive CNS examination. Psychiatric patients are not receiving a comprehensive physical examination. Whilst the patient's ability to co-operate may account for a delay in the examination, it is unlikely to be the reason for the CNS being examined in just half the patients. Opportunities to reduce the physical morbidity associated with mental illness may be being lost. (MJ Psych Clin Pract 2004; 8: 57-60).

Synthesis and testing of ZnO nanoparticles for photo-initiation: experimental observation of two different non-migration initiators for bulk polymerization.

PubMed

Schmitt, M

2015-06-07

The migration and transport of polymerization initiators are problematic for commercially used polymerization procedures. For example, UV printing of packaging generates products with potentially harmful components that come in contact with food. Enlarging the size of the initiator is the only way to prevent contamination, e.g., by gas phase transport. In this manuscript, the synthesis and advanced and full analyses of novel nanoparticle-based types of non-migration, fragmenting and non-fragmenting photo-initiators will be presented in detail. This study introduces non-fragmenting/"Norrish type II" and fragmenting/"Norrish type I" ZnO nanoparticle-based initiators and compares them with two commercial products, a "Norrish type I" initiator and a "Norrish type II" initiator. Therefore, inter alia, the recently developed analysis involves examining the solidification by UV-vis and the double bond content by Raman. Irradiation is performed using absolute and spectrally calibrated xenon flash lights. A novel procedure for absolute and spectral calibration of such light sources is also presented. The non-optimized "Norrish type II" particle-based initiator is already many times faster than benzophenone, which is a molecular initiator of the same non-fragmenting type. This experimentally observed difference in reactive particle-based systems without co-initiators is unexpected. Co-initiators are normally an additional molecular species, which leads to migration problems. The discovery of significant initiation potential resulting in a very well-dispersed organic-inorganic hybrid material suggests a new field of research opportunities at the interface of physical chemistry, polymer chemistry and engineering science, with enormous value for human health.

A path model analysis on predictors of dropout (at 6 and 12 months) during the weight loss interventions in endocrinology outpatient division.

PubMed

Perna, Simone; Spadaccini, Daniele; Riva, Antonella; Allegrini, Pietro; Edera, Chiara; Faliva, Milena Anna; Peroni, Gabriella; Naso, Maurizio; Nichetti, Mara; Gozzer, Carlotta; Vigo, Beatrice; Rondanelli, Mariangela

2018-02-22

This study aimed to identify the dropout rate at 6 and 12 months from the first outpatient visit, and to analyze dropout risk factors among the following areas: biochemical examinations, anthropometric measures, psychological tests, personal data, and life attitude such as smoking, physical activity, and pathologies. This is a retrospective longitudinal observational study. Patients undergo an outpatient endocrinology visit, which includes collecting biographical data, anthropometric measurements, physical and pathological history, psychological tests, and biochemical examinations. The sample consists of 913 subjects (682 women and 231 men), with an average age of 50.88 years (±15.80) for the total sample, with a BMI of 33.11 ± 5.65 kg/m 2 . 51.9% of the patients abandoned therapy at 6 months after their first visit, and analyzing the dropout rate at 12 months, it appears that 69.5% of subjects abandon therapy. The main predictor of dropout risk factors at 6 and 12 months is the weight loss during the first 3 months (p < 0.05). As regards the hematological predictors, white blood cell and iron level stated dropout at 12 months. Patients who introduced physical activity had a reduction of - 17% (at 6 months) and -13% (at 12 months) of dropout risk (p < 0.05). As regards the "worker" status, patients classified as"retired" had a decrease risk of dropout vs. other categories of worker (i = 0.58; p < 0.05). Dropout risk at 12 months decrease in patients with a previous history of cancer, Endocrine and psychic and behavioral disorders (p < 0.001). The main factor that predisposes patients to continue therapy or to abandon it is the success (or failure) of the diet in the initial period, based on weight lost (or not lost) in the early months of the initiation of therapy. Furthermore, considerable differences were found in different categories of "workers", and with previous "pathologies". The level of physical activity and previous diseases also seem to be predictors of dropout.

Let Us Look After the Veins of the Earth: The Sonification of Time-series Field Data by Analog Methods

NASA Astrophysics Data System (ADS)

Rivera, V. A.; Amaya, L. F.

2017-12-01

In 2016, graduate students from Northwestern University's Center for Interdisciplinary Exploration and Research in Astrophysics (CIERA) initiated the Science Sonification and Composition Project, which pairs scientists with student composers to create original music inspired by and utilizing the products of scientific research. In 2017, these pieces were performed at Northwestern for a mixed audience of scientists, musicians, and community members. Sonification of data, or the representation of data as sound, is an increasingly popular method of examining data in the geosciences, especially in astrophysics, where sonification of gravitational waves has recently made major news. Numerical time-series data are often excellent candidates for sonification, as the data can be modified by simple algorithmic means to convert numerical values which represent physical measurements to numerical values representing musical "variables" like volume, pitch, or timbre. Our collaboration, a result of the CIERA initiative, explores methods of sonification that do not involve a simple conversion of data to sound, instead attempting to create sound from data by analog methods. The piece uses both time-series groundwater elevation data and physical soil samples from the locations where the water table measurements were collected. The field site from which both data and samples were collected is Gensburg Markham Prairie, an urban nature preserve on Chicago's south side which hosts a long-term study on the collateral benefits of urban greenspace for stormwater management and storage. Our aim was to combine physical, living elements with technology to mirror the research, where we examine flows and cycles in nature by "taking the pulse" of the landscape using sensing networks. Soil samples were placed in metal vessels outfitted with contact microphones and manipulated by hand and with water, using time-series data as a guide, much like sheet music. This was repeated for samples and sensors at different physical locations throughout the prairie, with each recording comprising an audible representation of soil properties and water dynamics at each location. The resulting sound was processed to create electronic music, which was paired with live instrumental performance.

The validity of multiphase DNS initialized on the basis of single--point statistics

NASA Astrophysics Data System (ADS)

Subramaniam, Shankar

1999-11-01

A study of the point--process statistical representation of a spray reveals that single--point statistical information contained in the droplet distribution function (ddf) is related to a sequence of single surrogate--droplet pdf's, which are in general different from the physical single--droplet pdf's. The results of this study have important consequences for the initialization and evolution of direct numerical simulations (DNS) of multiphase flows, which are usually initialized on the basis of single--point statistics such as the average number density in physical space. If multiphase DNS are initialized in this way, this implies that even the initial representation contains certain implicit assumptions concerning the complete ensemble of realizations, which are invalid for general multiphase flows. Also the evolution of a DNS initialized in this manner is shown to be valid only if an as yet unproven commutation hypothesis holds true. Therefore, it is questionable to what extent DNS that are initialized in this manner constitute a direct simulation of the physical droplets.

Modeling an integrative physical examination program for the Departments of Defense and Veterans Affairs.

PubMed

Goodrich, Scott G

2006-10-01

Current policies governing the Departments of Defense and Veterans Affairs physical examination programs are out of step with current evidence-based medical practice. Replacing periodic and other routine physical examination types with annual preventive health assessments would afford our service members additional health benefit at reduced cost. Additionally, the Departments of Defense and Veterans Affairs repeat the physical examination process at separation and have been unable to reconcile their respective disability evaluation systems to reduce duplication and waste. A clear, coherent, and coordinated strategy to improve the relevance and utility of our physical examination programs is long overdue. This article discusses existing physical examination programs and proposes a model for a new integrative physical examination program based on need, science, and common sense.

Can physical therapists deliver a pain coping skills program? An examination of training processes and outcomes.

PubMed

Bryant, Christina; Lewis, Prudence; Bennell, Kim L; Ahamed, Yasmin; Crough, Denae; Jull, Gwendolen A; Kenardy, Justin; Nicholas, Michael K; Keefe, Francis J

2014-10-01

Physical therapists are well established as providers of treatments for common, painful, and disabling conditions, such as knee osteoarthritis (OA). Thus, they are well placed to deliver treatments that integrate physical and psychosocial elements. Attention is usually given to outcomes of such programs, but few studies have examined the processes and outcomes of training physical therapists to deliver such treatments. The aim of this study was to describe the processes in training physical therapists: (1) to deliver a standardized pain coping skills treatment and (2) to evaluate the effectiveness of that training. This study was an analysis of data relating to therapist performance in a randomized clinical trial. Eleven physical therapists were trained to deliver a 10-session pain coping skills training program for people with knee OA as part of a randomized controlled trial (N=222). The initial training was provided in a workshop format and included extensive, ongoing supervision by a psychologist and rigorous use of well-defined performance criteria to assess competence. Adherence to the program, ratings of performance, and use of advanced skills were all measured against these criteria in a sample (n=74, 10%) of the audio recordings of the intervention sessions. Overall, the physical therapists achieved a very high standard of treatment delivery, with 96.6% adherence to the program and mean performance ratings all in the satisfactory range. These results were maintained throughout the intervention and across all sessions. Only 10% of the delivered sessions were analyzed, and the physical therapists who took part in the study were a self-selected group. This study demonstrated that a systematic approach to training and accrediting physical therapists to deliver a standardized pain coping skills program can result in high and sustained levels of adherence to the program. Training fidelity was achieved in this group of motivated clinicians, but the supervision provided was time intensive. The data provide a promising indicator of greater potential for psychologically informed practice to be a feature of effective health care. © 2014 American Physical Therapy Association.

The impact of socioeconomic inequalities and lack of health insurance on physical functioning among middle-aged and older adults in the United States.

PubMed

Kim, Jinhyun; Richardson, Virginia

2012-01-01

Socioeconomic inequalities and lack of private health insurance have been viewed as significant contributors to health disparities in the United States. However, few studies have examined their impact on physical functioning over time, especially in later life. The current study investigated the impact of socioeconomic inequalities and lack of private health insurance on individuals' growth trajectories in physical functioning, as measured by activities of daily living. Data from the Health and Retirement Study (1994-2006) were used for this study, 6519 black and white adults who provided in-depth information about health, socioeconomic, financial and health insurance information were analysed. Latent growth curve modelling was used to estimate the initial level of physical functioning and its rate of change over time. Results showed that higher level of income and assets and having private health insurance significantly predicted better physical functioning. In particular, decline in physical functioning was slower among those who had private health insurance. Interestingly, changes in economic status, such as decreases in income and assets, had a greater impact on women's physical functioning than on men's. Black adults did not suffer more rapid declines in physical functioning than white adults after controlling for socioeconomic status. The current longitudinal study suggested that anti-poverty and health insurance policies should be enhanced to reduce the negative impact of socioeconomic inequalities on physical functioning throughout an individual's life course. © 2011 Blackwell Publishing Ltd.

Trends in physical activity and participation in sports clubs among Icelandic adolescents.

PubMed

Eithsdóttir, Sigríthur Th; Kristjánsson, Alfgeir L; Sigfúsdóttir, Inga D; Allegrante, John P

2008-06-01

Physical activity among adolescents and its implications for health status is of increasing concern. We examined trends in physical activity and participation in sports clubs among Icelandic adolescents. Cross-sectional survey data were used to determine levels of vigorous physical activity and participation in sports clubs (defined as engaging in moderately intensive activity four times or more a week) for cohorts of Icelandic adolescents in 1992, 1997, 2000 and 2006. There was a 6% increase in the rate of vigorous physical activity and a 15% increase in active sports club participation among 14- and 15-year old Icelandic adolescents from 1992 to 2006. The trends were consistent across genders; however, only 53% of boys actually achieved the recommended criterion for vigorous physical activity, with the percentage of girls averaging 16% lower than that for boys. Additionally, there was an overall increase in the proportion of inactive adolescents, with girls consistently reporting higher levels of inactivity than boys even though the net increase in inactivity was higher for boys. Although our results show an overall increase in vigorous physical activity and participation in sports clubs over the past decade among both genders, our data also indicate that over half of all Icelandic adolescents are not achieving the recommended level of participation in physical activity. Furthermore, less than one third of the population studied is achieving the recommended level of activity through organized clubs. Initiatives to increase physical activity among the least active of adolescents should receive high priority in public health.

Follow-up of obstructive sleep apnea in children.

PubMed

Barros, Emília Leite de; Pradella-Hallinan, Marcia; Moreira, Gustavo Antonio; Stefanini, Daniele de Oliveira Soares; Tufik, Sergio; Fujita, Reginaldo Raimundo

2014-01-01

the evolution of snoring and OSAS in children is not well established since few studies of patients without surgical treatment have been published. to evaluate the evolution of sleep disordered breathing in children who had not been submitted to upper airway surgery. twenty-six children with snoring who had not undergone upper airway surgery were evaluated prospectively. Patients were evaluated by full physical examination and nocturnal polysomnography, after which they were divided into 2 groups: apnea (16 children) and snoring (10 children). After 6 months following the initial evaluation, patients were submitted to a new nocturnal polysomnography, and all data were compared to those of the first examination. the groups did not show any differences regarding age, weight, height and airway physical examination. After 6 months of follow-up, the apnea index did not change, but the respiratory disturbance index increased in the snoring group and the number of hypopneas decreased in the group apnea. there was an increase in the percentage of N1 sleep stage and the respiratory disturbance index in the patients with primary snore. The AHI did not show significant alteration in both groups, but the number of hypopneas decreased in patients with SAOS. Copyright © 2014 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

The science and practice of river restoration

NASA Astrophysics Data System (ADS)

Wohl, Ellen; Lane, Stuart N.; Wilcox, Andrew C.

2015-08-01

River restoration is one of the most prominent areas of applied water-resources science. From an initial focus on enhancing fish habitat or river appearance, primarily through structural modification of channel form, restoration has expanded to incorporate a wide variety of management activities designed to enhance river process and form. Restoration is conducted on headwater streams, large lowland rivers, and entire river networks in urban, agricultural, and less intensively human-altered environments. We critically examine how contemporary practitioners approach river restoration and challenges for implementing restoration, which include clearly identified objectives, holistic understanding of rivers as ecosystems, and the role of restoration as a social process. We also examine challenges for scientific understanding in river restoration. These include: how physical complexity supports biogeochemical function, stream metabolism, and stream ecosystem productivity; characterizing response curves of different river components; understanding sediment dynamics; and increasing appreciation of the importance of incorporating climate change considerations and resiliency into restoration planning. Finally, we examine changes in river restoration within the past decade, such as increasing use of stream mitigation banking; development of new tools and technologies; different types of process-based restoration; growing recognition of the importance of biological-physical feedbacks in rivers; increasing expectations of water quality improvements from restoration; and more effective communication between practitioners and river scientists.

From see one do one, to see a good one do a better one: learning physical examination skills through peer observation.

PubMed

St-Onge, Christina; Martineau, Bernard; Harvey, Anne; Bergeron, Linda; Mamede, Silvia; Rikers, Remy

2013-01-01

Learning and mastering the skills required to execute physical exams is of great importance and should be fostered early during medical training. Observing peers has been shown to positively influence the acquisition of psychomotor skills. The current study investigated the influence of peer observation on the acquisition of psychomotor skills required to execute a physical examination. Second-year medical students (N=194) learned the neurological physical examination for low back pain in groups of three. Each student learned and performed the physical examination while the other students observed. Analyses compared the impact of the quantity and the quality of observed performances on students' learning of the physical examination skills. Students benefited from observing peers while they executed their examination. Moreover, observing a high-performing peer increased the acquisition of physical examination skills. Results suggest that group learning activities that allow students to observe their peers during physical examination should be favored.

RF-assisted current startup in FED

DOE Office of Scientific and Technical Information (OSTI.GOV)

Borowski, S. K.; Peng, Yueng Kay Martin; Kammash, T.

1981-01-01

Auxiliary rf heating of electrons before and during the current rise phase in FED is examined as a means of reducing both the initiation loop voltage and resistive flux expendicture during startup. Prior to current initiation, 1 to 2 MW of electron cyclotron resonance heating (ECRH) power at {approx} 90 GHz is used to create a small volume of high conductivity plasma (T{sub e} {approx_equal} 100-200 eV, n{sub e} {approx_equal} 10{sup 13} cm{sup -3}) near the upper hybrid resonance (UHR) region. This plasma conditioning permits a small radius (a{sub o} {approx_equal} 0.2-0.4 m) current channel to be established with amore » relatively low initial loop voltage (<25 V). During the subsequent plasma expansion and current ramp phase, additional rf power is introduced to reduce volt-second consumption due to plasma resistance. The physics models used for analyzing the UHR heating and current rise phases are also discussed.« less

A Comparison of Perturbed Initial Conditions and Multiphysics Ensembles in a Severe Weather Episode in Spain

NASA Technical Reports Server (NTRS)

Tapiador, Francisco; Tao, Wei-Kuo; Angelis, Carlos F.; Martinez, Miguel A.; Cecilia Marcos; Antonio Rodriguez; Hou, Arthur; Jong Shi, Jain

2012-01-01

Ensembles of numerical model forecasts are of interest to operational early warning forecasters as the spread of the ensemble provides an indication of the uncertainty of the alerts, and the mean value is deemed to outperform the forecasts of the individual models. This paper explores two ensembles on a severe weather episode in Spain, aiming to ascertain the relative usefulness of each one. One ensemble uses sensible choices of physical parameterizations (precipitation microphysics, land surface physics, and cumulus physics) while the other follows a perturbed initial conditions approach. The results show that, depending on the parameterizations, large differences can be expected in terms of storm location, spatial structure of the precipitation field, and rain intensity. It is also found that the spread of the perturbed initial conditions ensemble is smaller than the dispersion due to physical parameterizations. This confirms that in severe weather situations operational forecasts should address moist physics deficiencies to realize the full benefits of the ensemble approach, in addition to optimizing initial conditions. The results also provide insights into differences in simulations arising from ensembles of weather models using several combinations of different physical parameterizations.

Swimming motility plays a key role in the stochastic dynamics of cell clumping

NASA Astrophysics Data System (ADS)

Qi, Xianghong; Nellas, Ricky B.; Byrn, Matthew W.; Russell, Matthew H.; Bible, Amber N.; Alexandre, Gladys; Shen, Tongye

2013-04-01

Dynamic cell-to-cell interactions are a prerequisite to many biological processes, including development and biofilm formation. Flagellum induced motility has been shown to modulate the initial cell-cell or cell-surface interaction and to contribute to the emergence of macroscopic patterns. While the role of swimming motility in surface colonization has been analyzed in some detail, a quantitative physical analysis of transient interactions between motile cells is lacking. We examined the Brownian dynamics of swimming cells in a crowded environment using a model of motorized adhesive tandem particles. Focusing on the motility and geometry of an exemplary motile bacterium Azospirillum brasilense, which is capable of transient cell-cell association (clumping), we constructed a physical model with proper parameters for the computer simulation of the clumping dynamics. By modulating mechanical interaction (‘stickiness’) between cells and swimming speed, we investigated how equilibrium and active features affect the clumping dynamics. We found that the modulation of active motion is required for the initial aggregation of cells to occur at a realistic time scale. Slowing down the rotation of flagellar motors (and thus swimming speeds) is correlated to the degree of clumping, which is consistent with the experimental results obtained for A. brasilense.

Contributions of physical function and satisfaction with social roles to emotional distress in chronic pain: a Collaborative Health Outcomes Information Registry (CHOIR) study.

PubMed

Sturgeon, John A; Dixon, Eric A; Darnall, Beth D; Mackey, Sean C

2015-12-01

Individuals with chronic pain show greater vulnerability to depression or anger than those without chronic pain, and also show greater interpersonal difficulties and physical disability. The present study examined data from 675 individuals with chronic pain during their initial visits to a tertiary care pain clinic using assessments from Stanford University's Collaborative Health Outcomes Information Registry (CHOIR). Using a path modeling analysis, the mediating roles of Patient-Reported Outcomes Measurement Information Systems (PROMIS) Physical Function and PROMIS Satisfaction with Social Roles and Activities were tested between pain intensity and PROMIS Depression and Anger. Pain intensity significantly predicted both depression and anger, and both physical function and satisfaction with social roles mediated these relationships when modeled in separate 1-mediator models. Notably, however, when modeled together, ratings of satisfaction with social roles mediated the relationship between physical function and both anger and depression. Our results suggest that the process by which chronic pain disrupts emotional well-being involves both physical function and disrupted social functioning. However, the more salient factor in determining pain-related emotional distress seems to be disruption of social relationships, than global physical impairment. These results highlight the particular importance of social factors to pain-related distress, and highlight social functioning as an important target for clinical intervention in chronic pain.

The Hypothesis-Driven Physical Examination.

PubMed

Garibaldi, Brian T; Olson, Andrew P J

2018-05-01

The physical examination remains a vital part of the clinical encounter. However, physical examination skills have declined in recent years, in part because of decreased time at the bedside. Many clinicians question the relevance of physical examinations in the age of technology. A hypothesis-driven approach to teaching and practicing the physical examination emphasizes the performance of maneuvers that can alter the likelihood of disease. Likelihood ratios are diagnostic weights that allow clinicians to estimate the post-probability of disease. This hypothesis-driven approach to the physical examination increases its value and efficiency, while preserving its cultural role in the patient-physician relationship. Copyright © 2017 Elsevier Inc. All rights reserved.

Initial Employment Report: Physics and Astronomy Degree Recipients of 2003 & 2004. AIP Report. Number R-282.26

ERIC Educational Resources Information Center

Tesfaye, Casey Langer; Mulvey, Patrick J.

2007-01-01

This report describes the initial employment and educational paths pursued by physics and astronomy degree recipients at the bachelor's, master's, and PhD levels for the classes of 2002-03 and 2003-04. The report includes starting salaries, primary work activities, ratings of professional challenge and other aspects of initial employment. The…

42 CFR 21.58 - Physical examination for reappointment.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 1 2014-10-01 2014-10-01 false Physical examination for reappointment. 21.58... COMMISSIONED OFFICERS Appointment § 21.58 Physical examination for reappointment. Every officer of the Reserve Corps being considered for reappointment shall undergo such physical examination as the Surgeon General...

42 CFR 21.58 - Physical examination for reappointment.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 1 2012-10-01 2012-10-01 false Physical examination for reappointment. 21.58... COMMISSIONED OFFICERS Appointment § 21.58 Physical examination for reappointment. Every officer of the Reserve Corps being considered for reappointment shall undergo such physical examination as the Surgeon General...

42 CFR 21.58 - Physical examination for reappointment.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 1 2013-10-01 2013-10-01 false Physical examination for reappointment. 21.58... COMMISSIONED OFFICERS Appointment § 21.58 Physical examination for reappointment. Every officer of the Reserve Corps being considered for reappointment shall undergo such physical examination as the Surgeon General...

42 CFR 21.58 - Physical examination for reappointment.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Physical examination for reappointment. 21.58... COMMISSIONED OFFICERS Appointment § 21.58 Physical examination for reappointment. Every officer of the Reserve Corps being considered for reappointment shall undergo such physical examination as the Surgeon General...

42 CFR 21.58 - Physical examination for reappointment.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 1 2011-10-01 2011-10-01 false Physical examination for reappointment. 21.58... COMMISSIONED OFFICERS Appointment § 21.58 Physical examination for reappointment. Every officer of the Reserve Corps being considered for reappointment shall undergo such physical examination as the Surgeon General...

Evaluation and management of pediatric hypertensive crises: hypertensive urgency and hypertensive emergencies

PubMed Central

Patel, Nirali H; Romero, Sarah K; Kaelber, David C

2012-01-01

Hypertension (HTN) in the pediatric population is estimated to have a world-wide prevalence of 2%–5%. As with adults, pediatric patients with HTN can present with hypertensive crises include hypertensive urgency and hypertensive emergencies. However, pediatric blood pressure problems have a greater chance of being from secondary causes of HTN, as opposed to primary HTN, than in adults. Thorough evaluation of a child with a hypertensive emergency includes accurate blood pressure readings, complete and focused symptom history, and appropriate past medical, surgical, and family history. Physical exam should include height, weight, four-limb blood pressures, a general overall examination and especially detailed cardiovascular and neurological examinations, including fundoscopic examination. Initial work-up should typically include electrocardiography, chest X-ray, serum chemistries, complete blood count, and urinalysis. Initial management of hypertensive emergencies generally includes the use of intravenous or oral antihypertensive medications, as well as appropriate, typically outpatient, follow-up. Emergency department goals for hypertensive crises are to (1) safely lower blood pressure, and (2) treat/minimize acute end organ damage, while (3) identifying underlying etiology. Intravenous antihypertensive medications are the treatment modality of choice for hypertensive emergencies with the goal of reducing systolic blood pressure by 25% of the original value over an 8-hour period. PMID:27147865

Physical symptoms in very young children assessed for sexual abuse: a mixed method analysis from the ASAC study.

PubMed

Vrolijk-Bosschaart, Thekla F; Brilleslijper-Kater, Sonja N; Widdershoven, Guy A; Teeuw, Arianne Rian H; Verlinden, Eva; Voskes, Yolande; van Duin, Esther M; Verhoeff, Arnoud P; Benninga, Marc A; Lindauer, Ramón J L

2017-10-01

So far, a recognizable pattern of clinical symptoms for child sexual abuse (CSA), especially in young male children, is lacking. To improve early recognition of CSA, we reviewed physical complaints, physical examination, and tests on sexually transmitted infections (STIs) in confirmed victims (predominantly preschool boys) of CSA from the Amsterdam sexual abuse case (ASAC). We retrospectively analyzed the outcomes of the primary assessment using mixed methods: descriptive analysis of physical complaints, physical exams, and STI tests from medical files and a qualitative analysis on expert's interpretations of physical complaints and children's behavior during physical examination. We included 54 confirmed CSA victims, median age 3.2 (0-6) years, 43 boys (80%), and 11 girls (20%). Physical complaints were reported in 50%, of which gastrointestinal and anogenital complaints were most common. None of the children showed CSA-specific genital signs at physical examination. Most prominent finding during physical examination was a deviant behavioral response (anxiety, withdrawal, too outgoing) in 15 children (28%), especially in children who experienced anal/vaginal penetration. Testing for STIs was negative. Physical complaints and physical signs at examinations were non-specific for CSA. Deviant behavioral reactions during physical examination were the most prominent finding. Precise observation of a child's behavior during physical examination is needed. What is known • Child sexual abuse (CSA) affects many children on both the short and the long term but remains unrecognized in most cases. • So far, there is a lack of studies on symptom patterns of CSA in male, preschool children. What is new • None of the children showed CSA-specific findings at physical and anogenital examination; STIs were not found in the confirmed victims of CSA. • The most prominent finding was the deviant behavioral response of the children examined, especially in children who experienced anal/vaginal penetration; therefore, precise observation of a child's behavior during physical examination is a crucial part of the evaluation of suspected CSA.

News Conference: The Big Bangor Day Meeting Lecture: Charterhouse plays host to a physics day Festival: Science on Stage festival 2013 arrives in Poland Event: Scottish Physics Teachers' Summer School Meeting: Researchers and educators meet at Lund University Conference: Exeter marks the spot Recognition: European Physical Society uncovers an historic site Education: Initial teacher education undergoes big changes Forthcoming events

NASA Astrophysics Data System (ADS)

2013-09-01

Conference: The Big Bangor Day Meeting Lecture: Charterhouse plays host to a physics day Festival: Science on Stage festival 2013 arrives in Poland Event: Scottish Physics Teachers' Summer School Meeting: Researchers and educators meet at Lund University Conference: Exeter marks the spot Recognition: European Physical Society uncovers an historic site Education: Initial teacher education undergoes big changes Forthcoming events

Attitudes and beliefs to the uptake and maintenance of physical activity among community-dwelling South Asians aged 60-70 years: a qualitative study.

PubMed

Horne, M; Skelton, D A; Speed, S; Todd, C

2012-05-01

To identify the attitudes and beliefs associated with the uptake and adherence of physical activity among community-dwelling South Asians aged 60-70 years. A qualitative research study using an ethnographic approach. Focus groups and in-depth interviews were conducted to explore motivational factors associated with initiating and maintaining physical activity. Data analysis followed the framework approach. Health, maintaining independence and social support were important in terms of initiating physical activity. Social support, psychosocial elements of activity, health and integrating physical activity within everyday activities were important for adherence to physical activity. The need for gendered physical activity sessions was important to initiating exercise among Muslim South Asians aged 60-70 years. Promoting active lifestyles and building physical activity in and around day-to-day activities are important strategies in increasing activity levels. However, the needs for culturally appropriate facilities, peer mentors who could assist those with language barriers, specific tailored advice, advice on integrating physical activity in everyday life and general social support could promote uptake and subsequent adherence among this population group. Copyright © 2012 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Relationship between neighborhood walkability and older adults' physical activity: results from the Belgian Environmental Physical Activity Study in Seniors (BEPAS Seniors).

PubMed

Van Holle, Veerle; Van Cauwenberg, Jelle; Van Dyck, Delfien; Deforche, Benedicte; Van de Weghe, Nico; De Bourdeaudhuij, Ilse

2014-08-23

Adequate knowledge on environmental correlates of physical activity (PA) in older adults is needed to develop effective health promotion initiatives. However, research in this age group is scarce and most existing studies were conducted in North America. The present study aimed to examine relationships between GIS-based neighborhood walkability and objective and self-reported PA in community-dwelling Belgian older adults. Furthermore, moderating effects of neighborhood income levels were investigated. The Belgian Environmental Physical Activity Study (BEPAS) for Seniors is a cross-sectional study in older adults (≥65 yrs) and was conducted between October 2010 and September 2012. Data from 438 older adults living in 20 neighborhoods across Ghent (Belgium) were analyzed. Stratification of selected neighborhoods was based upon objective walkability and neighborhood income. Participants wore an accelerometer during seven consecutive days to obtain objective levels of moderate-to-vigorous physical activity (MVPA). Self-reported levels of transportation walking/cycling and recreational walking/cycling were assessed using the International Physical Activity Questionnaire (long, last 7 days version) adapted for the elderly. Multi-level regression analyses were conducted. Findings showed a positive relationship between neighborhood walkability and weekly minutes of older adults' self-reported walking for transportation (B = 4.63 ± 1.05;p < 0.001) and a negative relationship between walkability and accelerometer-derived low-light PA (B = -1.38 ± 0.62;p = 0.025). Walkability was not related to any measure of recreational PA. A walkability x income interaction was found for accelerometer-derived MVPA (B = -1.826 ± 1.03;p = 0.075), showing only a positive association between walkability and MVPA in low-income neighborhood residents. This was the first European study to examine walkability-PA relationships in older adults. These Belgian findings suggest that a high neighborhood walkability relates to higher levels of older adults' transport-related walking. As transport-related walking is an accessible activity for older adults and easy to integrate in their daily routine, policy makers and health promoters are advised to provide sufficient destinations and pedestrian-friendly facilities in the close vicinity of older adults' residences, so short trips can be made by foot. Neighborhood income moderated the relationship between walkability and objectively-measured MVPA. Increasing total MVPA levels in older adults should be a key topic in development of promotion initiatives and special attention should be paid to low-income neighborhood residents.

Risk assessment of technologies for detecting illicit drugs in containers

NASA Astrophysics Data System (ADS)

Brandenstein, Albert E.

1995-03-01

This paper provides the highlights of the role risk assessment plays in the United States technology program for nonintrusive inspection of cargo containers for illicit drugs. The Counterdrug Technology Assessment Center is coordinating the national effort to develop prototype technologies for an advanced generation, nonintrusive cargo inspection system. In the future, the U.S. Customs Service could configure advanced technologies for finding not only drugs and other contraband hidden in cargo, but for a wide variety of commodities for customs duty verification purposes. The overall nonintrusive inspection system is envisioned to consist primarily of two classes of subsystems: (1) shipment document examination subsystems to prescreen exporter and importer documents; and (2) chemical and physics-based subsystems to detect and characterize illicit substances. The document examination subsystems would use software algorithms, artificial intelligence, and neural net technology to perform an initial prescreening of the information on the shipping manifest for suspicious patterns. This would be accomplished by creating a `profile' from the shipping information and matching it to trends known to be used by traffickers. The chemical and physics-based subsystems would apply nuclear physics, x-ray, gas chromatography and spectrometry technologies to locate and identify contraband in containers and other conveyances without the need for manual searches. The approach taken includes using technology testbeds to assist in evaluating technology prototypes and testing system concepts in a fully instrumented but realistic operational environment. This approach coupled with a substance signature phenomenology program to characterize those detectable elements of benign, as well as target substances lends itself particularly well to the topics of risk assessment and elemental characterization of substances. A technology testbed established in Tacoma, Washington provides a national facility for testing and evaluating existing and emerging prototype systems in an operational environment. The results of initial tests using the advanced x-ray subsystem installed at the testbed are given in this paper. A description of typical cargo contents and those characteristics applicable to nuclear interrogation techniques are provided in the appendix.

Perceived Adequacy of Tangible Social Support and Health Outcomes in Patients with Coronary Artery Disease

PubMed Central

Woloshin, Steven; Schwartz, Lisa M.; Tosteson, Anna N. A.; Chang, Chiang-Hua; Wright, Brock; Plohman, Joy; Fisher, Elliott S.

1997-01-01

OBJECTIVE Health outcomes of patients with chronic disease might be influenced by assistance from others in performing daily activities. We examined whether perceived adequacy of such tangible support was associated with prognosis in a cohort of patients with coronary artery disease. DESIGN Longitudinal cohort study. SETTING/PARTICIPANTS In spring 1993, a cohort of 1,468 patients with chronic artery disease was identified using claims data. The cohort consisted of all surviving residents of Manitoba, Canada, who had been hospitalized for acute myocardial infarction from 1991 to 1992: 820 patients completed the initial survey, and 734 completed a follow-up survey approximately 1 year later. MEASUREMENTS AND MAIN RESULTS Adequacy of tangible support was assessed by asking if respondents needed help at home because of health problems, and whether these needs were met. We examined the association between perceived adequacy of tangible support and health outcomes at 1 year (mortality, physical function). Of 820 participants, 74% perceived no need for help, 13% had sufficient help, 9% needed more help, and 5% needed much more help; 31 patients died during follow-up. After adjustment for age and initial health status, odds ratios (95% confidence interval) for death were: sufficient help 1.8 (0.61, 5.8); need more help 3.2 (1.1, 9.4); and need much more help 6.5 (2.0, 21.6) compared with respondents with no perceived need. Decline in physical function was also linearly related to perceiving less-adequate tangible support. Sensitivity analyses indicated it is highly improbable that results were due to selection bias. CONCLUSIONS Perceived lack of needed assistance was related to mortality and to decline in physical functioning. Adequacy of tangible support was an important prognostic factor for these patients with coronary artery disease and may be a determinant of health outcomes. PMID:9346457

Physical Examination Variables Predict Response to Conservative Treatment of Nonchronic Plantar Fasciitis: Secondary Analysis of a Randomized, Placebo-Controlled Footwear Study.

PubMed

Wrobel, James S; Fleischer, Adam E; Matzkin-Bridger, Jonathon; Fascione, Jeanna; Crews, Ryan T; Bruning, Nicholas; Jarrett, Beth

2016-05-01

Plantar fasciitis is a common, disabling condition, and the prognosis of conservative treatment is difficult to predict. To determine whether initial clinical findings could help predict patient response to conservative treatment that primarily consisted of supportive footwear and stretching. Patients were recruited and seen at 2 outpatient podiatric clinics in the Chicago, Illinois, metropolitan area. Seventy-seven patients with nonchronic plantar fasciitis were recruited. Patients were excluded if they had a heel injection in the previous 6 months or were currently using custom foot orthoses at the time of screening. Sixty-nine patients completed the final follow-up visit 3 months after receiving the footwear intervention. Treatment failure was considered a <50% reduction in heel pain at 3 month follow-up. Logistic regression models evaluated the possible association between more than 30 clinical and physical examination findings prospectively assessed at enrollment, and treatment response. Inability to dorsiflex the ankle past -5° (odds ratio [OR] 3.9, P = .024), nonsevere (≤7 on ordinal scale) first-step pain (OR 3.8, P = .021), and heel valgus in relaxed stance (OR 4.0, P = .014) each predicted treatment failure in multivariable analysis (receiver operating characteristic area under the curve = .769). Limited ankle dorsiflexion also correlated with greater heel pain severity at initial presentation (r = - 0.312, P = .006). Patients with severe ankle equinus were nearly 4 times more likely to experience a favorable response to treatment centered on home Achilles tendon stretching and supportive therapy. Thus, earlier use of more advanced therapies may be most appropriate in those presenting without severe ankle equinus or without severe first step pain. The findings from our study may not be clinically intuitive because patients with less severe equinus and less severe pain at presentation did worse with conservative care. Copyright © 2016 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

[A school-level longitudinal study of clinical performance examination scores].

PubMed

Park, Jang Hee

2015-06-01

This school-level longitudinal study examined 7 years of clinical performance data to determine differences (effects) in students and annual changes within a school and between schools; examine how much their predictors (characteristics) influenced the variation in student performance; and calculate estimates of the schools' initial status and growth. A school-level longitudinal model was tested: level 1 (between students), level 2 (annual change within a school), and level 3 (between schools). The study sample comprised students who belonged to the CPX Consortium (n=5,283 for 2005~2008 and n=4,337 for 2009~2011). Despite a difference between evaluation domains, the performance outcomes were related to individual large-effect differences and small-effect school-level differences. Physical examination, clinical courtesy, and patient education were strongly influenced by the school effect, whereas patient-physician interaction was not affected much. Student scores are influenced by the school effect (differences), and the predictors explain the variation in differences, depending on the evaluation domain.

Support of evidence-based guidelines for the annual physical examination: a survey of primary care providers.

PubMed

Prochazka, Allan V; Lundahl, Kristy; Pearson, Wesley; Oboler, Sylvia K; Anderson, Robert J

2005-06-27

Current evidence does not support an annual screening physical examination for asymptomatic adults, but little is known about primary care provider (PCP) attitudes and practices regarding an annual physical examination. We conducted a postal survey (32 items) of attitudes and practices regarding the annual physical examination (in asymptomatic patients 18 years or older) of a random sample of PCPs (specializing in internal medicine, family practice, and obstetrics/gynecology) from 3 geographic areas (Boston, Mass; Denver, Colo; and San Diego, Calif). Respondents included 783 (47%) of 1679 PCPs. Overall, 430 (65%) of 664 agreed that an annual physical examination is necessary. Three hundred ninety-three (55%) of 712 disagreed with the statement that national organizations do not recommend an annual physical examination, and 641 (88%) of 726 perform such examinations. Most PCPs agreed that an annual physical examination provides time to counsel patients about preventive health services (696/739 [94%]), improves patient-physician relationships (693/737 [94%]), and is desired by most patients (572/737 [78%]). Most also believe that an annual physical examination improves detection of subclinical illness (545/738 [74%]) and is of proven value (461/736 [63%]). Many believed that tests should be part of an annual physical examination, including mammography (44%), a lipid panel (48%), urinalysis (44%), testing of blood glucose level (46%), and complete blood cell count (39%). Despite contrary evidence, most PCPs believe an annual physical examination detects subclinical illness, and many report performing unproven screening laboratory tests. Primary care providers do not appear to accept recommendations that annual physical examinations be abandoned in favor of a more selective approach to preventing health problems.

Leisure-time physical activity associates with cognitive decline

PubMed Central

Willey, Joshua Z.; Gardener, Hannah; Caunca, Michelle R.; Moon, Yeseon Park; Dong, Chuanhui; Cheung, Yuen K.; Sacco, Ralph L.; Elkind, Mitchell S.V.

2016-01-01

Objective: Because leisure-time physical activity (LTPA) is protective against incident dementia, we hypothesized that LTPA is protective against decline in domain-specific cognitive performance. Methods: As part of the Northern Manhattan Study, LTPA was ascertained at enrollment using a validated in-person questionnaire. We assessed cognition in participants in the Northern Manhattan Study MRI substudy using a standard neuropsychological examination (NPE) (n = 1,228), and a repeat examination was performed 5 years later (n = 876). LTPA was summarized as the maximum intensity of any activity performed, classified as none to light intensity (physical inactivity) (90%) vs moderate to heavy intensity (10%). The NPE was subcategorized using standardized z scores over validated domains: processing speed, semantic memory, episodic memory, and executive function. We used multivariable linear regression models to examine the association of LTPA with initial and change in cognitive performance. Analyses were adjusted for sociodemographics, cardiovascular disease risk factors, and MRI findings (white matter hyperintensity volume, silent brain infarcts, cerebral volume). Results: No/low levels of LTPA were associated with worse executive function, semantic memory, and processing speed scores on the first NPE. The associations were slightly attenuated and no longer significant after adjusting for vascular risk factors. Cognitively unimpaired participants reporting no/low LTPA vs moderate/high levels declined more over time in processing speed (β = −0.231 ± 0.112, p = 0.040) and episodic memory (β = −0.223 ± 0.117, p = 0.057) adjusting for sociodemographic and vascular risk factors. Conclusions: A low level of LTPA is independently associated with greater decline in cognitive performance over time across domains. PMID:27009261

Value of mammography and breast ultrasound in male patients with nipple discharge.

PubMed

Muñoz Carrasco, Rafaela; Álvarez Benito, Marina; Rivin del Campo, Eleonor

2013-03-01

To assess the contribution of mammography and ultrasound in men with nipple discharge. All men with nipple discharge who underwent mammography and/or ultrasound between 1993 and 2011 in our hospital were retrospectively evaluated. Radiological findings were classified according to BI-RADS lexicon. The final diagnosis was made based on histopathological results or clinical-radiological follow-up. The diagnostic performance of physical examination, mammography and ultrasound was calculated and compared. 26 men with 21 mammograms and 19 ultrasounds were reviewed. The final diagnoses were: 6 carcinomas (23.1%), 10 gynaecomastias, 2 pseudogynaecomastias and 8 normal breast tissues. Mammograms and ultrasounds performed on all five patients with infiltrating carcinoma showed a mass (categories 4 and 5). In all these patients except one, a breast mass was also noted and the physical examination was positive or suspected malignancy. In the patient with carcinoma in situ, the only conspicuous clinical sign was bloody nipple discharge and the mammography showed calcifications (category 4) that were not visible on ultrasound. Radiological findings of all patients without malignancy were classified as categories 1 and 2. The diagnostic performance of physical examination was lower than mammography and ultrasound (P>0.05). Mammography was more sensitive than ultrasound (100% vs. 83.3%). Both techniques showed the same specificity (100%). Men with nipple discharge have a high incidence of breast carcinoma. Nipple discharge may be the only clinical sign of carcinoma in situ. Mammography and ultrasound are useful in the evaluation of men with nipple discharge, diagnosing carcinoma in initial stages, avoiding unnecessary biopsies. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Hypothesis-driven physical examination curriculum.

PubMed

Allen, Sharon; Olson, Andrew; Menk, Jeremiah; Nixon, James

2017-12-01

Medical students traditionally learn physical examination skills as a rote list of manoeuvres. Alternatives like hypothesis-driven physical examination (HDPE) may promote students' understanding of the contribution of physical examination to diagnostic reasoning. We sought to determine whether first-year medical students can effectively learn to perform a physical examination using an HDPE approach, and then tailor the examination to specific clinical scenarios. Medical students traditionally learn physical examination skills as a rote list of manoeuvres CONTEXT: First-year medical students at the University of Minnesota were taught both traditional and HDPE approaches during a required 17-week clinical skills course in their first semester. The end-of-course evaluation assessed HDPE skills: students were assigned one of two cardiopulmonary cases. Each case included two diagnostic hypotheses. During an interaction with a standardised patient, students were asked to select physical examination manoeuvres in order to make a final diagnosis. Items were weighted and selection order was recorded. First-year students with minimal pathophysiology performed well. All students selected the correct diagnosis. Importantly, students varied the order when selecting examination manoeuvres depending on the diagnoses under consideration, demonstrating early clinical decision-making skills. An early introduction to HDPE may reinforce physical examination skills for hypothesis generation and testing, and can foster early clinical decision-making skills. This has important implications for further research in physical examination instruction. © 2016 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

Clinical Characteristics of Patients With Cancer Referred for Outpatient Physical Therapy

PubMed Central

Coronado, Rogelio A.; Lee, Derek; Bour, Barbara; George, Steven Z.

2015-01-01

Background Cancer rehabilitation is a developing area, with an increasing number of survivors of cancer in the United States. The increase in survivorship occurs alongside impairments arising directly from cancer or from treatment-related side effects. Objective This study described clinical characteristics of patients with cancer referred for outpatient physical therapy and explored patterns in frequency of impairments between type of cancer and mode of cancer treatment. Design This was a retrospective chart review of patients with cancer referred to a tertiary care physical therapy clinic over a 2-year period. Methods Characteristics such as age, sex, cancer type, mode of treatment, and neuromusculoskeletal impairments were identified. Impairment frequencies were computed based on cancer type and mode of treatment. Results Data from 418 patients (mean age=57.9 years, SD=14.3; 41.1% female) were examined. Genitourinary cancer (n=169) and breast cancer (n=90) were the most prevalent types of cancer reported in this sample. Impairments in strength (83.6%) and soft tissue (71.3%) were the most common examination findings. Lymphedema was most common in patients with breast cancer, and incontinence was most common in patients with genitourinary cancer. Limitations The types of cancer identified in this study may be reflective of this tertiary center and may not generalize to other facilities. Impairment identification during the initial physical therapist evaluation was not performed systematically. Conclusion These data reinforce that physical therapists should screen for lymphedema in patients with breast cancer and incontinence in urogenital cancers. Strength and soft tissue integrity should be evaluated in most patients with cancer. Assessing pain and fatigue levels is recommended for patients who have had radiation therapy. PMID:25504482

Communication pitfalls of traditional history and physical write-up documentation

PubMed Central

Brown, Jeffrey L

2017-01-01

Background An unofficial standardized “write-up” outline is commonly used for documenting history and physical examinations, giving oral presentations, and teaching clinical skills. Despite general acceptance, there is an apparent discrepancy between the way clinical encounters are conducted and how they are documented. Methods Fifteen medical school websites were randomly selected from search-engine generated lists. One example of a history and physical write-up from each of six sites, one teaching outline from each of nine additional sites, and recommendations for documentation made in two commonly used textbooks were compared for similarities and differences. Results Except for minor variations in documenting background information, all sampled materials utilized the same standardized format. When the examiners’ early perceptions of the patients’ degree of illness or level of distress were described, they were categorized as “general appearance” within the physical findings. Contrary to clinical practice, none of the examples or recommendations documented these early perceptions before chief concerns and history were presented. Discussion An examiner’s initial perceptions of a patient’s affect, degree of illness, and level of distress can influence the content of the history, triage decisions, and prioritization of likely diagnoses. When chief concerns and history are shared without benefit of this information, erroneous assumptions and miscommunications can result. Conclusion This survey confirms common use of a standardized outline for documenting, communicating, and teaching history-taking and physical examination protocol. The present outline shares early observations out of clinical sequence and may provide inadequate context for accurate interpretation of chief concerns and history. Corrective actions include modifying the documentation sequence to conform to clinical practice and teaching contextual methodology for sharing patient information. PMID:28096709

The Effects of Intellectual, Physical, and Social Activity on Further Prognosis in Mild Cognitive Impairment.

PubMed

Bidzan, Leszek; Bidzan, Mariola; Pąchalska, Maria

2016-07-19

BACKGROUND Our goal was to specify the relationship between the level of activity (intellectual, physical, and social) in persons diagnosed with mild cognitive impairment (MCI) and the further progression of cognitive dysfunction. MATERIAL AND METHODS We examined 193 patients diagnosed with MCI (according to the criteria of the Working Group on Mild Cognitive Impairment) and under treatment at our Mental Disorders Clinic. It was assumed that these persons would remain under systematic psychiatric observation until dementia was diagnosed. The present study results from a seven-year observation period. The mini-mental state examination (MMSE), the Activity Scale (with the intellectual, physical, and social subscales), and the Instrumental Activities of Daily Living (IADL) scale were used to evaluate the participants' status at baseline. The MMSE was re-administered after one year and again at the end of the observation (either upon diagnosis of dementia or after seven years). At each meeting with the participant, the clinical diagnosis was verified to determine if the patient had dementia or not. Of the 193 people initially qualified for the study, 75 were available for the final analysis. RESULTS It was found that there was no statistically significant difference in the baseline MMSE scores between the persons with stable MCI and the persons who had progressed to dementia. However, statistically significant differences in the level of activity at baseline on both the global IADL scale and the Activity Scale between those with stable MCI and those who had progressed to dementia were found. These differences were manifested in the IADL subscales for telephone use, shopping, transportation, and personal finances, and in the physical activity subscale. CONCLUSIONS An evaluation of intellectual, physical, and social activity can be useful in determining the prognosis for the future course of MCI.

[Return to sport after surgical treatment of a posterior cruciate ligament injury : A retrospective study of 60 patients].

PubMed

Ahrend, M; Ateschrang, A; Döbele, S; Stöckle, U; Grünwald, L; Schröter, S; Ihle, C

2016-12-01

Injuries of the posterior cruciate ligament (PCL) lead to an initial reduction of sporting activity. However, in previous studies, return to sport after operative treatment of PCL injuries has been analysed insufficiently. The aim of this study was (1) to determine the rate of return to sport in physically active patients, (2) to analyse possible changes in sporting activities and (3) to examine the influence of the severity of the initial injury. Within a retrospective clinical and radiological follow-up at least 24 months after surgery (80.3 ± 28.2 months), 60 patients (44.8 ± 12.1 years) with surgically treated isolated or combined PCL injuries were included in the study. Pre-accidental and post-operative sporting activities were queried and compared in a standardised questionnaire. Possible differences with respect to the initial injury severity (Cooper classification) were examined. The return-to-sport rate of the physically active patients was 87.0 %. 17.6 % of patients with a combined PCL injury and 4.8 % of patients with isolated PCL injury were not able to return to sport. Significant reductions in the frequency of exercise (p = 0.0087), the duration of exercise (p = 0.0003) and the amount of regularly performed sports (p < 0.0001) were found. A change from high-impact sports to low-impact sports was noted. Patients with operatively treated PCL injuries can return to sport. However, for competitive athletes an injury to the PCL can lead to the end of their career. A reduction of sporting activities and a change from high-impact sports to low-impact sports can be expected. A persisting inability to return to sporting activities in patients with isolated PCL injuries cannot be assumed.

Contribution to activity: a lens for understanding students' potential and agency in physics education

NASA Astrophysics Data System (ADS)

Farhangi, Sanaz

2017-03-01

In this paper I argue for using the concept of contribution to activity to understand student engagement with science education and its transformational potential in formal settings. Drawing on transformative activist stance, I explain contribution as how individuals take part in and transform collective practices according to their own life agendas and get transformed themselves. As contribution to science education is a concept based on transformation, not adaptation, it can be especially informative when examining how underrepresented students in science can be more engaged in science education and eventually science. Using survey, interview and group conversations, and field observations in an undergraduate physics course, I put forward Zoey's case to illustrate my argument and show how her contribution to the activities in the course initiated change in the activity among her peers.

Investigation into the role of NaCL deposited on oxide and metal substrates in the initiation of hot corrosion

NASA Technical Reports Server (NTRS)

Birks, N.

1981-01-01

The conversion to Na2SO4 of NaCl deposited on oxide substrates was studied as a function of temperature, in air with various SO2 and H2O partial pressures. The substrate was either a pure oxide or an oxide scale growing on a metal specimen. The progress of the reaction was observed using the SEM-EDAX technique to monitor morphological effects and, as far as possible, establish the rate of the process. The physical characteristics of the interaction between salt and substrate were also examined with particular reference to physical damage to the underlying oxide, especially when this is a scale on a metal specimen. An effort was also made to establish the conditions under which liquid phases may form and the mechanisms by which they form.

The effect of exercise training in adults with multiple sclerosis with severe mobility disability: A systematic review and future research directions.

PubMed

Edwards, Thomas; Pilutti, Lara A

2017-08-01

There is evidence for the benefits of exercise training in persons with multiple sclerosis (MS). However, these benefits have primarily been established in individuals with mild-to-moderate disability (i.e., Expanded Disability Status Scale [EDSS] scores 1.0-5.5), rather than among those with significant mobility impairment. Further, the approaches to exercise training that have been effective in persons with mild-to-moderate MS disability may not be physically accessible for individuals with mobility limitations. Therefore, there is a demand for an evidence-base on the benefits of physically accessible exercise training approaches for managing disability in people with MS with mobility impairment. To conduct a systematic review of the current literature pertaining to exercise training in individuals with multiple sclerosis (MS) with severe mobility disability. Four electronic databases (PubMed, EMBASE, OvidMEDLINE, and PsychINFO) were searched for relevant articles published up until October 2016. The review focused on English-language studies that examined the effect of exercise training in people with MS with severe mobility disability, characterized as the need for assistance in ambulation or EDSS score ≥ 6.0. The inclusion criteria involved full-text articles that: (i) included participants with a diagnosis of MS; (ii) included primarily participants with a reported EDSS score ≥ 6.0 and/or definitively described disability consistent with this level of neurological impairment; and (iii) implemented a prospective, structured exercise intervention. Data were analyzed using a descriptive approach and summarized by exercise training modality (conventional or adapted exercise training), and by outcome (disability, physical fitness, physical function, and symptoms and participation). Initially, 1164 articles were identified and after removal of duplicates, 530 articles remained. In total, 512 articles did not meet the inclusion criteria. 19 articles were included in the final review. Five studies examined conventional exercise training (aerobic and resistance training), and thirteen studies examined adapted exercise modalities including body-weight support treadmill training (BWSTT), total-body recumbent stepper training (TBRST), and electrical stimulation cycling (ESAC). Outcomes related to mobility, fatigue, and quality of life (QOL) were most frequently reported. Two of five studies examining conventional resistance exercise training reported significant improvements in physical fitness, physical function, and/or symptomatic and participatory outcomes. Nine of 13 studies examining adapted exercise training reported significant improvements in disability, physical fitness, physical function, and/or symptomatic and participatory outcomes. There is limited, but promising evidence for the benefits of exercise training in persons with MS with severe mobility disability. Considering the lack of effective therapeutic strategies for managing long-term disability accumulation, exercise training could be considered as an alternative approach. Further research is necessary to optimize the prescription and efficacy of exercise training for adults with MS with severe mobility disability. Copyright © 2017. Published by Elsevier B.V.

Determining early referral criteria for patients with suspected inflammatory arthritis presenting to primary care physicians: a cross-sectional study.

PubMed

Almoallim, Hani; Janoudi, Nahid; Attar, Suzan M; Garout, Mohammed; Algohary, Shereen; Siddiqui, Muhammad Irfanullah; Alosaimi, Hanan; Ibrahim, Ashraf; Badokhon, Amira; Algasemi, Zaki

2017-01-01

Early diagnosis and initiation of treatment for inflammatory arthritis can greatly improve patient outcome. We aimed to provide standardized and validated criteria for use by primary care physicians (PCPs) in the identification of individuals requiring referral to a rheumatologist. We analyzed the predictive value of a wide variety of demographic variables, patient-reported complaints, physical examination results, and biomarkers in order to identify the most useful factors for indicating a requirement for referral. Patients for this cross-sectional study were enrolled from various centers of the city of Jeddah, Saudi Arabia, if they were ≥18 years of age and presented to a PCP with small joint pain that had been present for more than 6 weeks. A total of 203 patients were enrolled, as indicated by the sample size calculation. Each patient underwent a standardized physical examination, which was subsequently compared to ultrasound findings. Biomarker analysis and a patient interview were also carried out. Results were then correlated with the final diagnosis made by a rheumatologist. A total of 9 variables were identified as having high specificity and good predictive value: loss of appetite, swelling of metacarpophalangeal joint 2 or 5, swelling of proximal inter-phalangeal joint 2 or 3, wrist swelling, wrist tenderness, a positive test for rheumatoid factor, and a positive test for anti-citrullinated protein antibodies. Nine variables should be the basis of early referral criteria. It should aid PCPs in making appropriate early referrals of patients with suspected inflammatory arthritis, accelerating diagnosis and initiation of treatment.

Etiologic yield of subspecialists' evaluation of young children with global developmental delay.

PubMed

Shevell, M I; Majnemer, A; Rosenbaum, P; Abrahamowicz, M

2000-05-01

To determine the etiologic yield of subspecialists' evaluation of young children with global developmental delay. In addition, variables that may predict finding an underlying etiology were also identified. All children <5 years of age, referred over an 18-month period to subspecialty services for initial evaluation of a suspected developmental delay, were prospectively enrolled. Diagnostic yield was ascertained after the completion of clinical assessments and laboratory investigations requested by the evaluating physician. Ninety-nine children (71 boys) were found to have global developmental delay; 96% had a mild or moderate delay documented. An etiologic diagnosis was determined in 44. Four diagnoses (cerebral dysgenesis, hypoxic-ischemic encephalopathy, toxin exposure, chromosomal abnormalities) accounted for 34 of 44 (77%) of the diagnoses made. The presence of co-existing autistic traits was associated with significantly decreased diagnostic yield (0/19 vs 44/80, P <.0001), whereas specific historical features (eg, family history, toxin exposure, and perinatal difficulty; 23/32 vs 21/67, P =.0002) and findings on physical examination (eg, dysmorphology, microcephaly, and focal motor findings; 35/48 vs 9/51, P <.0001) were significantly associated with identifying a diagnosis. Multiple logistic regression analysis identified antenatal toxin exposure, microcephaly, focal motor findings, and the absence of autistic traits as significant predictor variables for the identification of an etiology. An etiologic diagnosis is often possible in the young child with global developmental delay, particularly in the absence of autistic features. Etiologic yield is augmented by presence of specific findings on history or physical examination on initial assessment.

Implementation of an accelerated physical examination course in a doctor of pharmacy program.

PubMed

Ho, Jackie; Bidwal, Monica K; Lopes, Ingrid C; Shah, Bijal M; Ip, Eric J

2014-12-15

To describe the implementation of a 1-day accelerated physical examination course for a doctor of pharmacy program and to evaluate pharmacy students' knowledge, attitudes, and confidence in performing physical examination. Using a flipped teaching approach, course coordinators collaborated with a physician faculty member to design and develop the objectives of the course. Knowledge, attitude, and confidence survey questions were administered before and after the practical laboratory. Following the practical laboratory, knowledge improved by 8.3% (p<0.0001). Students' perceived ability and confidence to perform a physical examination significantly improved (p<0.0001). A majority of students responded that reviewing the training video (81.3%) and reading material (67.4%) prior to the practical laboratory was helpful in learning the physical examination. An accelerated physical examination course using a flipped teaching approach was successful in improving students' knowledge of, attitudes about, and confidence in using physical examination skills in pharmacy practice.

Daily Physical Activity for Children and Youth: A Review and Synthesis of the Literature

ERIC Educational Resources Information Center

Bates, Heidi

2006-01-01

A Daily Physical Activity (DPA) Initiative was implemented in all schools in Alberta starting in September 2005. The expected outcome of the DPA Initiative is to increase the activity levels and healthy habits of students and, in part, address related issues such as chronic disease. As part of the first tier of the DPA Initiative evaluation study,…

Policies for promotion of physical activity and prevention of obesity in adolescence.

PubMed

Pate, Russell R; Flynn, Jennifer I; Dowda, Marsha

2016-12-01

Obesity rates among children and adolescents in developed countries have increased dramatically since the 1970s. During that same period, numerous secular changes have combined to reduce the demand for physical activity in day-to-day life, and many barriers to physical activity are now evident. As a consequence, most children and adolescents do not meet the accepted public health guidelines for physical activity. Accordingly, public health interventions are needed to increase physical activity in adolescence. Such interventions, if successfully implemented, can be expected to improve fitness and health as well as reduce the prevalence of overweight and obesity in young people. Promotion of physical activity in populations of children and adolescents will require comprehensive strategic planning and adoption of new policies in multiple societal sectors. This paper highlights nine initiatives that can address the problem of physical activity in children. The initiatives are to: establish comprehensive school physical activity programming; demand high quality physical education; require physical activity in early child care and education; require physical activity in afterschool programs; create equity in community resources; activate youth sports programs; re-normalize active transport to school; institutionalize clinic-based physical activity assessment and counseling; and build activity-friendly homes. A case will be made for comprehensive national and international strategic planning aimed at effective and large-scale implementation of these initiatives and tactics.

Painful acute radiation thyroiditis induced by 131I treatment of Graves’ disease

PubMed Central

Shah, Kinjal K; Tarasova, Valentina; Davidian, Michael; Anderson, Robert J

2015-01-01

A 44-year-old woman, chronic smoker with Graves’ disease was treated with radioactive iodine ablation (RAI). One week after the treatment, she presented with severe pain in the anterior neck with radiation to the angle of the jaw associated with fatigue, tremor and odynophagia. Physical examination demonstrated an asymmetric and exquisitely tender thyroid gland. There was no laboratory evidence of thyrotoxicosis. Acute radiation thyroiditis was diagnosed. Non-steroidal anti-inflammatory drugs and hydrocodone-acetaminophen started initially were ineffective for pain control. Prednisone provided relief and was continued for 1 month with a tapering dose. Symptoms completely resolved after 1 month at which time the thyroid remained diffusely enlarged and non-tender. Three months following RAI ablation she developed hypothyroid symptoms. Levothyroxine was initiated. The patient has remained asymptomatic on continued follow-up care. PMID:25576511

Painful acute radiation thyroiditis induced by 131I treatment of Graves' disease.

PubMed

Shah, Kinjal K; Tarasova, Valentina; Davidian, Michael; Anderson, Robert J

2015-01-09

A 44-year-old woman, chronic smoker with Graves' disease was treated with radioactive iodine ablation (RAI). One week after the treatment, she presented with severe pain in the anterior neck with radiation to the angle of the jaw associated with fatigue, tremor and odynophagia. Physical examination demonstrated an asymmetric and exquisitely tender thyroid gland. There was no laboratory evidence of thyrotoxicosis. Acute radiation thyroiditis was diagnosed. Non-steroidal anti-inflammatory drugs and hydrocodone-acetaminophen started initially were ineffective for pain control. Prednisone provided relief and was continued for 1 month with a tapering dose. Symptoms completely resolved after 1 month at which time the thyroid remained diffusely enlarged and non-tender. Three months following RAI ablation she developed hypothyroid symptoms. Levothyroxine was initiated. The patient has remained asymptomatic on continued follow-up care. 2015 BMJ Publishing Group Ltd.

Military personnel sustaining Lisfranc injuries have high rates of disability separation.

PubMed

Balazs, George C; Hanley, M G; Pavey, G J; Rue, J-Ph

2017-06-01

Lisfranc injuries are relatively uncommon midfoot injuries disproportionately affecting young, active males. Previous studies in civilian populations have reported relatively good results with operative treatment. However, treatment results have not been specifically examined in military personnel, who may have higher physical demands than the general population. The purpose of this study was to examine rates of return to military duty following surgical treatment of isolated Lisfranc injuries. Surgical records and radiographic images from all active duty US military personnel treated for an isolated Lisfranc injury between January 2005 and July 2014 were examined. Demographic information, injury data, surgical details and subsequent return to duty information were recorded. The primary outcome was ability to return to unrestricted military duty following treatment. The secondary outcome was secondary conversion to a midfoot arthrodesis following initial open reduction internal fixation. Twenty-one patients meeting inclusion criteria were identified. Median patient age was 23 years, and mean follow-up was 43 months. Within this cohort, 14 patients were able to return to military service, while seven required a disability separation from the armed forces. Of the 18 patients who underwent initial fixation, eight were subsequently revised to midfoot arthrodesis for persistent pain. Military personnel sustaining Lisfranc injuries have high rates of persistent pain and disability, even after optimal initial surgical treatment. Military surgeons should counsel patients on the career-threatening nature of this condition and high rates of secondary procedures. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Understanding neighborhood environment related to Hong Kong children's physical activity: a qualitative study using nominal group technique.

PubMed

He, Gang; Cerin, Ester; Huang, Wendy Y; Wong, Stephen H

2014-01-01

Relationships between the neighborhood environment and children's physical activity have been well documented in Western countries but are less investigated in ultra-dense Asian cities. The aim of this study was to identify the environmental facilitators and barriers of physical activity behaviors among Hong Kong Chinese children using nominal group technique. Five nominal groups were conducted among 34 children aged 10-11 years from four types of neighborhoods varying in socio-economic status and walkability in Hong Kong. Environmental factors were generated by children in response to the question "What neighborhood environments do you think would increase or decrease your willingness to do physical activity?" Factors were prioritized in order of their importance to children's physical activity. Sixteen unique environmental factors, which were perceived as the most important to children's physical activity, were identified. Factors perceived as physical activity-facilitators included "Sufficient lighting", "Bridge or tunnel", "Few cars on roads", "Convenient transportation", "Subway station", "Recreation grounds", "Shopping malls with air conditioning", "Fresh air", "Interesting animals", and "Perfume shop". Factors perceived as physical activity-barriers included "People who make me feel unsafe", "Crimes nearby", "Afraid of being taken or hurt at night", "Hard to find toilet in shopping mall", "Too much noise", and "Too many people in recreation grounds". Specific physical activity-related environmental facilitators and barriers, which are unique in an ultra-dense city, were identified by Hong Kong children. These initial findings can inform future examinations of the physical activity-environment relationship among children in Hong Kong and similar Asian cities.

Sex differences in the implications of partner physical attractiveness for the trajectory of marital satisfaction.

PubMed

Meltzer, Andrea L; McNulty, James K; Jackson, Grace L; Karney, Benjamin R

2014-03-01

Do men value physical attractiveness in a mate more than women? Scientists in numerous disciplines believe that they do, but recent research using speed-dating paradigms suggests that males and females are equally influenced by physical attractiveness when choosing potential mates. Nevertheless, the premise of the current work is that sex differences in the importance of physical attractiveness are most likely to emerge in research on long-term relationships. Accordingly, the current work drew from 4 independent, longitudinal studies to examine sex differences in the implications of partner physical attractiveness for trajectories of marital satisfaction. In all 4 studies, both partners' physical attractiveness was objectively rated at baseline, and both partners reported their marital satisfaction up to 8 times over the first 4 years of marriage. Whereas husbands were more satisfied at the beginning of the marriage and remained more satisfied over the next 4 years to the extent that they had an attractive wife, wives were no more or less satisfied initially or over the next 4 years to the extent that they had an attractive husband. Most importantly, a direct test indicated that partner physical attractiveness played a larger role in predicting husbands' satisfaction than predicting wives' satisfaction. These findings strengthen support for the idea that sex differences in self-reported preferences for physical attractiveness do have implications for long-term relationship outcomes. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

Attitudes toward the physical examination: a comparison of U.S. and Dominican medical students.

PubMed

Fagan, Mark J; Lucero, Monica L; Wu, Edward H; Diaz, Joseph A; Reinert, Steven E

2006-01-01

Little information exists regarding whether medical students learning in relatively resource-scarce countries develop greater confidence in their physical examination skills or whether, compared to U.S. medical students, they have more positive attitudes regarding the utility of the physical examination. To compare U.S. And Dominican medical students' attitudes toward the physical examination. We surveyed final-year students at 1 medical school in the United States and 1 in the Dominican Republic regarding self-confidence in and perceived utility of the physical examination. Using 5-point Likert-type scales with response choices ranging from 1 (not at all confident) to 5 (very confident) and 1 (not at all useful) to 5 (very useful), respondents reported their attitudes toward the physical examination overall and toward 14 specific physical examination skills. The survey response rate was 117/164 (71%). Students at the Dominican school, compared to students at the U.S. school, reported significantly greater confidence in their overall physical examination skill (mean response 4.27 vs. 3.79, respectively, p < .001) and more positive views about the utility of the physical examination overall for providing diagnostically useful information (mean response 4.78 vs. 4.42, respectively, p < .001). Results for the specific skills also showed more positive attitudes in the students from the Dominican medical school. Students at a Dominican medical school reported more positive attitudes toward the physical examination than students at a U.S. medical school.

What is the Meaning of the Physical Magnitude `Work'?

NASA Astrophysics Data System (ADS)

Kanderakis, Nikos

2014-06-01

Usually, in physics textbooks, the physical magnitude `work' is introduced as the product of a force multiplied by its displacement, in relation to the transfer of energy. In other words, `work' is presented as an internal affair of physics theory, while its relation to the world of experience, that is its empirical meaning, is missing. On the other hand, in the history of its creation, `work' was a concept that had empirical meaning from the start. It was constructed by engineers to measure the work (labor) of motor engines, men, and animals. Very soon however this initial meaning seems to vanish. In this article, it will be looked at how `work' is presented in physics textbooks, what was its initial meaning in the history of its formulation, under what circumstances this initial meaning faded, and how elements from the history of its creation can be used in the classroom to teach it.

The use of annual physical examinations among the elderly in rural China: a cross-sectional study

PubMed Central

2014-01-01

Background Periodic physical examination is considered helpful in preventing illness and promoting health among the elderly. Limited information is available about the use of annual physical examinations among the elderly in rural areas, however. This research explores the distribution characteristics of annual physical examination use and its determinants among people aged 60 or over in rural China. Methods A cross-sectional study was undertaken to estimate distribution characteristics of annual physical examination use and to collect data of sociodemographic characteristics, health knowledge level, and health communication channels. Participants were 1128 people aged 60 or over, randomly selected from four different provinces in the East, Mid-East, Mid-West, and West China. Logistic regression determined the predictors of annual physical examination use. Results Participants were predominantly aged 60–79 (44.1%) and 70–79 (42.0%). A total of 716 (63.5%) participants underwent annual physical examinations. Those who reported acquiring health knowledge via bulletin boards and village doctors had a higher probability of using annual physical examinations (OR = 3.15 and 1.53). The probability for civil servants/retired having annual physical examinations was 2.16 times higher than for farmers. Those who had an average level of health knowledge had a higher probability of using annual physical examinations than those at the below-average level (odds ratio: 2.07). Conclusion The government and public health institutions should assist farmers to acquire the habit of having annual physical examinations. Traditional channels, such as bulletin boards, should be used to deliver health information. Village doctors should be supported in delivering health information to the elderly in rural areas. PMID:24423046

The use of annual physical examinations among the elderly in rural China: a cross-sectional study.

PubMed

Sun, Xi; Chen, Yingchun; Tong, Xuetao; Feng, Zhanchun; Wei, Li; Zhou, Donghua; Tian, Miaomiao; Lv, Benyan; Feng, Da

2014-01-14

Periodic physical examination is considered helpful in preventing illness and promoting health among the elderly. Limited information is available about the use of annual physical examinations among the elderly in rural areas, however. This research explores the distribution characteristics of annual physical examination use and its determinants among people aged 60 or over in rural China. A cross-sectional study was undertaken to estimate distribution characteristics of annual physical examination use and to collect data of sociodemographic characteristics, health knowledge level, and health communication channels. Participants were 1128 people aged 60 or over, randomly selected from four different provinces in the East, Mid-East, Mid-West, and West China. Logistic regression determined the predictors of annual physical examination use. Participants were predominantly aged 60-79 (44.1%) and 70-79 (42.0%). A total of 716 (63.5%) participants underwent annual physical examinations. Those who reported acquiring health knowledge via bulletin boards and village doctors had a higher probability of using annual physical examinations (OR = 3.15 and 1.53). The probability for civil servants/retired having annual physical examinations was 2.16 times higher than for farmers. Those who had an average level of health knowledge had a higher probability of using annual physical examinations than those at the below-average level (odds ratio: 2.07). The government and public health institutions should assist farmers to acquire the habit of having annual physical examinations. Traditional channels, such as bulletin boards, should be used to deliver health information. Village doctors should be supported in delivering health information to the elderly in rural areas.