The role of asymptomatic screening in the detection of recurrent ovarian cancer.

OBJECTIVE: To investigate the utility of asymptomatic screening, including CA-125, imaging, and pelvic exam, in the diagnosis and management of recurrent ovarian cancer. METHODS: Women with ovarian cancer whose cancer recurred after remission were categorized by first method that their provider suspected disease recurrence: CA-125, imaging, symptoms, or physical exam. Differences in clinicopathologic, primary treatment characteristics, and outcomes data including secondary cytoreductive surgery (SCS) outcome and overall survival (OS) were collected. RESULTS: 102 patients were identified at our institution from 2003 to 2015. 20 recurrences were detected by symptoms, while 62 recurrences were diagnosed first by asymptomatic rise in CA-125, 5 by pelvic exam, and 15 by imaging in the absence of known exam abnormality or rise in CA-125.Mean time to recurrence was 18.9 months, and median survival was 45.8 months. These did not vary by recurrence detection method (all p > 0.4). Patients whose disease was detected by CA-125 were less likely to undergo SCS than those detected by other means (21.7% vs. 35.0%, p = 0.007). In addition to the 5 patients whose recurrence was detected primarily by pelvic exam, an additional 10 (total n = 15) patients had an abnormal pelvic exam at time of diagnosis of recurrence. DISCUSSION: Recurrence detection method was not associated with differing rates of survival or optimal SCS, however those patients detected by CA-125 were less likely to undergo SCS. The pelvic exam was a useful tool for detecting a significant proportion of recurrences.

Effect of gender on fatigue and recovery following maximal intensity repeated sprint performance.

AIM: This study investigated the effects of gender on repeated, maximal-intensity intermittent sprint exercise following variable day-to-day recovery periods. METHODS: Sixteen volunteers (8 men, 8 women) performed four trials of high-intensity intermittent sprint exercise consisting of three bouts of eight 30 m sprints (total of 24 sprints). Following completion of the baseline trial, in repeated-measures design, participants were assigned, in counter-balanced order, variable recovery periods of 24, 48, and 72 h whereupon they repeated an identical exercise trial. RESULTS: Results from a series of 4 (trial) x 3 (bout) repeated measures ANOVAs revealed men produced significantly (P < 0.01) faster times throughout all bouts and trials of repeated sprint exercise. Additionally, women exhibited significantly lower (P < 0.05) blood lactate concentration and significantly lower (P < 0.05) decrement in performance, indicating increased resistance to fatigue during repeated exercise sessions. There were no significant differences (P > 0.05) between genders for heart rate or rating of perceived exertion during or following trials. There were no significant differences for overall sprint performance within either gender among trials. CONCLUSION: These results indicate men, while able to produce higher absolute power outputs (i.e., lower sprint time), demonstrate higher decrement scores within a trial compared to women, thus suggesting women may recover faster and fatigue less. Also, gender differences affecting recovery within in a trial were observed to be diminished between trials (i.e., day-to-day recovery) of maximal intermittent sprint work evidenced by the observed stability of performance between trials following various recovery durations.

Physiological and comfort effects of a commercial "cooling cap" worn under protective helmets.

Ballistic protective helmets can impair heat dissipation. A cooling device in the helmet (cooling pad, CP) could help prevent heat problems in military personnel and potentially enhance comfort. This study examined the effects of CP on rectal and skin temperatures, heart rate, percent change in plasma volume, urine specific gravity, rating of perceived exertion, and other subjective measures while performing light work in a hot environment. It was hypothesized that the CP would act as an insulator to the head, which would not positively affect any physiological variable but could positively affect wearer subjective comfort or temperature. Participants performed a work protocol for approximately 2 hr. A ballistic vest, slacks, short-sleeved button-up shirt, and a ballistic helmet (one trial with CP and one trial without) were worn. Repeated measures analysis of variance (ANOVA) showed no differences (p > 0.05) between wearing and not wearing the CP for any physiological parameter. However, participants perceived the CP as cooler (p = 0.002). Other trends in perceptual data such as thermal strain and helmet comfort indicated the CP felt cooler. However, based on forehead temperature and participant comments, the CP lost its cooling ability relatively quickly (within approximately 30 min).

Validation of a personal fluid loss monitor.

Dehydration raises heat injury risk and reduces performance [ , , ]. The purpose was to validate the Hydra-Alert Jr (Acumen). The Hydra-Alert was tested in two exercise/clothing conditions. Participants wore it while wearing exercise clothing and exercising at a self-selected intensity (n = 8). Others wore the Hydra-Alert while wearing a ballistic-vest and performing an industrial-protocol (n = 8). For each condition, the Hydra-Alert was tested on two occasions (T1 and T2). The Hydra-Alert was tested against nude weight loss for both conditions. The Hydra-Alert had low test-retest reliability for both conditions (average absolute value of the error between Hydra-Alert outputs of T1 and T2 = 0.08 +/- 0.08 percentage points). With exercise-clothing, the Hydra-Alert evidenced low-moderate correlations between percent nude weight loss and Hydra-Alert output at 20 min (r = 0.59-T1, p = 0.13; r = 0.12-T2, p = 0.78), at 40 min (r = 0.93-T1, p = 0.001; r = 0.63-T2, p = 0.10), and at approximately 2 % weight loss (r = 0.21-T1 and T2, p = 0.61 and 0.62, respectively). The correlation at 40 min during T1 fell during T2 suggesting the Hydra-Alert was inconsistent. When wearing a ballistic-vest, the Hydra-Alert had poor validity (T1: r = - 0.29 [p = 0.48] for weight loss vs. monitor; T2: r = 0.11 [p = 0.80]). At the higher levels of dehydration ( approximately 2 %), the Hydra-Alert error was so high as to render its readings of little value. In some cases, the Hydra-Alert could lead to a false level of security if dehydrated. Therefore, the Hydra-Alert is of little use for those who want to measure their fluid loss while exercising in the heat.

Accuracy and repeatability of the Yale physical activity survey in assessing physical activity of older adults.

The purpose of this study was to extend the initial evaluation of the Yale Physical Activity Survey to assess physical activity in older adults. The survey yields three indicators of physical activity reflecting activities performed during a typical week of the previous month (Total Time, Total Energy Expenditure) and the past month (Total Activity Summary Index). Questionnaire validity was studied in 56 men and women, ages 56 to 86 years, by comparing the average of 3- or 7 day 24-hr. physical activity records (n=56), predicted maximal oxygen consumption (VO2 max) (n = 23) and the sum of three skinfold measurements. Two-week repeatability was estimated by calculating an intraclass coefficient using an analysis of variance with repeated measures. Spearman rhos were used to study questionnaire validity. Analysis showed the survey was easily administered and scored and exhibited moderate-to-good repeatability. For the first administration the Total Energy Expenditure Index was significantly associated with the physical activity diary (r = .27). On the second administration, correlations were significant for the physical activity diary with the Total Energy Expenditure Index (r = .30), the Total Activity Summary Index (r = .36), and the Total Time Index (r = .27), and for VO2 max and the Total Time Index (r = .49) and Total Activity Summary Index (r = .64). Relative to the criterion measures used in this study, some validity was evident for the second administration in this relatively active and healthy sample of older adults.

Validation of the Stanford 7-day recall to assess habitual physical activity.

PURPOSE: The ability of the Stanford 7-Day Recall (7-DR), a well known instrument for surveying work and leisure-time physical activity (PA) in epidemiologic studies, to assess levels of habitual PA in men and women was evaluated. METHODS: The 7-DR was administered twice, one month apart. Its accuracy was studied in 77 men and women, aged 20-59 years, by its repeatability and comparison of both administrations of the 7-DR with: fourteen 48-hour physical activity records; fourteen 48-hour Caltrac accelerometer readings; peak oxygen uptake (VO(2) peak) determinations; and percent body fat. These criteria measures were obtained over a year's duration. RESULTS: One month repeatability correlation coefficients for 7-DR total activity were r = 0.60 and r = 0.36 for men and women, respectively. Comparison of corresponding indices of activity between the 7-DR and the PA record indicated: 1) a closer relationship in men for total (r = 0.58 for visit 10 7-DR and 0.66 for visit 11 7-DR, p < or = 0.01), and very hard (r = 0.44 and 0.60, p< or = 0.05) activity then in women (r = 0.32 and 0.33, p < or = 0.05, and r = 0.21, ns and 0.43, p< or = 0.01, respectively); and 2) in general, lower and less consistent associations for hard, moderate, and light activity. Total PA by the 7-DR was significantly associated with Caltrac readings in men only. 7-DR results were more consistently related to VO(2) peak in men than women, but were significantly related to percent body fat in women only. CONCLUSIONS: The ability of the 7-DR to assess habitual PA was greater for more vigorous than for lower intensity PA.

Evaluation of the kaiser physical activity survey in women.

PURPOSE: The Kaiser Physical Activity Survey (KPAS) was evaluated for test-retest reliability and comparison with direct and indirect measures of physical activity (PA) in 50 women (ages 20-60 yr) with a broad range of physical activity (PA) habits. METHODS: The KPAS, an adaptation of the Baecke usual physical activity survey, was designed specifically to assess activity in women. It provides four summary activity indexes: housework/caregiving, active living habits, sports, and occupation. Summary indexes were compared against direct (Caltrac accelerometer and PA records) and indirect (cardiorespiratory fitness (VO2 peak) and percent body fat) criterion measures of PA. Participants kept detailed PA records for two, 7-d periods, separated by 1 month. Caltrac accelerometers were worn concurrently with the PA records. RESULTS: Intraclass correlations for 1-month test-retest reliability were high for all KPAS indexes (r = 0.79 to 0.91, P < 0.01). Age-adjusted Spearman rho correlations between the KPAS sports/exercise and active living habits indexes were of moderate magnitude for VO2 peak (r = 0.34 to 0.76, P < 0.01) and percent body fat (r = -.30 to -0.59, P < 0.05). KPAS caregiving and occupation indexes were related to Caltrac kcal x d(-1) (r = 0.30 to 0.44, P < 0.05). Correlations between similar activities from the KPAS and PA records ranged from r = 0.03 to 0.64. Daily, habitual activities from the KPAS and PA records had the highest correlations (r > 0.28). Correlations among infrequent activities were lower (r < 0.05). CONCLUSION: The KPAS demonstrated good reliability and was reasonably accurate in detecting regular housework/caregiving, occupation, sports/exercise, and active leisure activities among women with a broad range of physical activity habits.

Intra-individual variation and estimates of usual physical activity.

PURPOSE: The magnitude of intra-individual variation, as determined by three methods of physical activity (PA) assessment, was estimated to determine the optimal number of repeated measures needed to reliably measure an individual's usual PA habits. METHODS: Data were obtained from 77 healthy adults enrolled in the Survey of Activity, Fitness, and Exercise (SAFE). PA was measured by: 1) Caltrac accelerometers worn 48-hours every 26 days for one year; 2) concurrent 48-hour PA records (PARs); and 3) a corresponding series of four-week PA histories (FWH). Repeated measures regression analyses were used to analyze the data. RESULTS: PA tended to be slightly higher in the summer months as compared with the winter months, but this seasonality explained little of the intra-individual variation. The intra-individual standard deviation (SD) estimated for the FWH (180 MET-min(d(-1))) was 39% of the mean annual MET-min(d(-1)), as compared with the Caltrac (163 MET-mind(d(-1)) or 9%) and PAR (259 MET-min(d(-1)) or 11%). Given the intra-individual variation, three repeated observations of the FWH, six Caltrac, or nine PAR over the course of the year were needed to achieve 80% reliability in estimation of mean annual PA. CONCLUSIONS: Intra-individual variation in PA is substantial and must be accounted for in estimates of usual PA.

Acute effects of thirty minutes of light-intensity, intermittent exercise on patients with chronic fatigue syndrome.

BACKGROUND AND PURPOSE: Currently, there is no consensus on exercise prescription for patients with chronic fatigue syndrome (CFS). This investigation examined whether light-intensity, intermittent physical activity exacerbated symptoms in patients with CFS immediately following exercise to 7 days following exercise. Subjects. Subjects were 9 women (mean age=44.2 years, SD=8.4, range=29-56; mean weight=74.2 kg, SD=18.8, range=56.36-110.91; and mean height=1.63 m, SD=0.8, range=1.55-1.78) and 1 man (age=48 years, weight=97.1 kg, and height= 1.98 m) who met the Centels for Disease Control and Prevention's criteria fi)r (FS. METHODS: Subjects performed 10 discontinuous 3-minute exercise bouts (separated by 3 minutes of recovery) at a self-selected, comfortable walking pace on a treadmill. Oxygen consumption, minute ventilation, respiratory exchange ratio, and heart rate were measured every minute during the exercise session. To assess degree of disability, general health status, activity level, symptoms, and mood, subjects completed various questionnaires before and after exercise. RESULTS: Results indicated that degree of disability, general health status, symptoms, and mood did not change immediately and up to 7 days following exercise. CONCLUSION AND DISCUSSION: Thirty minutes of intermittent walking did not exacerbate symptoms in subjects with CFS. The physiological data did not show any abnormal response to exercise. Although this study did not determine whether 30 minutes of continuous versus intermittent exercise would exacerbate symptoms, all 10 subjects felt that they could not exercise continuously for 30 minutes without experiencing symptom exacerbation. Despite this limitation, the results indicate that some individuals with CFS may be able to use low-level, intermittent exercise without exacerbating their symptoms.

Accuracy of recall of occupational physical activity by questionnaire.

The validity of the Tecumseh Occupational Activity Questionnaire (TOQ) and a modified Seven Day Recall (SDR) was measured in 46 healthy women, ages 20-60 years (mean +/- SD, 39.4 +/- 11.8). Occupational data were compared with direct (7-day occupational activity records and Caltrac accelerometer) and indirect (maximal oxygen uptake and percent body fat) measures of physical activity status. Physical activity survey and occupational record data were log transformed to normalize skewed distributions. Intraclass correlations ranged from r = 0.26 to 0.73 (P < 0.05) between similar activities on the TOQ and activity records for light intensity sitting, light-to-moderate intensity standing, and walking. Correlations between similar activities from the SDR and activity records ranged from r = 0.32 to 0.35 (P < 0.05) for light and moderate intensity activities. Correlations for total occupational activity between the surveys and activity records were r = 0.46 (P < 0.001) for the TOQ and r = 0.45 (P < 0.01) for the SDR. A modest correlation (r = 0.34, P < 0.10) was observed between the Caltrac scores and TOQ moderate intensity standing. Only the TOQ light-to-moderate intensity standing was related to maximal oxygen uptake (r = 0.32, P < 0.05). None of the measures were related to percent body fat (P > 0.05). These results suggest that the TOQ and SDR both provide reasonably accurate measurements of light and moderate intensity occupational physical activity.

Tolerance and specificity of recombinant 6-methylsalicyclic acid synthase.

BACKGROUND: 6-Methylsalicylic acid synthase (MSAS), a fungal polyketide synthase from Penicillium patulum, is perhaps the simplest polyketide synthase that embodies several hallmarks of this family of multifunctional enzymes--a large multidomain protein, a high degree of specificity toward acetyl-CoA and malonyl-CoA substrates, chain length control, and regiospecific ketoreduction. MSAS has recently been functionally expressed in Escherichia coli and Saccharomyces cerevisiae, leading to the engineered biosynthesis of 6-methylsalicylic acid in these hosts. These developments have set the stage for detailed mechanistic studies of this model system. RESULTS: A three--step purification procedure was developed to obtain >95% pure MSAS from extracts of E. coli. As reported earlier for the enzyme isolated from P. patulum, the recombinant enzyme produced 6-methylsalicylic acid (a reduced tetraketide) in the presence of acetyl-CoA, malonyl-CoA, and NADPH, but triacetic acid lactone (an unreduced triketide) in the absence of NADPH. Consistent with this observation, point mutations in the highly conserved nucleotide-binding motif of the ketoreductase domain also led to production of triacetic acid lactone in vivo. The enzyme showed some tolerance toward nonnatural primer units including propionyl- and butyryl-CoA, but was incapable of incorporating extender units from (R, S)-methylmalonyl-CoA. Interestingly, MSAS readily accepted the N-acetylcysteamine (NAC) analog of malonyl-CoA as a substrate. CONCLUSIONS: NAC thioesters are simple, cost-effective analogs of CoA thioester substrates, and therefore provide a facile strategy for probing the molecular recognition features of polyketide synthases using unnatural building blocks. The ability to produce 4-hydroxy-6-methyl-2-pyrone in both E. coli and yeast illustrates the feasibility of metabolic engineering of these hosts to produce unnatural polyketides. Finally, the abundant source of recombinant MSAS described here provides an opportunity to study this fascinating model system using a combination of structural, mechanistic, and mutagenesis approaches.

Disordered eating in female collegiate athletes and collegiate females in an advanced program of study: a preliminary investigation.

The purpose of this study was to use the Eating Disorders Inventory-2 (EDI-2) to compare disordered eating pathology between female intercollegiate athletes and a control group of nonathletic subjects enrolled in an advanced program of study. Analysis of variance (ANOVA) procedures revealed no significant difference (NSD) (p > .05) between any of the athletic groups or the control group on any EDI-2 subscale, and there was no significant difference between "lean" sports, other sports, and the control group. There was also NSD on EDI-2 subscale scores on the basis of age. African Americans had significantly lower scores on the Body Dissatisfaction and Impulse Regulation subscales than white Americans. Chi-square analysis revealed NSD between any groups in percentage of respondents scoring above anorexic norms. The results did not indicate a greater amount of disordered eating in female athletes compared to nonathlete controls.

Ability of the Atherosclerosis Risk in Communities (ARIC)/Baecke Questionnaire to assess leisure-time physical activity.

BACKGROUND: The Atherosclerosis Risk in Communities (ARIC)/Baecke Questionnaire is a general survey of both occupational and leisure (sport and exercise related and non-sport and exercise related) physical activity. METHODS: Its ability to assess leisure physical activity was studied in 78 men and women, age 20-59 years, by comparison to: six 48-hour physical activity records; 14 48-hour Caltrac accelerometer readings (Caltrac); three peak oxygen consumption (VO2 peak) determinations; and per cent body fat. These criteria measures were obtained over a year's duration. RESULTS: The following associations were evident in men and women respectively, between sport and exercise physical activity and: physical activity record heavy intensity activity (r = 0.73 and r = 0.63); VO2 peak (r = 0.67 and r = 0.45); and per cent body fat (r = -0.37, P = 0.08 and r = -0.44). Less concordance was evident (r = 0.39 for men and r = 0.23, NS, for women) between non-sport and exercise physical activity and physical activity record light intensity activity. Questionnaire and physical activity record indices of total leisure activity tended to be more closely related in men (r = 0.59) than women (r = 0.33). For both men and women, survey results were not closely associated with Caltrac readings. CONCLUSIONS: Although there are weaknesses, questionnaire strengths consistent for both men and women include: ease of administration, high reliability, and accurate assessment of heavy intensity activity as well as light intensity activities such as walking and bicycling.

Ability of the Caltrac accelerometer to assess daily physical activity levels.

PURPOSE: The purpose of this study was to determine the ability of the Caltrac accelerometer to assess habitual daily physical activity levels. METHODS: The ability of the Caltrac accelerometer to assess 24-hour physical activity (PA) levels was studied in 28 men and 50 women, age 20 to 59 years, with varying levels of self-reported PA. Twelve days of Caltrac readings obtained over 1 year's duration were compared to simultaneously recorded 48-hour PA records. Additionally, 28 days of Caltrac readings obtained over 1 year's duration were compared to mean values of the following validation measures assessed repeatedly over a 1-year period: a 4-week version of the Minnesota Leisure Time Physical Activity Questionnaire (FWH); VO2peak; and percent body fat. RESULTS: The Caltrac measurements of movement (in MET minutes per day-1) were significantly associated with the following: PA record indices of total (r = .51) and heavy (r = .34) and PA; FWH indices of total (r = .30), heavy R = .36) and moderate (r = .23) PA;, and VO2peak (r = .24). However, the Caltrac measurements of caloric PA record and FWH indices of PA, although there were directly associated with percent body fat (r = .50) and inversely associated with VO2peak (r = -.26). CONCLUSIONS: Caltrac measurements of movement exhibited a moderate associated with several criterion measures related to habitual PA, whereas Caltrac measurements of total energy expenditure, were not reflective of varying levels of PA.

The acute effect of moderate alcohol consumption on cardiovascular responses in women.

OBJECTIVE: The purpose of this study was to assess the effects of moderate dose alcohol consumption on human metabolic and cardiovascular responses during submaximal exercise. METHOD: Ten female subjects participated in two experimental conditions: (1) an alcohol session where the subjects ingested 0.625 g per kg body weight of 80-proof ethyl alcohol (0.25 g/kg of 100% ethanol), and (2) a placebo session. In each session, the subjects exercised on a stationary bicycle at 70% predicted maximum heart rate (HR) for 30 minutes. HR, blood pressure (BP) and oxygen consumption (VO2) were measured at the baseline and at 10, 20 and 30 minute intervals during exercise. Blood lactic acid (BLA) was measured at the baseline and at the end of exercise. RESULTS: Repeated analysis of variance and subsequent comparisons showed that the alcohol session had significantly higher scores for HR, BP, VO2 and BLA than the placebo session (p < .05). CONCLUSIONS: These results suggest that during submaximal work, acute moderate alcohol consumption may interfere with aerobic energy metabolism, thus increasing the demand placed upon the cardiovascular system.

The value of ten common exercise tolerance test measures in predicting coronary disease in symptomatic females.

The diagnostic contribution of ten common exercise tolerance test (ETT) measures compared with coronary angiography was studied in 62 symptomatic females (mean age = 53 +/- 9 years). Logistic regression revealed that maximal ST-segment depression, the percent of predicted maximal heart rate achieved, and test chest pain all contributed unique predictive information and formed a model generating probabilities for coronary disease (CAD). Using a predicted probability for the presence of CAD of 0.50 as a cutpoint, test accuracy was markedly improved (sensitivity = 73%, specificity = 94%, and overall correct classification rate = 90%) over the standard ST response. We conclude that multivariate analysis using these three easily assessed ETT measures provides superior discrimination between symptomatic women with and without CAD when compared to changes in the ST-segment alone.

Comprehensive evaluation of the Minnesota Leisure Time Physical Activity Questionnaire.

The accuracy of the Minnesota Leisure Time Physical Activity (LTPA) Questionnaire (a 1-year survey of non-occupational activity used in MRFIT) was studied in 78 men and women, age 20-59 years, by comparing survey results to the following measures obtained over a year's duration: six 48-hour physical activity records; fourteen 48-hour Caltrac accelerometer readings (Caltrac); 14 administrations of a 4-week version of the LTPA Questionnaire (FWH); 3 VO2peak determinations and percent body fat (% BF). The LTPA Questionnaire demonstrated: weak to moderate associations with % BF (r = -0.24) and with VO2peak (r = 0.47); a weak association with Caltrac readings expressed as MET.minutes.day-1 (r = 0.23); strong associations with corresponding activities reported on the FWH; and moderate associations with total and heavy activities reported in the physical activity record, but no associations with moderate and light activities. Furthermore, several types of LTPA were found to be either under-represented or not currently included in the Minnesota LTPA Questionnaire. It is concluded that although validation results were found to be quite good, several possible refinements were identified, which should improve the accuracy of the Minnesota LTPA Questionnaire in assessing habitual physical activity.

Accuracy of the College Alumnus Physical Activity Questionnaire.

The validity and reproducibility of the Physical Activity Index from the College Alumnus Questionnaire (PAI-CAQ) were determined in 78 men and women (21-59 yr) with a broad range of physical activity habits. The PAI-CAQ was computed as the sum of energy expended in stair climbing, walking, and sports and recreational physical activity recalled from the past week. Data were validated against measures of cardiorespiratory fitness, body fatness, motion detection, and physical activity records. All physical activity was recorded by participants for six 48-hour periods. Each day of the week, including weekends, were represented at least twice in the physical activity records. Age-adjusted correlation coefficients between like activities on the College Alumnus Questionnaire and physical activity records ranged from 0.25 to 0.65 in men and 0.28 to 0.86 in women. Correlations between the PAI-CAQ and validation criteria that reflected total and heavy-intensity physical activities were higher (r = 0.34-0.69, p < 0.05) than for lighter-intensity physical activities and motion detection expressed in MET-min.d-1 and kcal.d-1 (r < 0.35, p > 0.05). Test-retest reproducibility was higher over 1 month (r = 0.72) than over 8 and 9 months (r = 0.34 and 0.43) (p < 0.05). Energy expended in walking and stair climbing was underestimated on the College Alumnus Questionnaire, resulting in lower PAI-CAQ scores, as compared to the physical activity records.

Assessment of the accuracy of physical activity questionnaire occupational data.

The validity and reliability of occupational physical activity data from survey instruments were determined in 75 men and women (age 23 to 59 years) in white-collar jobs. Data were validated against measures of cardiorespiratory fitness, body fatness, motion detection, pulmonary function, and 12 days of occupational physical activity records. More than 90% of occupational physical activity was spent in light-intensity sitting, standing, and walking. Test-retest reliability was high for most occupational questions (r > or = .63, P < .05). Correlation coefficients between questionnaire data and validation criteria that reflect heavy-intensity physical activity were low (r < .17, P > .05). The modified Tecumseh Occupational Questionnaire and Seven-Day Recall, which classified occupational physical activity in hours per week worked and average level of ratio of associated metabolic rate for a specific activity divided by the resting metabolic rate, on the job, correlated best with physical activity records (r = .11 to .47). Validation of these self-administered questionnaires in populations with a greater diversity of jobs and occupational energy requirements is needed.

The value of chest pain during the exercise tolerance test in predicting coronary artery disease.

UNLABELLED: The predictive power of 10 common exercise test parameters compared with coronary angiography was studied. Only the exercise electrocardiogram (EXECG), maximal rate pressure product (MAXRPP), and exercise chest pain (EXCP) contributed unique predictive information with the emergence of two interactions involving EXCP (EXCP.EXECG and EXCP.MAXRPP). IN CONCLUSION: (1) EXCP appears to be a more serious finding only in those higher risk individuals with either a positive EXECG or lower MAXRPP; (2) EXCP and its interactions may help discriminate between anginal and nonanginal, exertional chest pain, and (3) the contradictory results found when EXCP was allowed to interact may explain conflicting results in previous multivariate models regarding the predictive significance of EXCP.