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1.
Cult Med Psychiatry ; 45(2): 234-267, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32740780

RESUMO

Interoceptive awareness is the conscious perception of sensations that create a sense of the physiological condition of the body. A validation study for the Japanese translation of the Multidimensional Assessment of Interoceptive Awareness (MAIA) surprised with a factor structure different from the original English-language version by eliminating two of eight scales. This prompted an exploration of the similarities and differences in interoceptive bodily awareness between Japanese and European Americans. Bicultural Japanese-Americans discussed concepts and experiences in the two cultures. We conducted focus groups and qualitative thematic analyses of transcribed recordings. 16 participants illustrated cross-cultural differences in interoceptive bodily awareness: switching between languages changes embodied experience; external versus internal attention focus; social expectations and body sensations; emphasis on form versus self-awareness; personal space; and mind-body relationship; context dependency of bodily awareness and self-construal. The participants explained key concepts that present challenges for a Japanese cultural adaptation of the MAIA, specifically the concept of self-regulation lost in the factor analysis. In Japanese culture, self-regulation serves the purpose of conforming to social expectations, rather than achieving an individual self-comforting sense of homeostasis. Our findings will inform the next phase of improving the MAIA's cross-cultural adaptation.


Assuntos
Interocepção , Conscientização , Análise Fatorial , Grupos Focais , Humanos , Percepção , Estados Unidos
2.
Equine Vet J ; 49(5): 624-628, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28238211

RESUMO

BACKGROUND: Erythromycin (ERY) induces anhidrosis in foals. Azithromycin (AZI) and clarithromycin (CLA), often combined with rifampicin (RIF), are commonly used to treat Rhodococcus equi infections, but effects on sweating have not been investigated. OBJECTIVE: To determine the effects of AZI, CLA and RIF on sweat responses in normal foals. STUDY DESIGN: Each experiment was a blinded, duplicated, six foal × three period counterbalanced within subjects design (12 foals/experiment). METHODS: Antimicrobials were given orally for 5 days. In Experiment 1, ERY, AZI and CLA were given. In Experiment 2, ERY, RIF and ERY/RIF combination were used. Quantitative intradermal terbutaline sweat tests were performed daily for 3 days before and 1, 2, 5, 9, 24, and 39 days after treatment. Data were analysed by repeated measures analysis of variance procedures. Significance was P≤0.05. RESULTS: In Experiment 1, all macrolides suppressed sweating although CLA and AZI were less potent than ERY. In Experiment 2, significant sweat suppression occurred in foals given ERY with or without RIF, but there was no effect of RIF alone. Rifampicin reduced sweat suppression by ERY on Day 1 of treatment but not thereafter. MAIN LIMITATIONS: Because ERY blood concentrations were not measured, effects of RIF on ERY-induced anhidrosis could not definitively be ascribed to altered ERY bioavailability. CONCLUSIONS: All macrolides commonly used to treat R. equi pneumonia, i.e. ERY, AZI and CLA, induce anhidrosis in foals. The potent anti-sudorific effect of ERY is delayed, but not substantially affected by concurrent RIF administration.


Assuntos
Azitromicina/farmacologia , Claritromicina/farmacologia , Rifampina/farmacologia , Sudorese/efeitos dos fármacos , Animais , Cavalos , Terbutalina
4.
J Fish Biol ; 78(1): 355-65, 2011 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-21235567

RESUMO

Although three species of the genus Macrourus are recognized in the Southern Ocean, DNA sequencing of the mitochondrial COI gene revealed four well-supported clades. These barcode data suggest the presence of an undescribed species, a conclusion supported by meristic and morphometric examination of specimens.


Assuntos
Código de Barras de DNA Taxonômico , Gadiformes/genética , Animais , Complexo IV da Cadeia de Transporte de Elétrons/genética , Gadiformes/classificação , Especificidade da Espécie
5.
Behav Brain Res ; 204(1): 162-8, 2009 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-19523988

RESUMO

Inbred Wistar-Kyoto (WKY) rats have been proposed as a model of anxiety vulnerability as they display behavioral inhibition and a constellation of learning and reactivity abnormalities relative to outbred Sprague-Dawley (SD) rats. Together, the behaviors of the WKY rat suggest a hypervigilant state that may contribute to its anxiety vulnerability. To test this hypothesis, open-field behavior, acoustic startle, pre-pulse inhibition and timing behavior were assessed in WKY and Sprague-Dawley (SD) rats. Timing behavior was evaluated using a modified version of the peak-interval timing procedure. Training and testing of timing first occurred without audio-visual (AV) interference. Following this initial test, AV interference was included on some trials. Overall, WKY rats took much longer to leave the center of the arena, made fewer line crossings, and reared less, than did SD rats. WKY rats showed much greater startle responses to acoustic stimuli and significantly greater pre-pulse inhibition than did the SD rats. During timing conditions without AV interference, timing accuracy for both strains was similar; peak times for WKY and SD rats were not different. During interference conditions, however, the timing behavior of the two strains was very different. Whereas peak times for SD rats were similar between non-interference and interference conditions, peak times for WKY rats were shorter and response rates higher in interference conditions than in non-interference conditions. The enhanced acoustic startle response, greater prepulse inhibition and altered timing behavior with audio-visual interference supports a characterization of WKY strain as hypervigilant and provides further evidence for the use of the WKY strain as a model of anxiety vulnerability.


Assuntos
Ansiedade , Modelos Animais , Ratos Endogâmicos WKY , Estimulação Acústica , Animais , Atenção , Encéfalo/metabolismo , Colina O-Acetiltransferase/metabolismo , Comportamento Impulsivo , Masculino , Atividade Motora , Testes Neuropsicológicos , Estimulação Luminosa , Ratos , Ratos Sprague-Dawley , Reflexo de Sobressalto , Especificidade da Espécie , Fatores de Tempo
6.
Cell Tissue Res ; 323(1): 11-25, 2006 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-16133146

RESUMO

Enteric neurons arise from vagal and sacral level neural crest cells. To examine the phenotype of neural-crest-derived cells in vagal and sacral pathways, we used antisera to Sox10, p75, Phox2b, and Hu, and transgenic mice in which the expression of green fluorescent protein was under the control of the Ret promoter. Sox10 was expressed prior to the emigration of vagal cells, whereas p75 was expressed shortly after their emigration. Most crest-derived cells that emigrated adjacent to somites 1-4 migrated along a pathway that was later followed by the vagus nerve. A sub-population of these vagal cells coalesced to form vagal ganglia, whereas others continued their migration towards the heart and gut. Cells that coalesced into vagal ganglia showed a different phenotype from cells in the migratory streams proximal and distal to the ganglia. Only a sub-population of the vagal cells that first entered the foregut expressed Phox2b or Ret. Sacral neural crest cells gave rise to pelvic ganglia and some neurons in the hindgut. The pathways of sacral neural crest cells were examined by using DbetaH-nlacZ mice. Sacral cells appeared to enter the distal hindgut around embryonic day 14.5. Very few of the previously demonstrated, but rare, neurons that were present in the large intestine of Ret null mutants and that presumably arose from the sacral neural crest expressed nitric oxide synthase, unlike their counterparts in Ret heterozygous mice.


Assuntos
Crista Neural/embriologia , Sacro/citologia , Sacro/embriologia , Nervo Vago/citologia , Nervo Vago/embriologia , Animais , Movimento Celular , Imuno-Histoquímica , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Transgênicos , Microscopia Confocal , Crista Neural/citologia , Fenótipo , Rombencéfalo/citologia
7.
Br J Cancer ; 91(4): 639-43, 2004 Aug 16.
Artigo em Inglês | MEDLINE | ID: mdl-15266327

RESUMO

Trastuzumab is an effective treatment for patients with metastatic breast cancer (MBC) that overexpresses HER-2. A high incidence of brain metastases (BM) has been noted in patients receiving trastuzumab. A retrospective chart review was conducted of 100 patients commencing trastuzumab for metastatic breast cancer from July 1999 to December 2002, at the Christie Hospital. Seven patients were excluded; five patients developed central nervous system metastases prior to starting trastuzumab, and inadequate data were available for two. Out of the remaining 93 patients, 23 (25%) have developed BM to date. In all, 46 patients have died, and of these 18 (39%) have been diagnosed with BM prior to death. Of the 23 patients developing BM, 18 (78%) were hormone receptor negative and 18 (78%) had visceral disease. Univariate analysis showed a significant association between the development of cerebral disease and both hormone receptor status and the presence of visceral disease. In conclusion, a high proportion of patients with MBC treated with trastuzumab develop symptomatic cerebral metastases. HER-2-positive breast cancer may have a predilection for the brain, or trastuzumab therapy may change the disease pattern by prolonging survival. New strategies to address this problem require investigation in this group of patients.


Assuntos
Anticorpos Monoclonais/uso terapêutico , Antineoplásicos/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/patologia , Neoplasias do Sistema Nervoso Central/secundário , Adulto , Idoso , Anticorpos Monoclonais Humanizados , Neoplasias do Sistema Nervoso Central/epidemiologia , Feminino , Humanos , Incidência , Pessoa de Meia-Idade , Receptor ErbB-2/análise , Receptores de Estrogênio , Receptores de Progesterona , Estudos Retrospectivos , Fatores de Risco , Trastuzumab
8.
Arch Dis Child Fetal Neonatal Ed ; 89(2): F112-8, 2004 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-14977893

RESUMO

OBJECTIVE: To explore, using functional magnetic resonance imaging (MRI), the functional organisation of phonological processing in young adults born very preterm. SUBJECTS: Six right handed male subjects with radiological evidence of thinning of the corpus callosum were selected from a cohort of very preterm subjects. Six normal right handed male volunteers acted as controls. METHOD: Blood oxygenation level dependent contrast echoplanar images were acquired over five minutes at 1.5 T while subjects performed the tasks. During the ON condition, subjects were visually presented with pairs of non-words and asked to press a key when a pair of words rhymed (phonological processing). This task alternated with the OFF condition, which required subjects to make letter case judgments of visually presented pairs of consonant letter strings (orthographic processing). Generic brain activation maps were constructed from individual images by sinusoidal regression and non-parametric testing. Between group differences in the mean power of experimental response were identified on a voxel wise basis by analysis of variance. RESULTS: Compared with controls, the subjects with thinning of the corpus callosum showed significantly reduced power of response in the left hemisphere, including the peristriate cortex and the cerebellum, as well as in the right parietal association area. Significantly increased power of response was observed in the right precentral gyrus and the right supplementary motor area. CONCLUSIONS: The data show evidence of increased frontal and decreased occipital activation in male subjects with neurodevelopmental thinning of the corpus callosum, which may be due to the operation of developmental compensatory mechanisms.


Assuntos
Corpo Caloso/fisiologia , Recém-Nascido Prematuro , Idioma , Adolescente , Estudos de Casos e Controles , Seguimentos , Humanos , Interpretação de Imagem Assistida por Computador , Recém-Nascido , Imageamento por Ressonância Magnética , Masculino , Testes Neuropsicológicos
9.
Clin Oncol (R Coll Radiol) ; 15(1): 25-31, 2003 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-12602551

RESUMO

Local recurrence of cancer in the treated breast following breast-conserving surgery and radiotherapy occurs in a minority of patients, but can represent a significant clinical problem. The impact of local relapse on the subsequent course of the disease is disputed. The aim of this retrospective review was to identify the rate and prognostic factors for breast recurrence and to determine the subsequent outcome. The case notes of 2159 patients treated between 1989 and 1992 were reviewed. Actuarial local relapse rate was 6.3% at 5 years. Factors predictive for recurrence on multivariate analysis were age (P<0.001), status of excision margins (P=0.019), and pathological UICC stage (P=0.01). One hundred and sixty-one patients developed local recurrence in the treated breast of whom 101 were treated with further surgery. The 5-year cancer-specific survival of this group was comparable with that of the patients who remained free of breast relapse (82 vs. 88%) but subsequently fell to 61 vs. 80% at 8 years (P<0.001). Sixty patients were unable to have salvage surgery; their cancer-specific survival was much worse than that of patients with operable recurrences at 33% at 5 years and 13% at 8 years. Eighty-three patients (4% of the original 2159 patients) had uncontrolled local disease at time of death or last follow-up. The prognosis of patients who developed recurrence within 2 years of their initial treatment was inferior to those who developed recurrences after 4 years (cancer-specific survival 5 years post-recurrence 23 vs. 57% P=0.008). Systemic therapy should be considered for patients with early breast recurrence in view of their inferior survival.


Assuntos
Neoplasias da Mama/mortalidade , Neoplasias da Mama/terapia , Recidiva Local de Neoplasia/epidemiologia , Adulto , Idoso , Neoplasias da Mama/radioterapia , Neoplasias da Mama/cirurgia , Feminino , Humanos , Pessoa de Meia-Idade , Prognóstico , Radioterapia Adjuvante , Estudos Retrospectivos , Fatores de Risco , Análise de Sobrevida
10.
Brain ; 125(Pt 8): 1782-92, 2002 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-12135969

RESUMO

We used functional MRI (fMRI) to establish the functional significance of corpus callosum damage in young adults who had been born very preterm. Seven subjects from a cohort of individuals who had been born at <33 weeks gestation and who had sustained callosal damage visualized on structural MRI were compared while they carried out auditory and visual tasks requiring callosal transfer with nine very preterm subjects with corpora callosa of normal appearance on structural MRI, and with seven full-term controls. The very preterm subjects with damaged corpora callosa had significantly different activation patterns compared with the two control groups. In the visual task, additional activity was seen in the right dorsolateral prefrontal cortex of the damaged callosum group, possibly because the task was accomplished by storing information in working memory. On the auditory task, a deficit of activity was seen in the right temporal lobe of the callosum group. The findings reveal a plasticity of function compensating for early damage to the corpus callosum.


Assuntos
Corpo Caloso/patologia , Imageamento por Ressonância Magnética/métodos , Adolescente , Adulto , Análise de Variância , Mapeamento Encefálico , Corpo Caloso/lesões , Lateralidade Funcional , Idade Gestacional , Humanos , Recém-Nascido , Recém-Nascido Prematuro/fisiologia , Plasticidade Neuronal , Desempenho Psicomotor/fisiologia , Reprodutibilidade dos Testes
11.
Drug Alcohol Depend ; 65(1): 65-75, 2001 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-11714591

RESUMO

Social support may play an important role in helping drug users achieve abstinence; however these benefits may depend on the type of support experienced. In this prospective observational study, we examined the extent to which general and abstinence-specific support, both structural and functional, predicted opiate and cocaine abstinence in 128 opioid maintenance patients receiving either methadone or LAAM. A new multidimensional self-report instrument assessing abstinence-specific functional support was developed for the study. Previously validated measures were used to assess the remaining types of support. With baseline abstinence and other statistically important covariates adjusted, hierarchical logistic regression analyses demonstrated that the associations between social support at study baseline and biochemically confirmed abstinence 3 months later varied by type of support and by drug. Greater abstinence-specific structural support (operationalized as fewer drug users in the social network) and decreases in three types of negative abstinence-specific functional support (Complaints about Drug Use, Drug Exposure, and Demoralization) predicted cocaine, but not opiate abstinence. There were no effects for general support, whether structural or functional, on abstinence from either drug. Interventions that focus on modifying patients' abstinence-specific support may be helpful in reducing the high rates of cocaine use disorders in this population.


Assuntos
Transtornos Relacionados ao Uso de Cocaína/terapia , Transtornos Relacionados ao Uso de Opioides/terapia , Apoio Social , Adulto , Idoso , Analgésicos Opioides/uso terapêutico , Terapia Comportamental , Distribuição de Qui-Quadrado , Transtornos Relacionados ao Uso de Cocaína/psicologia , Feminino , Seguimentos , Humanos , Modelos Logísticos , Masculino , Metadona/uso terapêutico , Pessoa de Meia-Idade , Transtornos Relacionados ao Uso de Opioides/psicologia , Estudos Prospectivos , Estatísticas não Paramétricas , Centros de Tratamento de Abuso de Substâncias/estatística & dados numéricos , Resultado do Tratamento
12.
Med Care ; 39(11): 1217-23, 2001 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-11606875

RESUMO

OBJECTIVES: To assess the 1- and 2-year health status, health care utilization and self-efficacy outcomes for the Chronic Disease Self-Management Program (CDSMP). The major hypothesis is that during the 2-year period CDSMP participants will experience improvements or less deterioration than expected in health status and reductions in health care utilization. DESIGN: Longitudinal design as follow-up to a randomized trial. SETTING: Community. PARTICIPANTS: Eight hundred thirty-one participants 40 years and older with heart disease, lung disease, stroke, or arthritis participated in the CDSMP. At 1- and 2-year intervals respectively 82% and 76% of eligible participants completed data. MAIN OUTCOME MEASURES: Health status (self-rated health, disability, social/role activities limitations, energy/fatigue, and health distress), health care utilization (ER/outpatient visits, times hospitalized, and days in hospital), and perceived self-efficacy were measured. MAIN RESULTS: Compared with baseline for each of the 2 years, ER/outpatient visits and health distress were reduced (P <0.05). Self-efficacy improved (P <0.05). The rate of increase is that which is expected in 1 year. There were no other significant changes. CONCLUSIONS: A low-cost program for promoting health self-management can improve elements of health status while reducing health care costs in populations with diverse chronic diseases.


Assuntos
Doença Crônica , Gerenciamento Clínico , Avaliação de Resultados em Cuidados de Saúde , Educação de Pacientes como Assunto , Autocuidado , Adulto , Idoso , Doença Crônica/economia , Serviços de Saúde Comunitária/estatística & dados numéricos , Análise Custo-Benefício , Feminino , Nível de Saúde , Humanos , Estudos Longitudinais , Masculino , Análise por Pareamento , Pessoa de Meia-Idade , Autoeficácia
13.
Early Hum Dev ; 65(2): 81-9, 2001 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-11641029

RESUMO

BACKGROUND: Neurodevelopmental and behavioural problems have been repeatedly reported in very preterm survivors, often showing themselves later in childhood as poor school performance. Early identification of problems would mean that appropriate remedial therapy can be implemented. We have previously shown that neurodevelopmental status at 1 year was predictive of outcome at 8 years in a cohort of preterm infants. The aim of this paper was to see if neurodevelopmental outcome in adolescence could be predicted by assessment by 1 year in the same cohort of preterm infants. STUDY DESIGN: Prospective cohort study. SUBJECTS: 150 adolescents, born before 33 weeks gestation. OUTCOME MEASURES: Neurological examination, developmental quotient, vision and hearing by 1 year. At 14-15 years, neurological examination, school performance questionnaire, Schonnell test of reading age, a premorbid adjustment score, Rutter behavioural score and for those born from 1981, cognitive tests (WISC-R). RESULTS: A highly significant relationship existed between neurological status by 1 year and the need for extra educational provision, overall neurodevelopmental status, cognitive function in those that had their IQs measured and premorbid adjustment score of prepsychotic symptoms in adolescence. However, status at 1 year was not predictive of adolescent reading age or behavioural score. CONCLUSIONS: Neurodevelopmental assessment at 1 year is predictive of school performance and outcome in the adolescent period.


Assuntos
Desenvolvimento Infantil/classificação , Transtornos Cognitivos/diagnóstico , Deficiências do Desenvolvimento/diagnóstico , Recém-Nascido Prematuro , Sistema Nervoso/crescimento & desenvolvimento , Adolescente , Transtornos Cognitivos/complicações , Transtornos Cognitivos/epidemiologia , Estudos de Coortes , Deficiências do Desenvolvimento/complicações , Deficiências do Desenvolvimento/epidemiologia , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Masculino , Testes Neuropsicológicos , Valor Preditivo dos Testes , Reino Unido/epidemiologia
14.
Ethn Health ; 6(2): 137-44, 2001 May.
Artigo em Inglês | MEDLINE | ID: mdl-11488294

RESUMO

Establishing comparable measurement properties across different populations or in different population subgroups is a crucial yet often neglected step in instrument development. Failure to have comparable factor structures across groups makes any comparison between groups suspect. Previous analyses of the measurement structure of the Center for Epidemiologic Studies Depression Scale (CES-D) in diverse racial/ethnic populations have resulted in conflicting results. In the present analysis, data from three studies of urban Latinos (N = 1,403) were analyzed using structural equation modeling techniques to (1) fit the original four-factor solution separately in men and women; (2) evaluate configural and metric invariance between men and women; and (3) evaluate the mediating effects of age and acculturation on the fit of this model to the data. Results indicated that the four-factor model proposed by Radloff provided adequate fit to the data for Latina women when age and acculturation were included in the model. The four-factor model did not fit the data for Latino men; thus tests of configural and metric invariance across these two groups failed. We conclude that the CES-D may not measure the same constructs in Latino men and women and that further evaluation of the use of this measure in diverse populations is needed. Additionally, prior to comparison with other groups in which the four-factor solution is observed, the effects of age and acculturation should be controlled in Latinas.


Assuntos
Transtorno Depressivo/etnologia , Hispânico ou Latino/psicologia , Escalas de Graduação Psiquiátrica , Saúde da População Urbana/classificação , Adulto , California/epidemiologia , Transtorno Depressivo/classificação , Análise Fatorial , Feminino , Humanos , Masculino , Fatores Socioeconômicos
15.
J Gerontol A Biol Sci Med Sci ; 56(8): M465-70, 2001 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-11487597

RESUMO

BACKGROUND: Despite well-known benefits of physical activity for older adults, about two thirds are underactive. Community-based programs are needed to facilitate increased physical activity. We examine the effectiveness of CHAMPS II, an inclusive, choice-based physical activity promotion program to increase lifetime physical activity levels of seniors. CHAMPS guided participants to choose activities that took into account their health, preferences, and abilities. It offered information on ways for them to exercise safely, motivate themselves, overcome barriers, and develop a balanced exercise regimen. METHODS: A 1-year randomized controlled trial was conducted with physically underactive seniors in a multispecialty group practice. Changes in self-reported physical activity by group were evaluated using ANCOVA, controlling for age and sex. RESULTS: Of 173 randomized subjects, 164 (95%) completed the trial. Subjects were aged 65 to 90 years (M = 74, SD = 6); 66% were female. The intervention group increased estimated caloric expenditure by 487 calories/week in moderate (or greater) intensity activities (MET >/= 3.0; p <.001) and by 687 calories/week in physical activities of any intensity (p <.001). Control group changes were negligible. Between-group analyses found that the changes were significantly different in both measures (p values <.05). Overweight persons especially benefited from this program. The program was as effective for women, older adults (75+), and those who did not set aside time to exercise at baseline. CONCLUSIONS: The program led to meaningful physical activity increases. Individually tailored programs to encourage lifestyle changes in seniors may be effective and applicable to health care and community settings.


Assuntos
Serviços de Saúde Comunitária/organização & administração , Exercício Físico , Promoção da Saúde/métodos , Estilo de Vida , Idoso , Idoso de 80 Anos ou mais , California , Feminino , Seguimentos , Humanos , Masculino , Análise Multivariada , Probabilidade , Avaliação de Programas e Projetos de Saúde , Valores de Referência , Sensibilidade e Especificidade , Resultado do Tratamento
16.
Med Sci Sports Exerc ; 33(7): 1126-41, 2001 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-11445760

RESUMO

PURPOSE: To evaluate effectively interventions to increase physical activity among older persons, reliable and valid measures of physical activity are required that can also detect the expected types of physical activity changes in this population. This paper describes a self-report physical activity questionnaire for older men and women, developed to evaluate the outcomes of the Community Healthy Activities Model Program for Seniors (CHAMPS), an intervention to increase physical activity. METHODS: The questionnaire assesses weekly frequency and duration of various physical activities typically undertaken by older adults. We estimated caloric expenditure/wk expended in physical activity and created a summary frequency/wk measure. We calculated measures of each of these for: 1) activities of at least moderate intensity (MET value >/= 3.0); and 2) all specified physical activities, including those of light intensity. Six-month stability was estimated on participants not likely to change (assessment-only control group, physically active cohort). Several tests of construct validity were conducted, and sensitivity to change was analyzed based on response to the CHAMPS intervention. RESULTS: The sample (N = 249) comprised underactive persons (N = 173 from the CHAMPS trial) and active persons (N = 76). The sample was aged 65-90 yr (mean = 74, SD = 6); 64% were women, and 9% were minorities. Six-month stability ranged from 0.58 to 0.67, using intraclass correlation coefficients. Nearly all construct validity hypotheses were confirmed, though correlations were modest. All measures were sensitive to change (P < or = 0.01), with small to moderate effect sizes (0.38-0.64). CONCLUSIONS: The CHAMPS measure may be useful for evaluating the effectiveness of programs aimed at increasing levels of physical activity in older adults.


Assuntos
Exercício Físico , Inquéritos e Questionários , Idoso , Idoso de 80 Anos ou mais , Feminino , Comportamentos Relacionados com a Saúde , Inquéritos Epidemiológicos , Humanos , Masculino , Transtornos da Memória , Avaliação de Processos e Resultados em Cuidados de Saúde , Psicologia , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
17.
Med Sci Sports Exerc ; 33(6): 962-70, 2001 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-11404662

RESUMO

PURPOSE: To assess the known-groups and construct validity of measures from the CHAMPS Physical Activity Questionnaire, Physical Activity Survey for the Elderly (PASE), and the Yale Physical Activity Survey (YPAS). METHODS: The three questionnaires were administered to a convenience sample of older adults (N = 87) recruited from community centers and retirement homes. Validation measures included the SF-36 measures of physical functioning, general health, mental health, and pain; body mass index; performance-based tests of lower body functioning and endurance; and Mini-Logger activity monitor data from ankle and waist sensors. Validity was estimated by testing hypotheses about associations between physical activity and validation measures. RESULTS: As hypothesized, differences in activity levels on all measures were found between older adults in retirement homes (less active) and community centers (more active) (P-values < 0.0001). Correlations of physical activity measures with performance-based measures ranged from 0.44 to 0.68, conforming to hypotheses; hypotheses regarding associations with the SF-36 measures were also confirmed. Body mass index was not correlated with any of the physical activity measures, contrary to hypotheses. Correlations of physical activity measures with Mini-Logger counts ranged from 0.36 to 0.59 (ankle) and 0.42 to 0.61 (waist) as hypothesized. Correlations among the measures from the three instruments ranged from 0.58 to 0.68. CONCLUSIONS: The PASE, YPAS, and CHAMPS each demonstrated acceptable validity, as all measures met nearly all hypotheses. Higher validity coefficients were found for subgroups (men, 65-74 yr, retirement home), suggesting that these instruments may perform better for certain segments of the older adult population.


Assuntos
Envelhecimento , Metabolismo Energético , Exercício Físico , Atividades Cotidianas , Idoso , Idoso de 80 Anos ou mais , Feminino , Nível de Saúde , Humanos , Masculino , Saúde Mental , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Inquéritos e Questionários
18.
Ultrasound Med Biol ; 27(4): 467-72, 2001 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-11368859

RESUMO

Two methods of neonatal cranial ultrasound (US) scanning, linear-array and mechanical-sector, were compared for their accuracy in predicting neurodevelopmental outcome in a cohort of 854, of whom 782 (92%) infants, all born less than 33 weeks of gestation and cared for on the Neonatal Intensive Care Unit at University College Hospital, London between 1979 and 1988, were included in the analysis. A total of 205 infants were studied by linear-array and 577 infants by mechanical-sector scan. Ultrasound findings were grouped into three risk categories on the basis of the US diagnosis. Outcome was assessed at 8 years of age. The probability estimates for neurologically disabling and nondisabling impairments, extra education and mean IQ were compared for the two US methods. There was no significant difference between the two methods in the accuracy of prediction of neurodevelopmental outcome.


Assuntos
Encefalopatias/diagnóstico por imagem , Deficiências do Desenvolvimento/etiologia , Ecoencefalografia , Doenças do Prematuro/diagnóstico por imagem , Encefalopatias/complicações , Hemorragia Cerebral/complicações , Hemorragia Cerebral/diagnóstico por imagem , Ventrículos Cerebrais/diagnóstico por imagem , Ventrículos Cerebrais/patologia , Criança , Deficiências do Desenvolvimento/diagnóstico por imagem , Dilatação Patológica , Ecoencefalografia/métodos , Seguimentos , Humanos , Hidrocefalia/complicações , Hidrocefalia/diagnóstico por imagem , Recém-Nascido , Leucomalácia Periventricular/complicações , Leucomalácia Periventricular/diagnóstico por imagem , Probabilidade , Fatores de Risco
19.
Dev Med Child Neurol ; 43(4): 226-33, 2001 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-11305398

RESUMO

Neuropsychological outcome at 14 to 15 years of age of a cohort of 75 participants (39 male, 36 female) born at <33 weeks' gestation was investigated. Research was conducted parallel to a recent MRI study by Stewart and colleagues which reported that 55% of this cohort had evidence of brain abnormality. One aim of the study was to compare neuropsychological function in those very preterm children with and without MRI abnormality. Compared to a control sample of term adolescents, very preterm participants had impairment only on a measure of word production. On measures of attention, memory, perceptual skill, and visuomotor and executive function, the adolescents born very preterm performed in the normal range, whether or not they had evidence of MRI abnormality. Our findings are encouraging as the neuropsychological consequences of damage to the very preterm brain, still evident on MRI at 14 to 15 years of age, appear to be minor.


Assuntos
Encéfalo/anormalidades , Deficiências do Desenvolvimento/etiologia , Recém-Nascido Prematuro/crescimento & desenvolvimento , Adolescente , Atenção , Estudos de Coortes , Feminino , Seguimentos , Humanos , Recém-Nascido , Recém-Nascido Prematuro/psicologia , Transtornos do Desenvolvimento da Linguagem/diagnóstico , Imageamento por Ressonância Magnética , Masculino , Transtornos da Memória/diagnóstico , Transtornos das Habilidades Motoras/diagnóstico , Testes Neuropsicológicos , Gravidez
20.
J Clin Epidemiol ; 54(2): 136-41, 2001 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-11166528

RESUMO

This study compares self-reports of medical utilization with provider records. As part of a chronic disease self-management intervention study, patients completed self-reports of their last six months of health care utilization. A subgroup of patients was selected from the larger study and their self-reports of utilization were compared to computerized utilization records. Consistent with earlier studies, patients tended to report less physician utilization than was recorded in the computerized provider records. However, they also tended to report slightly more emergency room visits than were reported in the computerized utilization records. There was no association between demographic or health variables and the tendency toward discrepancy between self-report and computerized utilization record reports. However, there was a tendency for the discrepancy to increase as the amount of record utilization increased. Thus, the likelihood of bias caused by differing demographic factors is low, but researchers should take into account that underreporting occurs and is likely to increase as utilization increases.


Assuntos
Doença Crônica/terapia , Serviços de Saúde/estatística & dados numéricos , Sistemas Computadorizados de Registros Médicos/normas , Inquéritos e Questionários/normas , Revisão da Utilização de Recursos de Saúde/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Viés , Serviço Hospitalar de Emergência/estatística & dados numéricos , Feminino , Sistemas Pré-Pagos de Saúde , Pesquisa sobre Serviços de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Visita a Consultório Médico/estatística & dados numéricos , Médicos/estatística & dados numéricos , Autocuidado/estatística & dados numéricos
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