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Biomedical subjects

A C King

Publications and source records attributed to A C King.

At least 37 records · Page 2Linked to original sources
PubMed2000

Promoting physical activity in rural communities: walking trail access, use, and effects.

INTRODUCTION: Environmental and policy approaches to promote physical activity, such as walking trail construction and promotion, are being widely recommended, yet sparse data exist on their effectiveness. In conjunction with ongoing community-intervention projects in Missouri, walking trails are being built, promoted, and evaluated. Objectives include determining: (1) patterns and correlates of walking, (2) the availability of places to walk and perform other forms of physical activity, (3) the extent of walking trail use and possible effects on rates of physical activity, and (4) attitudes toward the trails and their uses. METHODS: In 12 rural counties in Missouri we used a cross-s ectional telephone survey to ask a population-based sample of residents aged >18 years (n=1269) some standard and specially developed questions about walking behaviors, knowledge, and attitudes. RESULTS: Only 19.5% of respondents were classified as regular walkers. About one third of respondents (36.5%) reported having access to walking trails in their area, and 50.3% reported having access to indoor facilities for exercise. Among persons with access to walking trails, 38.8% had used the trails. Groups who were more likely to have used the walking trails included women, persons with more education, those making $35,000 or more per year, and regular walkers. Among persons who had used the trails, 55.2% reported they had increased their amount of walking since they began using the trail. Women and persons with a high school education or less were more than twice as likely to have increased the amount of walking since they began using the walking trails. CONCLUSIONS: Walking trails may be beneficial in promoting physical activity among segments of the population at highest risk for inactivity, in particular women and persons in lower socioeconomic groups.

Adolescent↗
PubMed2000

Personal and environmental factors associated with physical inactivity among different racial-ethnic groups of U.S. middle-aged and older-aged women.

Personal, program-based, and environmental barriers to physical activity were explored among a U.S. population-derived sample of 2,912 women 40 years of age and older. Factors significantly associated with inactivity included American Indian ethnicity, older age, less education, lack of energy, lack of hills in one's neighborhood, absence of enjoyable scenery, and infrequent observation of others exercising in one's neighborhood. For all ethnic subgroups, caregiving duties and lacking energy to exercise ranked among the top 4 most frequently reported barriers. Approximately 62% of respondents rated exercise on one's own with instruction as more appealing than undertaking exercise in an instructor-led group, regardless of ethnicity or current physical activity levels. The results underscore the importance of a multifaceted approach to understanding physical activity determinants in this understudied, high-risk population segment.

Activities of Daily Living↗
PubMed2000

The effect of life events and exercise program format on the adoption and maintenance of exercise behavior.

This study prospectively investigated the effects of major life events on subsequent exercise adherence rates of individuals (N = 173) participating in a 2-year, randomized, controlled clinical trial of 3 different exercise conditions (higher-intensity home-based; lower-intensity home-based; and higher-intensity class-based). For 3 of 4 6-month exercise-adherence periods, an analysis of variance indicated a significant main effect (p < .05) for major life events. Compared with participants reporting 0 or 1 major life event, exercise adherence in the maintenance phase was significantly lower for those reporting 3 or 4 major life events regardless of the exercise condition. No significant life-event-exercise-adherence relationship was found in the adoption phase of exercise participation (i.e., Months 1 to 6). The deleterious effect of life events emphasizes the importance of instruction regarding how to prepare for high-risk situations that can lead to missed exercise sessions or to program attrition.

Adult↗
PubMed2000

Comparative effects of two physical activity programs on measured and perceived physical functioning and other health-related quality of life outcomes in older adults.

BACKGROUND: Although inactivity is an important contributor to impaired functioning and disability with age, little is known concerning how improvements in physical functioning and well-being in older adults vary with the type of physical activity undertaken. METHODS: One hundred three adults age 65 years and older, recruited via population-based methods, were randomized to 12 months of community-based, moderate-intensity endurance and strengthening exercises (Fit & Firm) or stretching and flexibility exercises (Stretch & Flex). A combination of class- and home-based exercise formats was used. Measured and self-rated physical performance along with perceived functioning and well-being were assessed pre- and postintervention. RESULTS: Fit & Firm subjects showed greater 12-month improvements in both measured and self-rated endurance and strength compared to Stretch & Flex subjects. Stretch & Flex subjects reported greater improvements in bodily pain, and Stretch & Flex men evidenced greater improvements in flexibility relative to Fit & Firm subjects. Although overall exercise adherence was high in both exercise conditions (approximately 80%), subjects in both conditions showed better adherence to the home- versus class-based portions of their exercise prescriptions. CONCLUSIONS: Community-based programs focusing on moderate-intensity endurance and strengthening exercises or flexibility exercises can be delivered through a combination of formats that result in improvement in important functional and well-being outcomes. This represents one of the first studies to report significant improvements in an important quality of life outcome-bodily pain-with a regular regimen of stretching and flexibility exercises in a community-based sample of older adults.

Activities of Daily Living↗
PubMed2000

Sleep problems as a risk factor for falls in a sample of community-dwelling adults aged 64-99 years.

OBJECTIVES: The purpose of this study was to determine if reported nighttime sleep problems and daytime sleepiness were associated with reported falling during the previous 12 months in a representatively sampled older adult population. DESIGN: Random-digit dial telephone survey. SETTING: Representatively sampled older adult population living in northern California. PARTICIPANTS: Participants were 971 women and 555 men, aged 64 to 99 years. MEASUREMENTS: Twenty-minute telephone interview adapted from the National Health Interview Survey. RESULTS: Two hundred and eighty-four participants reported falling during the previous 12 months (19% of the sample). Significantly more women fell than men (20% and 14%, respectively, P < .001). The following variables were significant risk factors for falling in univariate analyses: female gender, being unmarried, living alone, income less than $15,000 per year, difficulty walking, having more than one chronic medical condition, history of cardiovascular disease, hypertension, arthritis, sensory impairment, psychological difficulties, and nighttime sleep problems. All of the nighttime sleep problem variables remained significant risk factors for falling after controlling for other risk factors for falling. CONCLUSIONS: The results provide support for an independent association between reported sleep problems and falls in an older population. One of the implications of these data is that behavioral research focusing on the effectiveness of insomnia treatment in old age should not only examine typical sleep-related outcomes (e.g., total time asleep, number of awakenings) but also the occurrence of falls as well.

Accidental Falls↗
PubMed2000

Determinants of leisure time physical activity in rural compared with urban older and ethnically diverse women in the United States.

STUDY OBJECTIVE: Determinants of leisure time physical activity (LTPA) in rural middle aged and older women of diverse racial and ethnic groups are not well understood. This study examined: (1) urban-rural differences in LTPA by sociodemographic factors, (2) urban-rural differences in LTPA determinants, and (3) the pattern of relations between LTPA determinants and LTPA. DESIGN: A modified version of the sampling plan of the Behavioral Risk Factor Surveillance Survey (BRFSS) was used. Zip codes were selected with 20% or more of each of the following race/ethnic groups: African American, American Indian/Alaskan Native (AI/AN), and Hispanic. A comparison group of white women were also surveyed using standard BRFSS techniques. PARTICIPANTS: Rural (n=1242) and urban (n=1096) women aged 40 years and older from the US Women's Determinants Study. MAIN RESULTS: Rural women, especially Southern and less educated women, were more sedentary than urban women. Rural women reported more personal barriers to LTPA, cited caregiving duties as their top barrier (compared with lack of time for urban women), and had greater body mass indices. Rural women were less likely to report sidewalks, streetlights, high crime, access to facilities, and frequently seeing others exercise in their neighbourhood. Multivariate correlates of sedentary behaviour in rural women were AI/AN and African American race, older age, less education, lack of enjoyable scenery, not frequently seeing others exercise, greater barriers, and less social support (p<0.05); and in urban women, older age, greater barriers, less social support (p<0.05), and less education (p<0.09). CONCLUSIONS: Rural and urban women seem to face different barriers and enablers to LTPA, and have a different pattern of determinants, thus providing useful information for designing more targeted interventions.

Adult↗
PubMed2000

Patterns and correlates of physical activity among US women 40 years and older.

OBJECTIVES: This study describes the patterns of physical activity among minority women by using a variety of definitions and determines sociodemographic and behavioral correlates of physical activity in this population. METHODS: A cross-sectional study was conducted in 1996 and 1997 among US women 40 years and older (n = 2912) of the following racial/ethnic groups: African American, American Indian/Alaskan Native, Hispanic, and White. RESULTS: Physical activity was lowest among African Americans and American Indians/Alaskan Natives (adjusted odds ratios [ORs] for no leisure-time activity were 1.35 [95% confidence interval (CI) = 1.08, 1.68] and 1.65 [95% CI = 1.33, 2.06], respectively). A much higher proportion of women were classified as being physically active when occupational activity rather than more traditional assessments of leisure activity were used to determine level of physical activity. On the basis of a composite definition of physical activity, 72% of respondents reported being physically active. Women living in rural regions (OR = 1.33; 95% CI = 1.12, 1.58) were more likely than urban inhabitants to be completely inactive during leisure time. CONCLUSIONS: Minority women are among the least active subgroups in American society, although not all groups are less active than White women when all domains of physical activity are taken into account.

Adult↗
PubMed2000

Subjective and objective responses to ethanol in moderate/heavy and light social drinkers.

BACKGROUND: Individuals who drink heavily are at an increased risk for adverse consequences of drinking and progression of their drinking habits to abuse or dependence. Therefore, it is important to delineate factors associated with their heavy drinking. METHODS: We examined individual differences in subjective and objective responses to ethanol associated with level of consumption by reanalyzing data from the nine heaviest and nine lightest social drinkers from each of two independently collected subject samples: Holdstock and de Wit (1998) and King et al. (1997). The light drinkers in both samples consumed five or less alcoholic drinks per week, whereas the moderate/heavy drinkers consumed eight or more drinks per week with frequent binge episodes. Acute subjective and objective responses to ethanol (0.6 or 0.8 g/kg) or placebo were compared in the two groups at baseline and during rising and falling blood alcohol concentrations. RESULTS: Moderate/heavy drinkers reported greater stimulant-like and fewer sedative-like and aversive subjective effects after ethanol than did lighter drinkers. These differences occurred in the absence of any group differences in breath alcohol levels, performance effects, or neuroendocrine changes or in overall reports of feeling any drug effects. CONCLUSIONS: These data indicate that habitual moderate/heavy ethanol use was associated with greater stimulant-like effects after an acute dose of alcohol. This finding is consistent with the idea (Newlin and Thomson, 1990, 1999) that individuals who experience greater stimulant-like effects during the ascending limb and lesser sedative-like effects on the descending limb of the blood alcohol concentration curve may be at greater risk for developing ethanol use disorders. Although we cannot determine the causality of this association, sensitivity to the stimulant effects of ethanol may play an important role in the continuation of heavy ethanol use and the increased risk of negative consequences from this use.

Adrenocorticotropic Hormone↗
PubMed1999

Acute subjective effects of dynorphin A(1-13) infusion in normal healthy subjects.

Twelve healthy subjects with no history of substance abuse participated in a placebo-controlled single-blinded study of subjective response to acute i.v. administration of placebo and two doses of the natural shortened peptide sequence of the kappa-opioid agonist, dynorphin A(1-13) (low dose 120 micrograms/kg, high dose 500 micrograms/kg). Visual analog scales showed small but significant negative mood and positive drug effect 10 min post infusion in the high dose dynorphin compared to placebo infusion. The differences were no longer apparent at 30 min. These results show that dynorphin A(1-13), shown previously to have both neuroendocrine and modest analgesic effects, was well tolerated and produced modest transient subjective responses.

Adult↗
PubMed1999

Reliability of information on physical activity and other chronic disease risk factors among US women aged 40 years or older.

Data on chronic disease risk behaviors and related variables, including barriers to and attitudes toward physical activity, are lacking for women of some racial/ethnic groups. A test-retest study was conducted from July 1996 through June 1997 among US women (n = 199) aged 40 years or more who were white, black, American Indian/Alaska Native, or Hispanic. The sample was selected and interviews were conducted using a modified version of the methods of the Behavioral Risk Factor Surveillance System. For behavioral risk factors such as physical inactivity, smoking, and low fruit and vegetable consumption, group prevalences were generally similar between interviews 1 and 2. However, kappa values for selected physical activity variables ranged from 0.26 to 0.51 and tended to be lower for black women. Discordance was low for variables on cigarette smoking and exposure to environmental tobacco smoke (kappa = 0.64-0.92). Discordance was high (kappa = 0.33) for low consumption of fruits and vegetables. Additional variables for barriers to and access to exercise ranged widely across racial/ethnic groups and in terms of measures of agreement. These methods illustrate an efficient way to sample and assess the reliability of data collected from women of racial/ethnic minority groups.

Adult↗
PubMed1999

Physical activity social support and middle- and older-aged minority women: results from a US survey.

BACKGROUND: Many American adults remain sedentary despite many known health benefits. Research on the determinants of physical activity have indicated that social support is one of the strongest correlates, but little is known about this relation in important subgroups of middle and older-aged women. OBJECTIVE: The purpose of this study was to assess the association of physical activity-related social support on several measures of physical activity in a national sample of minority women. A unique aspect of these measures is the inclusion of vigorous household tasks and occupational physical activities. METHODS: The US Women's Determinants Study was conducted in 1996-1997. The survey was a modified-random sample, telephone survey of 2912 Black, Hispanic, American Indian/Alaskan Native, and White women age 40 and older. A composite score of physical activity social support (PASS) was analyzed as the independent variable in logistic regression analyses. Four measures of physical activity levels served as the dependent variables. A separate analysis was done to distinguish PASS from friends versus PASS from relatives. The potential confounding effect of race/ethnicity, marital status, age, income and education were evaluated and adjusted in the models. RESULTS: Hispanic women were more likely to have high PASS scores than the other racial/ethnic groups. Odds ratios indicate that subjects with high levels of PASS were significantly less likely to be sedentary than those with low support, even after adjusting for race/ethnicity. While there were significant associations among levels of social support and physical activity, this was not true for the measure of "regular exercise." There was no significant difference between the contribution of "friend" support versus "family" support on all four measures on physical activity. DISCUSSION: Based on our results, enhancing social support may be an important aspect of interventions aimed at increasing physical activity in a population of sedentary women of various racial/ethnic backgrounds. Also, "regular exercisers" in this population appear to be less reliant social support to maintain their behavior.

Adult↗
PubMed1999

Assessment of minimally responsive patients: clinical difficulties of single-case design.

Improved management of very severely central nervous system (CNS) injured individuals has given rise to an increasing number of patients in a minimally responsive state. There is a growing literature stressing the importance of accurately determining these patients' level of cognitive functioning and its role in appropriate rehabilitation and long term management. The single case design model appears to be the intervention of choice, with its great flexibility and tailored approach to each individual case. The recent literature has focused on the technical aspects of the assessment, offering clear procedural guidelines. Unfortunately, there is a dearth of information about clinical factors such as clinical setting and family involvement, which may interfere with or prevent a planned intervention. The case of MT is presented, who was the subject of a single case intervention 9 months following an extremely severe traumatic brain injury. The planned intervention was to examine the effects of a psychostimulant on MT's level of arousal, in order to improve his participation in the rehabilitation programme. Beyond the results (which were equivocal), the clinical difficulties in conducting single case study designs in rehabilitation are discussed. Ways to minimize these difficulties are proposed.

Adult↗
PubMed1999

Prevalence and correlates of physician recommendations to exercise among older adults.

BACKGROUND: This study explored the prevalence of and factors associated with physician suggestions to exercise in a sample of older adults. METHODS: We conducted telephone interviews of a random sample of members of two Medicare health maintenance organizations (HMOs) in Northern California. Participants were 893 community-dwelling older adults of whom 63% were women, 52% were married, and 12% were in a minority group. Mean years of education was 14.8 +/- (2.6) and mean years of age was 74.9 +/- (6.5). The associations between patient self-reports of ever receiving physician recommendations to exercise and the following categories of variables were assessed: demographics, health-related quality of life, medical conditions, health/risk behaviors, and health knowledge/interest/satisfaction. RESULTS: The prevalence of older adults in this study ever receiving a physician suggestion to exercise was 48.2%. In a multivariate logistic regression model, being younger, sedentary, and having a higher body mass index were independently (p < or = .05) and positively associated with increased reports of having ever received a physician's advice to exercise. Those who were precontemplators (not thinking about changing physical activity behavior), and those who reported greater frequency of endurance exercise were less likely to report receiving a physician recommendation to exercise (p < or = .05). CONCLUSIONS: Although physician advice appeared to be targeted to subgroups that could benefit, physician advice on exercise could be particularly increased for patients over 75 years of age, those currently not thinking about an increase in physical activity, and those currently active patients who may benefit from ongoing physician advice to promote maintenance.

Aged↗
PubMed1999

Sleep complaints in older women who are family caregivers.

Providing care to a family member with dementia has significant psychological and physical consequences. Sleep quality is likely affected by caregiving, yet this domain has received surprisingly little empirical study. In this study, sleep complaints were examined in 90 older women who were family caregivers of adults with dementia. Caregivers reported more sleep complaints than similarly aged healthy adults on all seven components of the Pittsburgh Sleep Quality Index, and a similar level of sleep complaints to those of sleep-impaired women and depressives on 6 and 4 components, respectively. Sleep medication was used by 38% of caregivers in the past month. The most common sleep complaints that occurred at least weekly were waking up in the night or early morning (84%), bathroom needs (83%), and sleep onset difficulties (41%). Sixty percent of the sample reporting nighttime care recipient disruptions stated that these disruptions occurred 3 or more times per week. Caregiver relationship and care recipient diagnosis were unrelated to sleep complaints. Lower levels of education, less internalized anger, care recipient disruptions, and psychological distress were related to poorer overall sleep quality. Sleep complaints are a common yet understudied problem in family caregivers.

Aged↗
PubMed1999

Key informant surveys as a tool to implement and evaluate physical activity interventions in the community.

Key informant surveys are important tools for planning and evaluating community health programs. A survey was conducted to gather views on policies toward physical activity from four sets of key informants: physicians, church leaders, business leaders and civic leaders. Surveys were mailed to 797 key informants who were selected from 12 southeastern Missouri counties. For comparison, data from a telephone survey of 2106 persons in the general population were also analyzed. The majority (> 85%) in all four key informant groups were very supportive of required physical education in schools, but less supportive (< 69%) of government funding for places where community members can exercise. Physicians perceived community members as having somewhat greater access to places to exercise relative to the other key informant groups. Comparisons of the key informant surveys to the population survey indicated similar levels of support for physical activity policy. The information from this survey has been useful in identifying support for physical activity policy and gaining access to potential influences for community change. Since key informant research in the area of physical activity policy and cardiovascular disease prevention is sparse, there is a need for future studies.

Adult↗
PubMed1999

Managing job strain: a randomized, controlled trial of an intervention conducted by mail and telephone.

A randomized, clinical intervention focused on alleviating job strain was conducted over 6 months by mail and/or telephone with a total of 136 employees of Bank of America. Both the mail and mail plus telephone interventions evidenced positive results, with the mail plus telephone intervention being the more effective. Given the relative low cost of such mediated interventions, the results provide a basis for the further development of interventions that may demonstrate both clinical and cost effectiveness.

Adaptation, Psychological↗
PubMed1998

99mTc-HL91: "hot spot" detection of ischemic myocardium in vivo by gamma camera imaging.

BACKGROUND: 99mTc-HL91 is a new hypoxia imaging agent that demonstrates increased uptake and retention in globally hypoxic myocardium in vitro. The purpose of this study was to determine whether 99mTc-HL91 could detect regional ischemia in vivo by gamma camera imaging. METHODS AND RESULTS: Eight open-chest dogs with left circumflex (LCx) stenoses were studied. Injection of 5 mCi of 99mTc-HL91 and microspheres was followed by imaging over 4 hours. Heart slices were imaged, then stained with triphenyltetrazolium chloride (TTC), and tissues were well-counted. TTC staining demonstrated no injury. Mean LCx blood flow was 0.32+/-0.04 mL x min(-1) x g(-1), and mean left anterior descending coronary artery (LAD) flow was 0.96+/-0.02 mL x min(-1) x g(-1) (ratio, 0.33). "Hot spots" were detected in 8 of 8 experiments in vivo within 60 minutes and improved over 4 hours. Region of interest analysis of LCx/LAD activity ratios demonstrated significant increases within 30 minutes (final ratio, 3.0; P<0.05). LCx and LAD washout curves demonstrated significant differences within 15 minutes. Washout curves were biexponential over 1 hour, followed by linear retention from 1 to 4 hours. Four-hour fractional retention was 0.12 for LAD and 0.44 for LCx (P<0.01). Myocardial flow versus tracer uptake demonstrated 2 phases: phase 1 (flow, 0.05 to 0.7 mL x min(-1) x g(-1)) had an inverse linear correlation (r= -0.80); phase 2, (flow, >0.7 mL x min(-1) x g(-1)) had no correlation. Ischemic heart/liver ratios remained near 1.0 for 4 hours. CONCLUSIONS: 99mTc-HL91 positively identifies regional myocardial ischemia in a canine model using 99mTc imaging. Quantitative techniques allowed identification of ischemic myocardium within 15 minutes of tracer administration.

Animals↗