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Biomedical subjects

E Kennedy

Publications and source records attributed to E Kennedy.

At least 37 records · Page 2Linked to original sources
PubMed1998

US Department of Agriculture School Breakfast Program.

This article reviews the history of the US Department of Agriculture School Breakfast Program (SBP) and provides a synthesis of factors influencing participation rates. Certain children are more likely to participate than others, such as those in lower grades and those from low-income households, and African American, Hispanic, and male students. A few studies in the past 25 y have examined the effectiveness of the SBP in improving the diets and nutritional status of children. The overall pattern that emerges from these studies is that the SBP contributes to improved nutrient intake in program participants. Less attention has been devoted to assessing the effects of SBP on cognitive development. Some of the evidence reviewed here suggests that the SBP significantly improves school performance and reduces absenteeism and tardiness. Future directions for research and operation of the SBP are discussed in light of the changing dietary profile of American children.

Child↗
PubMed1998

Dietary fat consumption and health.

Dietary Guidelines have emerged over the past 30 years recommending that Americans limit their consumption of total fat and saturated fat as one way to reduce the risk of a range of chronic diseases. However, a low-fat diet is not a no-fat diet. Dietary fat clearly serves a number of essential functions. For example, maternal energy deficiency, possible exacerbated by very low-fat intakes (< 15% of energy), is one key determinant in the etiology of low birth weight. The debate continues over recommendations for limiting total fat and saturated fatty acid intake in children. Recent evidence indicates that diets with adequate energy providing less than 30% of energy from fat are sufficient to promote normal growth and normal sexual maturation. More attention needs to be devoted to the effect of dietary fat reduction on the nutrient density of children's diets. The association between dietary fat and CHD has been extensively studied. Diets high in saturated fatty acids and trans fatty acids increase LDL cholesterol levels, and in turn, the risk of heart disease. The relationship between high-carbohydrate/low-fat diets and CHD is more ambiguous because high-carbohydrate diets induce dyslipidemia in certain individuals. Obesity among adults and children is now of epidemic proportions in the United States. High-fat diets leading to excessive energy intakes are strongly linked to the increasing obesity in the United States. However, the prevalence of obesity has increased during the same time period that dietary fat intake (both in absolute terms and as a percentage of total dietary energy) has decreased. These trends suggest that a concomitant decrease in total dietary energy and modifications of other lifestyle factors, such as physical activity, also need to be emphasized. Obesity is also an independent risk factor for the development of diabetes. The current availability of fat-modified foods offers the potential for dietary fat reduction and treatment of the comorbidities associated with diabetes. However, to date, few studies have documented the effectiveness of fat-modified foods as part of a weight loss regimen or in reduction in CHD risks among individuals with diabetes mellitus. The association between total dietary fat and cancer is still under debate. While there is some evidence demonstrating associations between dietary fat intake and cancers of the breast, prostate, and colon, there are serious methodologic issues, including the difficulty in differentiating the effects of dietary fat independent of total energy intake. Reported total fat and saturated fatty acid intakes as a percentage of total energy have been declining over the past 30 years in the United States. Despite this encouraging trend, the majority of individuals--regardless of age--do not report consuming a diet that meets the levels of fat and saturated fatty acids recommended by the Dietary Guidelines for Americans. On a relative basis, saturated fat intake has gone down less than has total fat intake. Individuals of all ages who report consuming a diet with < or = 30% of energy from fat consistently have lower energy intakes. Given the increasing rates of obesity in the United States at an earlier and earlier age, dietary fat reduction may be an effective part of an overall strategy to balance energy consumption with energy needs. In each of the age/gender groups reporting consumption of < or = 30% of energy from fat and less than 10% of energy from saturated fatty acids, fat-modified foods play a more important role in their diets than for people who are consuming higher levels of fat and saturated fat. The data are clear than fat-modified foods make a more significant contribution to diets of consumers with low-fat intakes. While one cannot argue cause and effect from the results presented, the patterns of fat-modified foods/low-fat intakes are consistent. The focus on overall diet quality is often lost in the national obsession with lowering fat inta

Adult↗
PubMed1998

Consonant-vowel intensity ratios for maximizing consonant recognition by hearing-impaired listeners.

The effect of adjusting the consonant-vowel (C-V) intensity ratio on consonant recognition in 18 subjects with sensorineural hearing impairment was investigated. C-V intensity ratios in a set of 48 vowel-consonant nonsense syllables were adjusted in steps of 3-6 dB depending on the subject's dynamic range of hearing. An increase in consonant intensity is referred to here as consonant enhancement (CE). The value of CE producing the highest consonant recognition score (CRmax) is defined as CEmax. Both CEmax and CRmax were determined for each subject for each of the 48 nonsense syllables. Consonant type was found to have a highly significant effect on CRmax, the gain in consonant recognition, and CEmax. The effect of vowel environment was also significant, but of much smaller magnitude. Audiogram configuration was found to have a small effect and was only significant for CRmax. The results of the study also showed that individualized adjustment of the C-V intensity ratio for each subject and consonant-vowel combination can produce substantial improvements in consonant recognition. These data can be used to estimate upper bounds of performance that, in principle, can be obtained by appropriate adjustment of the C-V intensity ratio.

Audiometry, Pure-Tone↗
PubMed1998

Reduce home care aide turnover: give aides real jobs.

What do home care aides want even more than a raise? Consistent, full-time work hours. That's what one agency found out in its attempt to decrease employee turnover. There are other steps agencies can take, too, to keep their aides coming back.

Career Mobility↗
PubMed1997

Changing eating patterns of American children: a view from 1996.

A major diet-related problem in the US has changed from growth retardation to childhood obesity. This paper compares the consumption patterns of children using data from nationally representative surveys conducted by the US Department of Agriculture from 1986 to 1994. Children's consumption patterns were analyzed by age groups, income groups and food security levels. From 1986 to 1994, no distinct trends of the energy intakes of children 5 years of age and under were observed. In 1994, a greater percentage of children were meeting the dietary guidelines for fat and saturated fat than in 1989-91. However, most of the children's diet in each sex/age category still exceeds the dietary guideline's recommendations.

Adolescent↗
PubMed1996

Incidence and prophylaxis of deep vein thrombosis in a high risk trauma population.

BACKGROUND: Pelvic fractures, lower extremity injuries, acute head or spinal injury, and extended bedrest place trauma patients at an increased risk for deep vein thrombosis (DVT) and pulmonary embolism (PE). We reviewed patients with traumatic brain injuries (TBI), spinal cord injuries (SCI), and lower extremity fractures (LEF) to examine our DVT and PE incidence and evaluate the success of our DVT and PE prophylaxis. METHODS: From January 1, 1994 to March 1, 1995, the records of trauma patients with TBI, SCI, and LEF who were admitted to the trauma service and transferred to an inpatient rehabilitation facility were reviewed. RESULTS: Twenty-two patients had a TBI, 16 patients with SCI, and 12 patients with LEF. Forty-nine of the 50 patients received DVT prophylaxis, with 7 inferior vena cava (IVC) filters placed. The DVT incidence was 6% and the PE incidence was 2%. CONCLUSION: The 6% incidence of DVT was lower than expected due to diligent DVT prophylaxis and appropriate screening of symptomatic patients for clinically significant DVT. The 2% incidence of PE was also lower than expected, most likely due to our lower DVT incidence and the use of IVC filters. The lower DVT and PE incidence verifies our success at DVT and PE prophylaxis.

Adult↗
PubMed1996

Corrections to the target and critical values for the National Institute for Occupational Safety and Health validation tests.

In 1974 the National Institute for Occupational Safety and Health (NIOSH) and the Occupational Safety and Health Administration joined to complete exposure standards promulgated by federal regulations. In that effort NIOSH scientists developed an accuracy criterion (AC) and a statistical protocol for evaluating its fulfillment. That AC and those procedures have been widely used ever since. This article presents corrections to the target and critical coefficients of variation published as part of the statistical protocol.

Bias↗
PubMed1996

A prospective analysis of the HOMA model. The Mexico City Diabetes Study.

OBJECTIVE: Both insulin resistance (IR) and decreased insulin secretion have been shown to predict the development of NIDDM. However, methods to assess insulin sensitivity and secretion are complicated and expensive to apply in epidemiological studies. The homeostasis model assessment (HOMA) has been suggested as a method to assess IR and secretion from the fasting glucose and insulin concentrations. RESEARCH DESIGN AND METHODS: We applied the HOMA model in the 3.5-year follow-up of the Mexico City Diabetes Study. RESULTS: Out of 1,449 subjects, 97 developed diabetes. When modeled separately insulin resistance but not insulin secretion predicted NIDDM. However, when both variables were entered into the same regression model, both increased IR and decreased beta-cell function significantly predicted NIDDM. CONCLUSIONS: We conclude that the HOMA provides a useful model to assess beta-cell function in epidemiological studies and that it is important to take into account the degree of IR in assessing insulin secretion.

Adult↗
PubMed1995

Inhibition of intimal hyperplasia in rat aortic allografts with cyclosporine.

The rat aortic transplant model of chronic rejection was used to study the effect of cyclosporine (CsA) on the development of intimal hyperplasia. ACI and Lewis rat strains were used to create isograft and allograft CsA nontreated and treated groups. After orthotopic abdominal aortic transplantation, recipients received either no treatment, CsA 2.5 mg/kg/day, CsA 5 mg/kg/day, or CsA 10 mg/kg/day by gavage. Treated grafts were harvested at 3 and 6 months after transplantation, and computer image digital analysis was used to measure intimal and medial areas of graft cross-sections. At 3 months, the reduction in percent intima was 62% (P = 0.005), 74% (P = 0.002), and 97% (P < 0.0001) for the 2.5-, 5-, and 10-mg/kg allograft groups, respectively. There was a 93% (P < 0.0001) reduction in percent intima at 6 months in the 10-mg/kg allograft group. CsA treatment also preserved the aortic media. In comparison to nontreated isografts, medial area in nontreated allografts was decreased by 37% at 3 months after transplantation. In contrast, medial area was not significantly changed in CsA-treated recipients (10 mg/kg/day) in comparison to nontreated isografts. More importantly, medial nuclear density was preserved in the CsA-treated recipients in comparison to nontreated allografts and was similar to treated or nontreated isografts. In conclusion, daily high dose CsA treatment was found to markedly inhibit intimal hyperplasia in rat aortic allografts up to 6 months after transplantation, which suggests that CsA at an adequate dosage can suppress chronic rejection.

Animals↗
PubMed1995

What are American children eating? Implications for public policy.

As the health and demographic profile of the U.S. population changes, the food consumption patterns of American children have also changed. This review is organized around a series of policy issues looking at these new food consumption patterns, their relationship to the Dietary Guidelines, and their impact on children's health.

Adolescent↗
PubMed1994

The voices of reform. The final stretch. Interview by Renee Blankenau.

Following a complex research and development process last year that led to the drafting of a comprehensive health care reform proposal, President Bill Clinton presented the U.S. Congress and the nation with an outline for reform in September, and followed up with a detailed plan and with a reform bill in October. Now it's Congress' turn to respond. Hospitals & Health Networks' senior editor Renee Blankenau interviewed 11 members of Congress whose views represent a broad spectrum of congressional opinion. What version of federal reform will emerge this year? These legislators have the inside track.

Forecasting↗
PubMed1994

Beneficial cardiopulmonary effects of pentoxifylline in experimental sepsis are lost once septic shock is established.

OBJECTIVE: To determine the effects of pretreatment and posttreatment with pentoxifylline in a porcine model of gram-negative sepsis. DESIGN: Nonrandomized controlled trial. STUDY SUBJECTS: Young Yorkshire swine. INTERVENTIONS: Six groups of ventilated swine were studied for 5 hours. Group 1 swine (control, n = 8) received saline solution only. Group 2 swine (sepsis, n = 8) received a 1-hour infusion of Pseudomonas aeruginosa. Groups 3, 4, and 5 swine received the P aeruginosa infusion and a 20 mg/kg bolus followed by a 6 mg/kg per hour infusion of pentoxifylline. Group 3 swine (n = 6) received pentoxifylline prior to the onset of sepsis; group 4 swine (n = 6) received pentoxifylline at 1 hour and group 5 swine (n = 4) at 2 hours after the onset of the P aeruginosa infusion. Group 6 swine (control pentoxifylline, n = 3) received pentoxifylline only. OUTCOME MEASURES: Hemodynamic variables, neutrophil counts and CD18 expression, tumor necrosis factor activity, and arterial blood gases were measured hourly. Bronchoalveolar lavage was performed at 0 and 5 hours to measure neutrophil and protein content. RESULTS: All variables remained unchanged in the control and control pentoxifylline groups. Both pretreatment and posttreatment with pentoxifylline significantly attenuated lung injury and improved arterial PaO2. The cardiac index was significantly improved by administration of pentoxifylline in groups 3 and 4. Administration of pentoxifylline to group 5 animals in established septic shock caused uncontrolled, fatal systemic hypotension in two of the four animals. Plasma tumor necrosis factor activity, blood polymorphonuclear leukocyte counts, and CD18 expression were unaffected by the administration of pentoxifylline. CONCLUSIONS: Pentoxifylline protects against pulmonary and systemic hemodynamic derangements in fulminant sepsis and protects against pulmonary dysfunction. Pentoxifylline has a "therapeutic window" when given in established sepsis; if administration is delayed until overt septic shock occurs, it may then have deleterious effects.

Animals↗
PubMed1994

Body mass index and economic productivity.

The paper reviews the evidence to date on the nutritional links with productivity and then goes on to provide results from a multi-country study on the effects of increasing body mass index (BMI) on productivity. The research relating nutritional status to work capacity is more consistent than the research linking nutritional status to productivity. None of the studies to date elucidate the pathways through which improved nutrition improves economic productivity. In addition, many of the studies that have been conducted on the nutrition/wage links have been based on samples that contained a disproportionate number of male subjects. The few studies that have disaggregated data by gender report different results for men and women. Research conducted at IFPRI is presented to examine the trends in BMI for men and women across countries and for Kenya to examine the relationships between various measures of nutritional status--BMI and height--and energy expenditures in women. BMIs of men show a more consistent relationship with increasing household income than do the BMIs of women. In the case of the Gambia and Kenya, the mean BMI of women decreases with increasing household income. One reason for the apparently low response of BMI to increasing household income in Kenya is the time allocation patterns of women. Women in the Kenya sample spend the largest proportion of their day in home production activities which are energy intensive. In examining the relationship between nutritional indicators and the time devoted to work, the results suggest a significant, positive association between both BMI and height and the amount of time devoted to work. In the models presented, both BMI and height appear to increase the capacity to carry out work. It is difficult to value much of this work time since a disproportionate share is devoted to home production activities. Some of the more classic methods of measuring economic productivity, such as measuring wage rates, are not relevant for women in this setting. The data from Kenya suggest that more appropriate measures for specifying the value of women's work need to be developed in order to capture some of the nutrition/productivity links which may exist.

Body Mass Index↗