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Konrad Jamrozik

Publications and source records attributed to Konrad Jamrozik.

77 records · Page 5Linked to original sources

Developing a reliable audit instrument to measure the physical environment for physical activity.

BACKGROUND: The physical environment plays an important role in influencing participation in physical activity, although which factors of the physical environment have the greatest effect on patterns of activity remain to be determined. We describe the development of a comprehensive instrument to measure the physical environmental factors that may influence walking and cycling in local neighborhoods and report on its reliability. METHODS: Following consultation with experts from a variety of fields and a literature search, we developed a Systematic Pedestrian and Cycling Environmental Scan (SPACES) instrument and used it to collect data over a total of 1987 kilometers of roads in metropolitan Perth, Western Australia. The audit instrument is available from the first author on request. Additional environmental information was collected using desktop methods and geographic information systems (GIS) technology. We assessed inter- and intra-rater reliability of the instrument among the 16 observers who collected the data. RESULTS: The observers reported that the audit instrument was easy to use. Both inter- and intra-rater reliability of the environmental scan instrument were generally high. CONCLUSIONS: Our instrument provides a reliable, practical, and easy-to-use method for collecting detailed "street-level" data on physical environmental factors that are potential influences on walking in local neighborhoods.

Bicycling↗

Prevalence of peripheral arterial disease: persistence of excess risk in former smokers.

OBJECTIVE: To determine the age-standardised prevalence of peripheral arterial disease (PAD) and associated risk factors, particularly smoking. METHOD DESIGN: Cross-sectional survey of a randomly selected population. SETTING: Metropolitan area of Perth, Western Australia. PARTICIPANTS: Men aged between 65-83 years. RESULTS: The adjusted response traction was 77.2%. Of 4,470 men assessed, 744 were identified as having PAD by the Edinburgh Claudication Questionnaire and/ or the ankle-brachial index of systolic blood pressure, yielding an age-standardised prevalence of PAD of 15.6% (95% confidence intervals (CI): 14.5%: 16.6%). The main risk factors identified in univariate analyses were increasing age, smoking-current (OR = 3.9, 95% CI 2.9-5.1) or former (OR = 2.0, 95% CI 1.6-2.4), physical inactivity (OR = 1.4, 95% CI 1.2-1.7), a history of angina (OR = 2.2, 95% Cl 1.8-2.7) and diabetes mellitus (OR = 2.1, 95% Cl 1.7-2.6). The multivariate analysis showed that the highest relative risk associated with PAD was current smoking of 25 or more cigarettes daily (OR = 7.3, 95% Cl 4.2-12.8). In this population, 32% of PAD was attributable to current smoking and a further 40% was attributable to past smoking by men who did not smoke currently. CONCLUSIONS: This large observational study shows that PAD is relatively common in older, urban Australian men. In contrast with its relationship to coronary disease and stroke, previous smoking appears to have a long legacy of increased risk of PAD. IMPLICATIONS: This research emphasises the importance of smoking as a preventable cause of PAD.

Aged↗

Long-term disability after first-ever stroke and related prognostic factors in the Perth Community Stroke Study, 1989-1990.

BACKGROUND AND PURPOSE: Few reliable estimates of the long-term functional outcome after stroke are available. This population-based study aimed to describe disability, dependency, and related independent prognostic factors at 5 years after a first-ever stroke in patients in Perth, Western Australia. METHODS: All individuals with a suspected acute stroke who were resident in a geographically defined region (population, 138 708) of Perth, Western Australia, were registered prospectively and assessed according to standardized diagnostic criteria over a period of 18 months in 1989 to 1990. Patients were followed up prospectively at 4 and 12 months and 5 years after the index event. RESULTS: There were 370 cases of first-ever stroke, and 277 patients survived to 30 days. Of these early survivors, 152 (55%) were alive at 5 years, and among those who were neither institutionalized (n=146) nor disabled (n=129) at the time of their stroke, 21 (14%) were institutionalized in a nursing home, and 47 (36%) were disabled. The most important predictors of death or disability at 5 years were increasing age, baseline disability defined by a Barthel Index score of <20/20 (odds ratio [OR], 6.3; 95% confidence interval [CI], 2.7 to 14), moderate hemiparesis (OR, 2.7; 95% CI, 1.1 to 6.2), severe hemiparesis (OR, 4.5; 95% CI, 1.1 to 19), and recurrent stroke (OR, 9.4; 95% CI, 3.0 to 30). A low level of activity before the stroke was a significant predictor of institutionalization, and subsequent recurrent stroke was a consistent, independent predictor of institutionalization, disability, and death or institutionalization, increasing the odds of each of these 3 adverse outcomes by 5- to 15-fold. CONCLUSIONS: Among 30-day survivors of first-ever stroke, about half survive 5 years; of survivors, one third remain disabled, and 1 in 7 are in permanent institutional care. The major modifiable predictors of poor long-term outcome are a low level of activity before the stroke and subsequent recurrent stroke. Efforts to increase physical activity among the elderly and to prevent recurrent stroke in survivors of a first stroke are likely to reduce the long-term burden of cerebrovascular disease.

Aged↗

What drives the NHS?

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Efficiency, Organizational↗