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Biomedical subjects

R Fielding

Publications and source records attributed to R Fielding.

46 records · Page 3Linked to original sources
PubMed1991

Leucine metabolism during fasting and exercise.

Whole body leucine kinetics were examined in seven healthy young men while in a 14-h postabsorptive state (PAS) and after a 3.5-day fast (FS). Subjects received a primed constant intravenous infusion of L-[1-13C]leucine while resting for 3 h and then while exercising on a cycle ergometer at 45% maximal O2 uptake to exhaustion. Blood samples drawn during isotopic steady state were analyzed for 13C enrichment of leucine and alpha-ketoisocaproic acid, and expired gas samples were analyzed for 13CO2. Resting leucine flux was higher in the FS, and there was a slight increase in leucine oxidation. During exercise, leucine flux did not differ between PAS and FS but leucine oxidation rose markedly. In the FS, leucine oxidation was 25 +/- 7 (SD) mumol.kg-1.h-1 at rest and rose to 75 +/- 21 mumol.kg-1.h-1 during exercise; in the PAS, oxidation was 20 +/- 5 mumol.kg-1.h-1 at rest and 52 +/- 17 mumol.kg-1.h-1 during exercise. These data indicate that the high rate of leucine oxidation previously found during exercise was increased further by a 3.5-day fast.

Adult↗
PubMed1989

The role of communication in the alteration of patient-care practices in hospital--a prospective study.

In infection control, ward practices often need alteration, as in Queen Mary Hospital, Hong Kong, when a policy was introduced to discontinue the recapping of needles among nurses. Nine randomly selected wards were divided into three groups (A, B and C) of 3 wards each. From an initial survey, nurses were divided into those who agreed with the discontinuation (the 'agreeables') and those who did not (the 'non-agreeables'). Methods used to introduce the policy included a simple announcement through the nursing hierarchy in group A (control), a passive method (posters and pamphlets) was added in group B and both passive and active methods (in-service lectures) were used in group C. Five weeks later, behavioural change was assessed by another survey and by an unannounced direct needle-count. Only 21% of the nurses changed their practice by simple announcement. For the 'agreeables', 85% changed by the passive method and no further improvement was observed when the active method was added. However, 83% of the 'non-agreeables' changed their practice when the active method was used while the passive method alone changed only 21%. Six months later, a third survey indicated that when the active method was included the change persisted at over 85%, while a 36% change was noted for the 'agreeables' who were only exposed to the passive method.

Communication↗
PubMed1989

A note on early indicators of non-adherence to a cardiac rehabilitation programme.

Of 44 patients enrolled in a study to examine rehabilitation efficacy from myocardial infarction (MI), seven experimental subjects did not adhere to the rehabilitation programme. Serendipitous differences in early cortisol levels following admission for MI differentiated adherent from non-adherent subjects at six to 12 weeks post-MI.

Combined Modality Therapy↗
PubMed1985

Energy expenditure during front crawl swimming: predicting success in middle-distance events.

Male (n = 25) and female (n = 14) competitive swimmers were studied during tethered (breaststroke) and free (front crawl) swimming to determine the validity of calculating exercise oxygen uptake (VO2) from expired gas samples taken immediately after the activity. Based on a single 20-s recovery VO2, the swimmers' VO2 max was correlated with performance in a 400-yd (365.8-m) front crawl swim. The best predictors of VO2 max for trained swimmers were lean body weight and stroke index (r = 0.97). The single best predictor of performance in the 365.8-m front crawl swim was the distance per stroke (r = 0.88), whereas the combination of distance per stroke and VO2 max (ml/kg LBW/min) correlated 0.97 with performance in the swim. This study demonstrates that it is possible to accurately determine the VO2 during maximal and submaximal swimming using a single, 20-s expired gas collection taken immediately after a 4-7 min swim. These findings demonstrate the importance of stroke technique on the energy cost and variations in performance during competitive swimming.

Adolescent↗
PubMed1985

Metabolic characteristics of skeletal muscle during detraining from competitive swimming.

After 5 months of intense training, eight male swimmers were studied during 4 wk of inactivity. Biopsy specimens from the deltoid muscle revealed that its respiratory capacity (QO2) decreased by 50% (5174 to 2559 microliter X h-1 X g-1) after 1 wk of inactivity. Subsequent weeks of detraining did not change the QO2. Although the trained swimmers' muscle phosphofructokinase and phosphorylase activities were significantly higher (P less than 0.05) than those from a group (N = 8) of untrained men, 4 wk of detraining had no effect on these enzyme activities. Mean (+/-SE) resting muscle glycogen concentrations were significantly higher (P less than 0.05) for the trained swimmers (153 +/- 3 mmol X kg-1) than for the untrained men (85 +/- 7.5 mmol X kg-1). Over the 4 wk of inactivity, the swimmers' muscle glycogen progressively decreased from 153 (+/- 3) to 93 (+/-7) mmol X kg-1. After a standard 183-m swim at 90% of the swimmer's best time for that distance, blood lactate rose from a mean of 4.2 (+/-0.8) at week 0 to 9.7 (+/-0.8) mmol X 1(-1) at week 4. These observations demonstrate dramatic changes in the metabolic characteristics of the swimmer's muscle with a 1-4-wk interruption in training.

Adult↗
PubMed1982

Psychological issues arising from the development of new male contraceptives.

Reading et al. (Bulletin, October 1982) report low correlations between morning erectile frequency and diary card records of sexual behavior, and consider difficulties in accurately assessing the monthly frequency of such erections. It seems that the authors have a problem that may derive from the assumption that erections are always associated with sexual arousal. I would argue that this is not the case. If the authors consider the frequency with which morning erections are maintained following micturation, I suspect they would find a lower incidence of early morning erection than they have hiterto. A full bladder in the morning is frequently associated with erection, with detumescence following micturation (Fielding, R. unpublished observations on a single case study for 16 years). Is it possible, therefore, that to consider the term erection as synonymous with sexual arousal can sometimes confuse the simple minds of men? The authors also considered whether retarded ejaculation is perceived as positive or negative. Obviously, this would depend on the duration of retardation. Total retardation would, I predict, prove to be an effective, though unpopular means of contraception, whilst a contraceptive which trebled or quadrupled the duration of intercourse might be much more popular. Finally, as an effective male contraceptive would function by preventing spermatogenesis only, and as spermatozoa constitute less than 1% of the total volume of ejaculatory fluid, no significant changes in the volume of ejaculate should occur. Perhaps contrary to the author's assumption than basic information on the subject is lacking, it has been there under our noses, so to speak, all the time.

Behavior↗
PubMed1980

A note on behavioural treatment in the rehabilitation of myocardial infarction patients.

Ten patients, diagnosed as suffering acute myocardial infarction were allocated to an Experimental (behavioural counselling with relaxation training) group, or a Control (waiting list) group. Measures of electromyogram activity, covert and self-rated anxiety, serum enzymes, length of illness and outcome were made. Experimental subjects had 12 weekly sessions of counselling on a variety of topics relating to psychological adaptation to the illness, plus relaxation training. The results show a significant reduction in muscle tension in experimental subjects after training. Significant changes were also found respecting covert anxiety. Self-rated anxiety and SGOT levels were related. More experimental than control subjects returned to work.

Anxiety↗
PubMedDate not supplied

Strategies of information disclosure to Chinese cancer patients in an Asian community.

There is little information available on strategies of information disclosure used by doctors in the care of patients with cancer. This report focuses on the style of disclosure used by doctors when giving diagnostic and prognostic information to patients with cancer. Among 46% of 133 surgeons and radiotherapists interviewed, disclosure of diagnosis involved a sudden approach (information given outright at one sitting). Less commonly used (19%) was a gradual disclosure style. Of the remainder who disclosed, more than half did so through the family or left it to the family to tell the patient. Doctors' specialty and patients' requests for prognostic information dictated disclosure style most frequently. Single people were more likely to have information disclosed to their families than were married people. While anecdotal accounts indicate negative reactions on the part of patients are a major reason for withholding such information, different disclosure style had little effect on doctors' reports of patient reactions to the bad news. Doctors perceived 25% of patients appeared to react 'with depression' but the remaining 75% appeared 'calm'. These results suggest patients are more likely to be told bad news suddenly, and that doctors do not perceive that this impacts too negatively on patients. The high levels of reported preference for information about cancer in Hong Kong (Fielding and Hung, 1996) conflict with actual prevalence patterns. It seems that commonly cited anecdotal reasons for withholding information from cancer patients in Hong Kong are not sustained by the data produced in these studies.

Adolescent↗
PubMedDate not supplied

Prevalence of travel related illness amongst a group of Chinese undergraduate students in Hong Kong.

BACKGROUND: Regional and global travel by Asian residents is increasing. Young people seeking new experiences through travel may be particularly at risk of a wide spectrum of health problems. This study assesses travel-associated health risks and examines the prevalence and likely impact of pretravel health advice among Chinese undergraduate students in Hong Kong. METHODS: Year 1 and year 3 undergraduate students of the University of Hong Kong were surveyed during September to December 1996, using a structured self-administered questionnaire. A total of 1,067 subjects were required to give a power of 95% (p =.50+/-3%). RESULTS: Of 1,197 students (514 male and 680 female) surveyed, 52% had traveled outside Hong Kong at least once within the previous 12 months. Of these travelers (n = 578), 41% had developed one or more health problems, 7% had to consult a doctor and 2% needed hospitalization during travel, and 8% developed health problems within 2 weeks of returning for which they had to consult a doctor. Most (75%) took no pretravel health advice and 48% took no travel health precautions. About half (41%) of those who received advice received this from nonexpert sources. Those more likely to develop health problems were aged over 20 years (Odds Ratio, 1.49, 95% confidence interval, 1.06-2.10), in financial difficulties (1.60, 1.02-2.51), ever-smokers (1.69, 1.03-2.77), reporting poorer current health status (1.64, 1.04-2.57). Also, those who sought health advice from nonprofessional sources (2.13, 1.03-4.01) and took precautions (1.88, 1.33-2.63) were more likely to develop health problems. CONCLUSIONS: This study demonstrated that young Chinese adults, with the benefits of higher education, are potentially at risk of a variety of avoidable travel-related health problems. Taking pretravel health advice from nonprofessional sources was common among respondents, but taking precautions did not reduce health problems. The comprehensibility and effectiveness of the advice and appropriateness of precautions taken need scrutiny in randomized trials. Specific topics for pretravel health education that will target higher risk travelers with preventive messages need to be identified and evaluated.

Adolescent↗