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At least 505 records · Page 28Linked to original sources
PubMed1991

The identification of nasal obstruction through clinical judgments of hyponasality and nasometric assessment of speech acoustics.

This study examined the records of a consecutive series of 79 patients referred for evaluation at the Oral-Facial and Communicative Disorders Program during a 3-month period in 1989. The purpose was to determine whether clinical judgments of hyponasality, based on a six-point equal-appearing interval scale or an acoustic assessment with a Kay Elemetrics nasometer could provide information concerning nasal airway patency comparable to that obtained by means of aerodynamic measurement techniques. Among the 40 adults in the series, the sensitivity of hyponasality ratings was 0.55 when nasal airway impairment was defined as a condition in which the airway was less than 0.40 and 0.71 when the definition was limited to airways of less than 0.30 cm2. Specificities for the two groups were 0.89 and 0.85, respectively. Similarly, the sensitivity of nasometer ratings was 0.30 for the first group and 0.38 for the second group, while the specificity for the two groups was 0.83 and 0.92, respectively. Comparable analyses for children were not possible because of the extent to which nasal airway size varies in children younger than 15 years of age. Possible reasons for the findings and their clinical significance are discussed.

Adolescent↗
PubMed2005

Natural product-like chemical space: search for chemical dissectors of macromolecular interactions.

Macromolecular interactions (i.e. protein-protein or DNA/RNA-protein interactions) play important cellular roles, including cellular communication and programmed cell death. Small-molecule chemical probes are crucial for dissecting these highly organized interactions, for mapping their function at the molecular level and developing new therapeutics. The lack of ideal chemical probes required to understand macromolecular interactions is the missing link in the next step of dissecting such interactions. Unfortunately, the classical combinatorial-chemistry community has not successfully provided the required probes (i.e. natural product inspired chemical probes that are rich in stereochemical and three-dimensional structural diversity) to achieve these goals. The emerging area of diversity-oriented synthesis (DOS) is beginning to provide natural product-like chemical probes that may be useful in this arena.

Biological Factors↗
PubMed2006

Lessons learned from Action Schools! BC--an 'active school' model to promote physical activity in elementary schools.

The 'active school' model offers promise for promoting school-based physical activity (PA); however, few intervention trials have evaluated its effectiveness. Thus, our purpose was to: (1) describe Action Schools! BC (AS! BC) and its implementation (fidelity and feasibility) and (2) evaluate the impact of AS! BC on school provision of PA. Ten elementary schools were randomly assigned to one of the three conditions: Usual Practice (UP, three schools), Liaison (LS, four schools) or Champion (CS, three schools). Teachers in LS and CS schools received AS! BC training and resources but differed on the level of facilitation provided. UP schools continued with regular PA. Delivery of PA during the 11-month intervention was assessed with weekly Activity Logs and intervention fidelity and feasibility were assessed using Action Plans, workshop evaluations, teacher surveys and focus groups with administrators, teachers, parents and students. Physical activity delivered was significantly greater in LS (+67.4 min/week; 95% CI: 18.7-116.1) and CS (+55.2 min/week; 95% CI: 26.4-83.9) schools than UP schools. Analysis of Action Plans and Activity Logs showed fidelity to the model and moderate levels of compliance (75%). Teachers were highly satisfied with training and support. Benefits of AS! BC included positive changes in the children and school climate, including provision of resources, improved communication and program flexibility. These results support the use of the 'active school' model to positively alter the school environment. The AS! BC model was effective, providing more opportunities for "more children to be more active more often" and as such has the potential to provide health benefits to elementary school children.

British Columbia↗
PubMed1997

The treatment gap in coronary artery disease and heart failure: community standards and the post-discharge patient.

Progress in vascular biology, epidemiology, clinical trials, and cost-effectiveness analyses have allowed development of guidelines for risk reduction in patients with vascular disease and congestive heart failure. However, these advances appear necessary but not sufficient to promote implementation of these guidelines for treating coronary artery disease (CAD) and congestive heart failure (CHF). Evidence from the United Kingdom and Europe, and estimates from the United States, suggest that a large "treatment gap" exists between recommended therapies for patients with cardiovascular disease and the care that they are actually receiving. Despite known interventions with proven efficacy to reduce disease recurrence and death from CAD and CHF, only a minority of patients are receiving any intervention whatsoever. A second problem is that, among those receiving care, many are undertreated resulting in a very small number of patients reaching goals and recommended levels of therapy. Third, the levels of intervention and the proportion of patients at goal that should be attainable (i.e., community standards) are not known. A variety of barriers exist for implementation of preventive cardiology services. Although the patient has a chain of opportunities for risk reduction, it is not clear which of the links in this chain (inpatient/hospital programs, specialist/generalist communication, ambulatory care, or patient compliance) is the major reason for the treatment gap. An ongoing project, the American College of Cardiology Evaluation of Preventive Therapeutics (ACCEPT), will attempt to quantify the treatment gap in coronary disease patients in the United States and will try to identify those barriers playing the greatest role in limiting the optimal care of the coronary disease patient.

Coronary Disease↗
PubMed1996

Prevention of HIV infection in developing countries.

The HIV/AIDS epidemic continues to spread rapidly in developing countries. Heterosexual transmission accounts for almost three-quarters of infections. Current strategies have been effective in the prevention of HIV spread within certain groups but they have had limited impact on the general spread of the epidemic. There is a need to complement these strategies with approaches that will influence the social and environmental determinants of risk to enable those vulnerable to infection to protect themselves.

Acquired Immunodeficiency Syndrome↗
PubMed2003

Participation by clients and nurse midwives in family planning decision making in Indonesia.

In order to enhance understanding of the quality of decision making during family planning consultations in developing countries, provider competencies and client behaviors during 179 randomly selected consultations in Indonesia were assessed. Results show that family planning clients make a significant contribution to the quality of the decision-making process, most notably by identifying the problem requiring a decision, expressing their feelings about using a method, and asking questions. Client involvement may compensate for provider weaknesses, which tend to be in areas calling for interpersonal rather than technical skills. However, the programmatic ideal of informed choice has not yet been realized. Supervisors, trainers, communicators, and program managers can improve the quality of decision making by: creating opportunities for client involvement during consultations, strengthening providers' ability to fully inform clients about their options, and making providers aware of the opportunities for decision making in consultations with continuing clients.

Adolescent↗
PubMed1993

Effects of prebehavioral cognitive work on adolescents' acceptance of condoms.

Two educational strategies designed to promote condom use for sexually transmitted disease protection were tested in a field experiment involving 291 female, adolescent family planning clinic clients. The 1st strategy was designed to enhance attitude-behavior correspondence by increasing direct experience with handling condoms. The 2nd, a contingency-planning exercise, induced clients to generate a mental representation of negotiating condom use with a sexual partner. Both strategies were compared with the standard education. The dependent measures were condom acceptance (operationalized by the number of condoms taken), attitudes, and knowledge. Clients in the contingency-planning condition accepted about 60% more condoms than did other clients. Condom attitudes followed the same pattern, and knowledge did not differ among conditions.

Adolescent↗
PubMed1991

A preliminary investigation concerning the use of nasometry in identifying patients with hyponasality and/or nasal airway impairment.

A series of 76 patients referred for evaluation at the Oral-Facial and Communicative Disorders Program was studied in an attempt to determine the extent to which acoustic assessments of speech, made utilizing a Kay Elemetrics Nasometer, corresponded with clinical judgments of hyponasality and aerodynamic measurements of nasal cross-sectional area. Among the 38 adults, the sensitivity of Nasometer ratings in correctly identifying adult subjects with moderate to severe nasal airway impairment was 0.38, whereas the specificity was 0.92. Comparable analyses for the group of 38 children were not possible because of the extent to which nasal airway size varies up to the age of 15 years. Among the entire group of patients, the sensitivity and specificity of nasometry in correctly identifying the presence or absence of hyponasality was 0.48 and 0.79, respectively. However, when patients with audible nasal emission were eliminated from analysis, the sensitivity rose to 1.0 and the specificity rose to 0.85. Possible reasons for the findings obtained and their clinical significance are discussed.

Adult↗
PubMed2002

The revised NASPE/BPEG generic code for antibradycardia, adaptive-rate, and multisite pacing. North American Society of Pacing and Electrophysiology/British Pacing and Electrophysiology Group.

In light of evolving pacemaker technology and increasing interest in multisite pacing, the Committee on the Development of Position Statements (CDPS) of the North American Society of Pacing and Electrophysiology (NASPE) created an ad hoc Pacemaker Mode Code Task Force in April 2001 under the chairmanship of David L. Hayes, MD, for the purpose of bringing the NASPE/British Pacing and Electrophysiology Group (BPEG) Generic Pacemaker Code (NBG Code) up to date. The task force, whose members are the authors of this article, designed a revised NBG Code in which three major issues were taken into account. First, it was recognized that all modern pacemakerpulse generators are capable of extensive bidirectional communication with an external programming device, making them "communicating" pulse generators as defined by the current (1987) NBG Code. Second, it was decided that a means of providing basic information regarding the location of multisite pacing would be a useful ingredient of the NBG Code. Third, in view of the extensive antibradycardia pacing capabilities common in modern implantable cardioverter defibrillators and the availability of the NASPE/BPEG Defibrillator Code (NBD Code), it was considered unnecessary for the NBG Code to address the presence or absence of antitachycardia features. The resulting updated version of the NBG Code as described herein was endorsed by the BPEG on September 20, 2001 and adopted by the NASPE Board of Trustees on October 18, 2001. The structure of the revised NBG Code differs from that of the previous version in two respects alone: Position IV specifies only the presence or absence of rate modulation, and Position V specifies only the location or absence of multisite pacing (i.e., biatrial or biventricular pacing with at least two stimulation sites in each case) more than one stimulation site in any single cardiac chamber, or any combination of these. The revised NBG Code is deliberately configured to avoid confusion with earlier mode codes, and it is the authors' hope that it will serve as an enhanced resource for communication among those engaged in every phase of the multidisciplinary practice of cardiac rhythm management.

Bradycardia↗