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At least 631 records · Page 35Linked to original sources
PubMed1995

Physical activity within a community-based weight control program: program evaluation and predictors of success.

OBJECTIVES: To assess the feasibility and effectiveness of adding physical activity sessions to a weight control program in a community health center and to identify individuals suitable for outpatient group treatment with and without physical activity. METHODS: The study population included 42 overweight women who were randomly divided into treatment groups. Both treatment groups received guidance in nutrition and behavior modification and the exercise group also participated in physical activity sessions. Both treatments included 20 sessions and participants were followed up for eight months. RESULTS: In both treatments, significant improvements were seen in physical fitness, anthropometric measurements, nutritional knowledge, food consumption, and eating behaviors. Weight loss following three months of weekly sessions did not differ by treatment group. At follow-up there was a trend towards increased maintenance of weight loss in the exercise group, however differences were not statistically significant. Attrition rates were low in both treatments and participant satisfaction was high. Lower baseline BMI predicted larger weight losses, in particular in the exercise group. Other predictors of weight loss included poorer baseline eating behaviors and employment outside of the home. Perceived spouse support predicted continual participation.

Adult↗
PubMed1979

Five-year findings of the hypertension detection and follow-up program. II. Mortality by race-sex and age. Hypertension Detection and Follow-up Program Cooperative Group.

Data are reported for four race-sex and three age subgroups of the Hypertension Detection and Follow-up Program (HDFP). Throughout the HDFP trial, for black men, black women, white men, and white women and for persons aged 30 to 49, 50 to 59, and 60 to 69 years at entry, control of blood pressure was consistently better for Stepped Care (SC) than Referred Care (RC) participants. This difference in degree of control was least for white women; it was less for whites than for blacks of the same sex. For white men, black men, and black women and for age subgroups 50 to 59 and 60 to 69 years, five-year all-cause death rates were substantially lower--by 15% to 28%--for the SC subgroups compared to the RC subgroups.

Adult↗
PubMed2004

Characteristics of cancer patients entering a smoking cessation program and correlates of quit motivation: implications for the development of tobacco control programs for cancer patients.

Even though survival and quality of life are adversely affected by smoking among cancer patients, about one-third of cancer patients who smoked prior to their diagnosis continue to smoke. One barrier to the provision of smoking cessation treatments to cancer patients is the paucity of data on the characteristics of cancer patients who continue to smoke and a lack of data on correlates of quit motivation in this population. This descriptive study assessed demographic, medical, smoking history, and psychological characteristics of cancer patients in a smoking cessation program (N=111) and examined these characteristics as correlates of quit motivation. Methods used by patients to quit smoking were also queried. We found that: (1) most patients are Caucasian, married, diagnosed with head and neck (versus lung) cancer, highly addicted to nicotine, and in the contemplation or preparation stage of change; (2) most patients attempt to quit smoking without formal treatment, although 33-50% have used the transdermal nicotine patch, nicotine gum, or bupropion; (3) depressive symptoms, low quitting self-efficacy, low perceived risk, and low perceived benefits of quitting are prevalent among patients, but most patients do not endorse the perceived disadvantages of quitting or fatalistic beliefs; and (4) quit motivation is associated with higher quitting self-efficacy, risk perceptions, and perceived benefits of quitting, lower tobacco use and nicotine addiction, and shorter time since diagnosis. These findings can help guide the development of smoking cessation interventions for cancer patients.

Aged↗
PubMed1995

Evaluating the efficacy of the National Cholesterol Education Program adult treatment guidelines: cholesterol lowering intervention program.

BACKGROUND: A cross-sectional analysis was conducted to test the feasibility of the National Cholesterol Education Program Adult Treatment Panel I Guidelines (ATPI) in physician office practices. METHODS: Twenty-two physician practices in communities from western Pennsylvania and West Virginia were recruited. Using a patient tracking system, 9,171 patients were assessed for cholesterol screening and treatment by their physicians according to the ATPI guidelines. RESULTS: Cholesterol screening was ordered for 1,698 patients or 19% of the population visiting the physician offices. The reasons for not screening included the patient was already under therapy (2,371), screened within the past 5 years (1,714), or acutely ill at the time of the visit (1,691). The frequency of patient refusal for screening was low (444). However, the majority of patient diagnoses were based on a single lipid measurement, and only 817 or 56% of patients evaluated had lipoprotein measures obtained prior to treatment. Follow-up measurement was not performed according to the ATPI schedule, and the magnitude of cholesterol response was inversely related to time to first follow-up measurement. CONCLUSIONS: Many patients in these physician practices had initial cholesterol screening. However, repeat measurements as recommended for initial evaluation were not performed routinely, nor were most patients followed within the recommended 3-month time period. This lack of follow-up is detrimental to effective, long-term patient management since the magnitude of the cholesterol response is related to time of the first follow-up measurement.

Adult↗
PubMed1991

Nosocomial outbreaks: the Centers for Disease Control's Hospital Infections Program experience, 1980-1990. Epidemiology Branch, Hospital Infections Program.

From January 1980 to July 1990, the Hospital Infections Program of the Centers for Disease Control conducted 125 on-site epidemiologic investigations of nosocomial outbreaks. Seventy-seven (62%) were caused by bacterial pathogens, 11 (9%) were caused by fungi, 10 (8%) were caused by viruses, five (4%) were caused by mycobacteria, and 22 (18%) were caused by toxins or other organisms. The majority of fungi and mycobacterial outbreaks occurred since July 1985. Fourteen (11%) outbreaks were device related, 16 (13%) were procedure related, and 28 (22%) were product related. The proportion of outbreaks involving products, procedures, or devices increased from 47% during 1980-1985 to 67% between 1986 and July 1990. Recent outbreaks have shown that packed red blood cell transfusion-associated Yersinia enterocolitica sepsis results from contamination of the blood by the asymptomatic donor; that povidone-iodine solutions can become intrinsically contaminated and cause outbreaks of infection and/or pseudoinfection; and that rapidly growing mycobacteria can cause chronic otitis media, surgical wound infection, and hemodialysis-associated infections. These and other outbreaks demonstrate how epidemiologic and laboratory investigations can be combined to identify new pathogens and sources of infection and ultimately result in disease prevention.

Centers for Disease Control and Prevention, U.S.↗
PubMed1985

Mortality findings for stepped-care and referred-care participants in the hypertension detection and follow-up program, stratified by other risk factors. The Hypertension Detection and Follow-up Program Cooperative Research Group.

Analyses of 5-year mortality data from the Hypertension Detection and Follow-up Program (HDFP) were performed with stratification according to several baseline traits. The HDFP participants were 10,940 white and black men and women ages 30-69 at baseline who were randomized to either stepped-care (SC) or referred-care (RC) groups. All-causes mortality rates were lower for the SC than the RC group, both overall and for the 90-104 mm Hg stratum, for both cigarette smokers and nonsmokers, and for persons with and without hypercholesterolemia, hyperglycemia, diagnosed diabetes, hyperuricemia, or rapid pulse rate. The SC group also fared better than RC for all strata of body mass index, with an apparent trend toward an inverse relationship between body mass index and degree of benefit. Several of the traits--cigarette smoking, fasting hyperglycemia, and hyperuricemia--were associated with significantly higher 5-year mortality rates in both SC and RC participants, in both univariate and multivariate analyses, and a significant U-shaped relationship was recorded between body mass index and mortality for both SC and RC groups. These findings indicate the broad benefit of vigorous antihypertensive stepped-care treatment for hypertensive patients regardless of the presence or absence of the other major risk factors. They also underscore the need for comprehensive management of persons with high blood pressure to control not only their hypertension but also other risk factors associated with negative impact on long-term prognosis.

Adult↗
PubMedDate not supplied

RECPAM: a computer program for recursive partition and amalgamation for censored survival data and other situations frequently occurring in biostatistics. I. Methods and program features.

The methodology of recursive partition and amalgamation in biostatistics is presented and a FORTRAN program for its implementation, RECPAM, is described. RECPAM can be used to obtain classifications of patients according to several criteria commonly occurring in clinical biostatistics: an example is prognostic classification based on survival data. Classes are defined by simple statements, expressed in clinical terms, about predictor variables (e.g. prognostic factors). Special features of RECPAM are: the possibility of implementing a variety of classification criteria, the integration of recursive partition and amalgamation, and the availability of several strategies for constructing classification trees. A simple example to illustrate input and output features is given. The scope and flexibility of RECPAM will be illustrated in greater detail in a subsequent paper.

Algorithms↗
PubMedDate not supplied

The Beech Hill Hospital Eating Disorders Treatment Program for Drug Dependent Females: program description and case analysis.

The association of eating disorders and substance abuse has increasingly been noted among chemically dependent women. Without diagnosis and focused interventions around the disordered eating, female substance abusers are vulnerable to chemical relapse and continued out of control eating. This paper describes an eating disorder treatment program for drug-dependent females during the inpatient phase of chemical dependency treatment. The interrelationship and need to treat both addiction and eating disorder at the beginning of early sobriety is emphasized.

Adult↗
PubMedDate not supplied

Nicotine treatment at the Drug Dependency Program of the Minneapolis VA Medical Center. A program director's perspective.

Nicotine addiction treatment has been integrated with inpatient chemical dependency treatment in the Drug Dependency Treatment program (DDTP) of the Minneapolis VA Medical Center since June 1988. The process of addressing this "new" drug (nicotine) is described. It has required significant changes in staff awareness and attitudes and several years to melt denial of nicotine addiction and develop new habits that address nicotine in therapeutic interactions with patients. Nicotine recovery has gradually been incorporated into all educational and therapeutic activities as well as the traditional recovery tools. Six weeks postdischarge 58% of patients who were smokers upon admission were nicotine-free or had greatly reduced use, and 98% of these were abstinent from drugs/alcohol. Nicotine use produces frequent and intense addictive urges/cravings that are a central issue in treatment. We believe that including nicotine in chemical dependency treatment supports fuller freedom from addictive urges and abstinence from drugs/alcohol.

Adolescent↗
PubMed2005

Spatial and temporal variability of the overall error of National Atmospheric Deposition Program measurements determined by the USGS collocated-sampler program, water years 1989-2001.

Data from the U.S. Geological Survey (USGS) collocated-sampler program for the National Atmospheric Deposition Program/National Trends Network (NADP/NTN) are used to estimate the overall error of NADP/NTN measurements. Absolute errors are estimated by comparison of paired measurements from collocated instruments. Spatial and temporal differences in absolute error were identified and are consistent with longitudinal distributions of NADP/NTN measurements and spatial differences in precipitation characteristics. The magnitude of error for calcium, magnesium, ammonium, nitrate, and sulfate concentrations, specific conductance, and sample volume is of minor environmental significance to data users. Data collected after a 1994 sample-handling protocol change are prone to less absolute error than data collected prior to 1994. Absolute errors are smaller during non-winter months than during winter months for selected constituents at sites where frozen precipitation is common. Minimum resolvable differences are estimated for different regions of the USA to aid spatial and temporal watershed analyses.

Air Pollutants↗
PubMed2005

A proposal for a national program reporting beneficial drug responses, analogous to the existing program to detect adverse drug responses.

Many countries have regulatory agencies, such as the Food and Drug Administration in the United States, not only to determine approval of drugs into the marketplace, but also to monitor their safety following the approval process. The logic for the latter role of these agencies is that several important changes occur in the patient population after the approval to market. These changes include the tremendous expansion in the numbers of patients, the removal of many exclusion criteria of co-existing diseases that may have been included in the clinical trials, and the fact that the treatment time for agents used chronically will now exceed any previous exposure time. All of these factors may contribute to the development of adverse drug responses (ADRs) that were not predictable or observable during the clinical trial phases. While the programs to monitor ADRs have important limitations such as the absence of a control group, they are extremely useful at determining possible associations between a drug and an adverse response that can now be used to generate hypotheses to be tested in a more proper and controlled set of trials. A similar system could, in principle, be used to monitor non-predictable serendipitous beneficial drug responses (BDRs) that would otherwise not be seen due to the same limitations of clinical trials in detecting ADRs. The system would expand data collection beyond clinical trials - which often can pick up BDRs of drugs such as minoxidil and sildenafil. This system of monitoring for BDRs would have the tremendous advantages of generating hypotheses derived from data obtained in humans with the disease and a drug-able molecule. The data obtained from this system of monitoring for BDRs could lead to new uses for old drugs as well as provide starting molecules that could be modified to treat diseases unrelated to the original indicated disease for the parent drug. The cost of creating and maintaining a BDR database are in-line with budgets of some of the projects funded by agencies such as the NIH or MRC. One possible feature is that the patient, rather than the doctor, does the majority of BDR reporting. Although lay-reporting would lead to false positives; repeated observations of a beneficial association would be a reasonable basis for further study in formal, professional clinical investigations. It is time to create the largest stage ever for serendipity to appear in biomedical research. After all, her previous appearances have marked some of science's most amazing discoveries.

Databases, Factual↗
PubMed2006

Characterization of Minnesota dairy herds participating in a Johne's disease control program and evaluation of the program risk assessment tool.

The objectives of this study were to: (1) characterize Minnesota dairy herds participating in a Johne's disease control program (JDCP) based on herd size, milk production, and clinical Johne's disease (JD) history, (2) evaluate if change in farm management practices, expressed in risk assessment (RA) total score, is associated with the change between the first and most recent ELISA test herd seroprevalence or change in clinical JD culling rate, and (3) identify farm factors associated with ELISA seroprevalence. A total of 1234 RA, performed between January 2000 and February 2004, were available for analysis from 714 dairy herds. ELISA test results from herd sampling between 2000 and 2004 were obtained from the Minnesota board of animal health (MBAH) database, and were available for 474 herds. Both the first and the most recent ELISA test results for herds with more than one RA were available for 262 herds. Mean herd size and mean annual milk production per cow was higher in JDCP dairy herds (161 milking cows) than either all Minnesota dairy herds or Minnesota dairy herd improvement association (DHIA) herds. For herds with more than one RA available, the most recent RA total score was significantly lower (mean 11% less) than the first. The change in RA total score (and any RA subtotal scores) between the first and most recent RA was not associated with the change between the first and the most recent ELISA within-herd seroprevalence or the change in JD culling rate between the first and most recent RA. The most recent ELISA test results were positively associated with postweaned heifer score and JD culling rate. The RA score was not found to be an effective tool for the prediction of ELISA seroprevalence.

Animal Husbandry↗
PubMed1998

Epigenetic control of programmed cell death: inhibition by 5-azacytidine of 1,25-dihydroxyvitamin D3-induced programmed cell death in C6.9 glioma cells.

In mammalian DNA cytosine methylation occurs specifically at CpG dinucleotide. Although the full array of function of DNA methylation is yet to be elucidated, it is well established that DNA methylation is an important mechanism involved in gene expression, DNA replication and cancer. Rat glioma C6.9 cells undergo programmed cell death (PCD) after treatment with 1,25-dihydroxyvitamin D3 (1,25-D3). Hence, these cells were used to study whether DNA methylation was involved in the control of PCD. We found that 1,25-D3-mediated PCD of C6.9 cells was suppressed by exposure of the cells to the DNA demethylating agents 5-azacytidine (5-AzaC) and 5-aza-2'-deoxycytidine. This effect remains detectable several cell divisions following removal of 5-AzaC and, therefore, involves DNA methylation as an epigenetic regulatory mechanism of PCD. Accordingly, internucleosomal fragmentation, a feature of apoptosis that is detected in 1,25-D3-treated cells, is no longer observable after treatment of these cells with 5-AzaC. However, 5-AzaC does not totally suppress the responsiveness of C6.9 cells to 1,25-D3 since the induction of the c-myc gene remains unaffected. These results suggest that a change in DNA methylation pattern could suppress 1,25-D3-mediated PCD through the expression of previously hypermethylated genes such as proto-oncogenes with death-repressor activity, endogenous virus sequences or even genes inducing change in the differentiated state of these cells.

Animals↗
PubMed1998

An assessment of the influence of clinical breast examination reports on the interpretation of mammograms in a breast screening program. Ontario Breast Screening Program Radiologists Research Group.

The population-based Ontario Breast Screening Program (OBSP) provides two-yearly screening by both nurse examiner clinical breast examination (CBE) and two-view mammography to women aged 50 to 69. CBE alone accounts for about 5% of cancer detection. The purpose of this study was to determine whether CBE information affects radiologists' interpretation of mammography. Interpretation was defined by 1) radiologists' referral rates for diagnostic evaluation and 2) radiologists' accuracy in distinguishing cancer from non-cancer on mammograms. Mammograms were obtained from women randomly selected from those screened in the OBSP between 1990 and 1992. Selection was stratified by whether or not the nurse examiner had independently referred for diagnostic evaluation. Additional women diagnosed with breast cancer were selected to increase the precision of the receiver-operating characteristic (ROC) curve. Each participating OBSP radiologist read a set of mammograms twice, approximately three weeks apart. The first reading was based on mammograms alone. At the second reading, the CBE report was included on the reporting form. Among 620 women referred by the nurse, radiologist referral rate increased from 37.7% to 40.8% (p = 0.079) when CBE information was available. Among the 637 not referred by the nurse, radiologist referral rate decreased from 29.8% to 25.6% (p = 0.005). There was little effect on the sensitivity and specificity of radiologist referral and the areas under the two ROC curves (with and without CBE information) were not significantly different (p = 0.571). Although there was some effect of CBE information on radiologists' pattern of referral, there was no effect on accuracy of cancer detection.

Breast Neoplasms↗
PubMed2000

Neurocognitive functioning in children with mild and moderate asthma in the childhood asthma management program. The Childhood Asthma Management Program (CAMP) Research Group.

BACKGROUND: The Childhood Asthma Management Program (CAMP) is a multicenter double-blind, randomized, placebo-controlled, clinical trial of two anti-inflammatory agents and placebo in children with mild and moderate asthma. OBJECTIVE: The interrelationship between asthma severity and neurocognitive functioning among 1041 children (age range, 5-12 years) enrolled in the CAMP trial was examined. METHODS: Asthma severity was established at baseline with a clinical history of asthma symptomatology and measures of lung function (spirometry and methacholine challenge). Diary cards were used in a screening to record nighttime awakenings and doctor contacts caused by asthma symptoms, symptom severity, and number of puffs from a rescue inhaler. All children received a comprehensive neurocognitive assessment at the end of the 28-day screening period (before randomization), including measures of intelligence, attention, memory, and academic achievement. RESULTS: Significant differences were found between children with mild and moderate asthma on lung function and symptom outcome variables (log(e)FEV(1)PC(20), DeltaFEV(1) percent predicted, change in peak flow percent predicted, nighttime awakenings caused by asthma, average symptom severity score, and average daily number of puffs from a rescue inhaler) but not on neurocognitive variables. Multiple regression analyses revealed that asthma outcomes could not be predicted by neurocognitive variables despite controlling for socioeconomic status. The prevalence of neurocognitive dysfunction, as indicated by the use of psychostimulant medication, was found to be consistent with that found in the existing literature. CONCLUSION: Mild and moderate asthma symptoms are not related to neurocognitive functioning in the children enrolled in CAMP. Mean performance on neurocognitive variables was found to be similar to that of national normative data.

Asthma↗