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PubMed1991

Effect of exercise on muscle function decline with aging.

As people age, changes in muscle occur that are associated with a decrease in strength and endurance. These changes result in decreased functional capacity and quality of life. A substantial portion of this decrease is the result not of aging but of the sedentary life-style so frequently associated with aging. In "healthy old" persons and in older animals in experiments, an appropriate exercise program can result in increased strength and endurance. This is true both in longitudinal and short-term studies. As physical impairment increases, the exercise program must be individualized, and results are not as readily predictable. Much work remains before we may be certain how much exercise can be tolerated in these more impaired persons and what the effects may be.

Aged↗
PubMed1991

Major infectious diseases causing excess morbidity in the Hispanic population.

Current data indicate that there are a number of infectious diseases, ie, acquired immunodeficiency syndrome/human immunodeficiency virus infections, cysticercosis, hepatitis A, syphilis, tuberculosis, and typhoid fever, among others that cause disproportionately increased morbidity in Hispanics. The greater rate of poverty with its associated socioenvironmental problems, increased barriers to health care, and importation of infectious diseases endemic in the mother country are some of the major reasons that probably account for this disparity in disease burden in Hispanics. This formidable health problem can be addressed by targeting efforts at improving health education of family units and communities, environmental improvements, elimination or reduction of barriers to health care management and disease prevention, and appropriate screening programs. A comprehensive and uniform assessment of the impact of infectious diseases on Hispanics (and other minorities) in this country remains elusive, but is of paramount importance in establishing priorities and effective/efficient strategies to address this issue.

Adult↗
PubMed1990

Pulmonary rehabilitation.

Any COPD patient with symptoms is a candidate for pulmonary rehabilitation. A careful assessment of the individual to determine the patient's precise disease process and needs is essential to outlining an appropriate treatment program. Following the sequence described in the ATS Statement on Pulmonary Rehabilitation included in the appendix to this article provides the best potential for successfully returning the patient to the highest level of function possible. An increase in the availability of pulmonary rehabilitation programs should allow more COPD patients to participate in this process, resulting in an enhanced ability to carry out daily activities, an improved quality of life, and a reduction in the long-term costs of caring for such individuals.

Combined Modality Therapy↗
PubMed1990

Direct selenium determination in human whole blood by graphite furnace atomic absorption spectrometry with deuterium correction using a L'vov-platform, a Pd/Mg matrix modification and appropriate dilution.

A mixture of palladium/magnesium nitrate was used as matrix modifier in graphite furnace atomic absorption spectrometry for the direct determination of selenium in human whole blood Addition of HCl up to 0.2 M, a twenty-five fold diluted sample and an appropriate furnace program are necessary to eliminate the interference of iron. Reproducibility of less than 3% at the 95 micrograms/L level, a detection limit of 10 micrograms/L and good accuracy, as determined by intercomparison runs and recovery of spiked samples, are obtained. The proposed method can be used for analysing 4 blood samples per hour.

Deuterium↗
PubMed1990

Trauma in the workplace. An overview.

To attenuate the incidence of occupational deaths and injuries, which occur at a rate of approximately 25 deaths and 10,000 injuries daily, occupational health nurses must focus on injury control for the entire population of workers. Knowledge of the mechanics of injury and populations at risk for various types and severities of injuries is essential to developing injury prevention programs and appropriately responding to emergent injuries. The lack of a comprehensive and reliable surveillance method has been described as a major obstacle in evaluating the occupational injury problem, as well as measuring progress toward achievement of the 1990 Objectives in Occupational Safety and Health. Variations in the estimates have been attributed to different methodologies used in collecting surveillance data, including diverse definitions, inclusion criteria, and data sources. Lost workdays due to injuries reported for 1983 cost an estimated $33.4 billion in direct and indirect costs. Mining, construction, agriculture, and transportation are the most hazardous industries in terms of both fatalities and injuries. Activities appropriate for the occupational health nurse in preventing injury include retrospective analysis of injury patterns and costs, proactive inspection of the workplace for high risk factors, preplacement screening of workers, ergonomic analysis of jobs, evaluation of the type and use of personal protective equipment, provision of safety training, and collaboration with other agents of the firm in evaluating and designing injury reduction strategies and disaster plans.

Accidents, Occupational↗
PubMed1990

Intraocular pressure-dependent light sensitivity in glaucoma.

The intraocular pressure-dependent light sensitivity of discrete retinal points was measured using the Heijl-Krakau automated light-emitting diode perimeter with an appropriate software program. A total of 300 measurements of light sensitivity were recorded from six retinal points during the test period of 8-10 min; increased intraocular pressure was induced using a Langham scleral suction-cup system. The ocular pulsatile blood flow and the ophthalmic arterial pressure were measured in the same patients. The fluctuation of the light sensitivity was less than 5% over the test period in healthy eyes and remained unaffected by an intraocular-pressure increment of 20 mm Hg; a small decrease of sensitivity occurred at a pressure increment of 30 mm Hg. In glaucomatous eyes the light sensitivity was lower and the fluctuation of the light sensitivity at some but not all retinal points was substantially greater than in the controls. In the glaucomatous eyes, and intraocular-pressure increment of 20 mm Hg increased the fluctuation and decreased the light sensitivity. The pulsatile ocular blood flow was lower in the glaucomatous eyes but not severe enough to be solely responsible for the loss of vision. The coexistence of retinal points with normal and abnormal stabilities of light sensitivity in glaucomatous eyes was consistent with impaired blood flow in the lamina cribrosa.

Adult↗
PubMed1990

[The relationship between early motor stage and hand function recovery six months after stroke].

The prognosis of hemiplegic hand function may reflect intrinsic recovery. Applying the variables of initial neurological loss in the hemiplegic upper extremity to predict the prognosis of hand function will enable therapists to establish the ultimate goals of rehabilitation and to select the appropriate treatment programs. Pinch and grip strength tests, Frenchay arm function test and the nine-hole peg test were used to determine the relationship between the initial Brunnstrom motor stage of the hemiplegic upper extremity and the prognosis of hand function after six months. Forty stroke patients were divided into three groups. Group I was subjects with a motor stage below the Brunnstrom motor stage III in both proximal and distal parts of the hemiplegic upper extremity. Group II was subjects with motor stage below Brunnstrom motor stage III in the proximal part and above stage III in the distal part or vice versa. Group III was subjects with a motor stage above Brunnstrom motor stage III both in the proximal and the distal parts. The results of this study indicated that the prognosis of the Brunnstrom motor stage of the hemiplegic upper extremity generally improved about one or two stages. According to the results of the grip and pinch strength tests, the Frenchay arm function test or the nine-hole peg test, group I patients could hardly use their affected hand functionally. The grip strength and the pinch strength deficits of group I were 93.8% and 91.4% respectively. The grip strength and the pinch strength deficits of group II were 72.1% and 68.5% respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1990

[Skin cancer risk of Israeli workers exposed to sunlight].

To assess the number and types of workers occupationally overexposed to sunlight, we interviewed a national sample of 450 employers in occupational categories involving outdoor work and 5000 of their workers. The workers were assigned to 5 overall risk levels, according to combinations of skin sensitivity to ultraviolet radiation (UVR), total weekly hours of outdoor occupational sun-exposure between 0800 and 1400, and percent of skin surface exposed during outdoor work in the summer. Based on this information it was estimated that out of a total of 379,000 Israeli workers in outdoor occupations, 167,000 (44%) are at increased risk for skin cancer (risk levels 1-3) due to occupational exposure to solar UVR. Their estimated lifetime skin cancer risk is 1.5- to 20-fold higher than that of workers at low or minimal risk levels (4-5). The characteristics of those interviewed with regard to occupation, duration of solar exposure, demographic traits, geographic location, degree of risk awareness and protective measures undertaken, provide a data base for effective intervention to reduce the hazards of occupational solar exposure in Israel. We estimate that an appropriate preventive program may reduce skin cancer in Israeli men to half its current rate.

Humans↗
PubMed1990

Designing a culturally sensitive AIDS educational program for black and Hispanic women of childbearing age.

A disproportionate number of AIDS cases is seen among Hispanics and women. However, there is a lack of knowledge relative to effectively educating and motivating behavioral change among minority women at risk for HIV infection. Using the Health Belief Model as a framework to promote behavioral change, methods for designing a culturally sensitive AIDS educational program that appropriately addresses the needs of a population at risk, are given. A list of national resources relating to AIDS resources for the black and Hispanic community is also provided.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Extracapsular cataract and lens implant surgery in developing countries: keeping it simple.

Extracapsular cataract extraction and posterior chamber lens implantation would be the ideal method of rehabilitating the cataract blind of the developing world. However, these procedures usually have been considered too complex, time-consuming, and "high tech" to be used in these areas of the world. We argue that, in the context of an appropriate support program, they can be performed rapidly and safely using a few simple, manual instruments.

Cataract Extraction↗
PubMed1989

[The mapping information system: an experience in the development of appropriated software for analysis and presentation of information].

The mapping system (SIMAP), is an experience of the Institute of Nutrition of Central America and Panama in developing an appropriate software (programs) for information needs of the countries of the Central American Isthmus. Through its main characteristics: geographic association, easy use, flexible and versatile, SIMAP is a tool that can easily be used for decision-making in the different sectors. The system's main modules are presented in this article as well as some applications where the SIMAP would serve as support in the analysis and interpretation of information.

Adolescent↗
PubMed1989

HIV infection and developmental services for adults.

The achievement of community living and greater personal independence has placed adults with developmental disabilities in a potentially vulnerable position regarding acquisition of HIV infection. Early surveys have identified a limited number of individuals who have become infected. Few states have undertaken planning for assurance of appropriate services. Program managers must consider the diverse educational and ethical issues involved; advisory committees can be of assistance. Strong antidiscrimination measures will be required for the protection of adults with developmental disabilities and HIV infection.

Acquired Immunodeficiency Syndrome↗
PubMed1989

The caregiving role: dimensions of burden and benefits.

Rapidly increasing public expenditures for nursing home care raise the policy question of how to support community care of disabled elderly persons and postpone admissions to nursing homes. It is crucial that research clearly identify the burdens of community caregivers in order to devise appropriate support programs. Data from the Caregiver Survey of the 1982 Long Term Care Survey are used here to understand dimensions of caregiver burdens and benefits, to develop reliable scales, and to identify sources of variation in burden and benefits. Using factor analysis, two dimensions of caregiver burden were identified, including role strain and role conflicts indicated by items comprising Guttman scales. Caregiver characteristics associated with variations in total perceived caregiver burdens, role strain and role conflict include the extent of caregiving work (disabled person's ADL, IADL scores), caregiver resources (age, health status, employment), latent social characteristics (gender), and the need to make adjustments in living (e.g. among employed caregivers, having to change work schedule to care for the disabled person). Caregiver benefits of two types - help with tasks and socio-emotional support - related inversely to objective burden as well as to relationship to the caregiver (spouse/nonspouse, primary caregiver/other).

Activities of Daily Living↗
PubMed1989

Arm exercise training for wheelchair users.

Although individuals with lower-limb paralysis typically use their arms for wheelchair locomotion and exercise training, several factors including the relatively small muscle mass available, as well as deficient cardiovascular reflex responses and inactivity of the venous muscle pump (resulting in hypokinetic circulation), can cause the early onset of fatigue during arm activity. Thus, cardiopulmonary (aerobic) fitness is difficult to develop and maintain; this situation can often be exacerbated by a sedentary lifestyle. The purpose of this paper is to present research related to exercise capability of wheelchair users, arm exercise modes, physical fitness training programs using arm exercise, and newly developed exercise techniques which incorporate combinations of voluntary arm exercise and functional neuromuscular stimulation-induced exercise of paralyzed leg muscles. It is evident that exercise training programs utilizing appropriate techniques can markedly improve the physical fitness, functional independence, and rehabilitation outcome of wheelchair users.

Arm↗
PubMed1989

School functioning and disease severity in boys with hemophilia.

There have been few recent studies investigating the scholastic progress of children with hemophilia. The advent of PL94-142, which ensures an appropriate educational program based on a child's specific learning disabilities, and home Factor VIII therapy, which increases the hemophiliac's school attendance and sense of freedom and control, might have had a positive impact on the academic performance of these patients. We investigated past and current educational functioning of 26 boys with hemophilia, using both parental and teacher reports. Twenty-two of these children were administered reading and math achievement tests. Results indicate that school absenteeism is a continuing problem for these children, with the average hemophiliac missing 18 school days in an academic year (median = 11 school days missed); one child had missed 77% of the year. Although these boys had normal intelligence and made average grades in school, six of the 22 tested performed more than two grade levels below expectations in reading and 10 performed greater than two grade levels below expectations in math. School underachievement did not necessarily correlate with disease severity (as indicated by serum factor level), school absenteeism, or grade point average. Although eight parents indicated that their children had past or current school problems, and teachers reported that greater than 50% of the group received special tutoring or classes for learning disabled students, six out of 22 (27%) performed below expectations in either math or reading and yet had no current individual educational remediation plan.(ABSTRACT TRUNCATED AT 250 WORDS)

Absenteeism↗
PubMedDate not supplied

Cardiovascular disease risk factors in an Indochinese population.

One hundred seventeen Indochinese adults were screened for heart disease risk factors at a San Diego community health facility during December 1986. Two levels of excess risk, moderate-high and high, were categorically defined for blood pressure, total cholesterol, cigarette smoking, and obesity. Overall, 61% were at moderate-high or high risk in at least one category, and 34% were at high risk by these criteria. Systolic blood pressure, diastolic blood pressure, and total cholesterol were positively correlated to age, and ethnicity was a significant covariate for cholesterol, body mass index, and cigarette smoking. The Hmong, compared with other Indochinese, had a significantly lower mean cholesterol level, which remained after adjusting for age and body mass. High rates of cigarette smoking were found among Vietnamese men and young Indochinese men. If confirmed, the high prevalence of heart disease risk factors in Indochinese refugees and immigrants suggests that cardiovascular health education programs are appropriate in Indochinese communities.

Adolescent↗
PubMed1989

Reduction of fresh frozen plasma use with a simple education program.

Fifty-six charts of patients who received 307 units of fresh frozen plasma (FFP) were audited to determine the transfusion practice of this component at our 550-bed regional referral hospital. Forty-six patients (82%) were on the surgical service. Indications for FFP transfusion were poorly documented. Forty-nine patients (87%) lacked evidence of a coagulopathy. An educational program addressing appropriate use of FFP was initiated. Over the course of two years, FFP usage dropped by over 1,000 units annually (46%).

Blood Transfusion↗