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History of the calorie in nutrition.

The calorie was not a unit of heat in the original metric system. Some histories state that a defined Calorie (modern kcal) originated with Favre and Silbermann in 1852 or Mayer in 1848. However, Nicholas Clément introduced Calories in lectures on heat engines that were given in Paris between 1819 and 1824. The Calorie was already defined in Bescherelle's 1845 Dictionnaire National. In 1863, the word entered the English language through translation of Ganot's popular French physics text, which defined a Calorie as the heat needed to raise the temperature of 1 kg of water from 0 to 1 degrees C. Berthelot distinguished between g- and kg-calories by 1879, and Raymond used the kcal in a discussion of human energy needs in an 1894 medical physiology text. The capitalized Calorie as used to indicate 1 kcal on U.S. food labels derives from Atwater's 1887 article on food energy in Century magazine and Farmers' Bulletin 23 in 1894. Formal recognition began in 1896 when the g-calorie was defined as a secondary unit of energy in the cm-g-s measurement system. The thermal calorie was not fully defined until the 20th century, by which time the nutritional Calorie was embedded in U.S. popular culture and nutritional policy.

Calorimetry↗

Post-viral fatigue syndrome. Epidemiology: a critical review.

Numerous reports in medical journals, lay magazines, and newspapers bear witness to the level of interest in the postviral fatigue syndrome and the heated controversy about the true nature of this condition. For many, it represents a 'rag bag' diagnosis into which unsolved diagnostic problems are discarded. Others are in no doubt that there is a discrete syndrome, probably with a specific causation. The real answer almost certainly lies somewhere in between, but the truth can only be established through epidemiological studies designed to answer key questions. Does it exist at all, and, if so, how frequently does it occur? Who is most likely to get it and what is its cause? What is the nature of its implied association with viral infections and what is the role of other frequently postulated factors, such as psychiatric morbidity? What is its natural history and is there any evidence that any of the treatment/management regimes on offer can effectively lead to symptomatic relief or improve prognosis? In this chapter, we consider the evidence on these key questions, identify some of the deficiencies in our current knowledge and highlight the kind of research which is still required.

Epidemiologic Methods↗

Consumer poultry meat handling and safety education in three Texas cities.

Shifting demographics, increased poultry consumption and a general ignorance concerning food safety measures provide the potential for increased foodborne illness. In order to determine where food safety educational efforts would be most effective and the needed content of the messages, a survey addressing poultry preparation, storage and thawing methods, and sources of food safety education was constructed and distributed in supermarkets in three Texas urban centers. Between 60 and 67% of consumers prepared poultry once or twice per week. A majority of Hispanics (57%), minors (79%) and uneducated (55%) respondents thaw poultry outside of the refrigerator, either on a counter, in a microwave, or in a sink of water. A majority of Caucasians receive food safety information from either magazines (52%) or television (60%), whereas minors receive education mainly from the educational system (57%) or family (71%). Through increased education in these areas, good food safety habits may be increased in those target groups, especially the next generation of consumers.

Animals↗

Declines in tobacco brand recognition and ever-smoking rates among young children following restrictions on tobacco advertisements in Hong Kong.

BACKGROUND: We compared the recognition of tobacco brands and ever-smoking rates in young children before (1991) and after (2001) the implementation of cigarette advertising restrictions in Hong Kong and identified continuing sources of tobacco promotion exposure. METHODS: A cross-sectional survey of 824 primary school children aged from 8 to 11 (Primary classes 3-4) living in two Hong Kong districts was carried out using self-completed questionnaires examining smoking behaviour and recognition of names and logos from 18 tobacco, food, drink and other brands common in Hong Kong. RESULTS: Ever-smoking prevalence in 2001 was 3.8 per cent (1991, 7.8 per cent). Tobacco brand recognition rates ranged from 5.3 per cent (Viceroy name) to 72.8 per cent (Viceroy logo). Compared with 1991, in 2001 never-smoker children recognized fewer tobacco brand names and logos: Marlboro logo recognition rate fell by 55.3 per cent. Similar declines were also seen in ever-smoker children, with recognition of the Marlboro logo decreasing 48 per cent. Recognition rates declined amongst both boys and girls. Children from non-smoking families constituted 51 per cent (426) of the sample, whereas 34.5 per cent (284), 8.5 per cent (70), 1.7 per cent (14) and 4.4 per cent (36) of the children had one, two, three or more than three smoking family members at home, respectively. Tobacco brand recognition rates and ever-smoking prevalence were significantly higher among children with smoking family members compared with those without. Among 12 possible sources of exposure to cigarette brand names and logos, retail stalls (75.5 per cent; 622), indirect advertisements (71.5 per cent; 589) and magazines (65.3 per cent; 538) were ranked the most common. CONCLUSION: Advertising restrictions in Hong Kong have effectively decreased primary-age children's recognition of tobacco branding. However, these children remain vulnerable to branding, mostly through exposure from family smokers, point-of-sale tobacco advertisement and occasional promotions. Action to curb these is now required.

Advertising↗

So-called accidental firearm fatalities in children and teenagers in Tennessee, 1961-1988.

Tennessee State medical examiner reports of firearm fatalities classified as accidents involving victims aged 19 year or less from 1961 through 1988, were reviewed to evaluate circumstantial and contributing factors. A total of 225 were analyzed. The peak age for victims was 17 years, and there were more than five times more male than female victims. In Shelby County (Memphis), the racial distribution of fatalities was approximately that of the general population. Playing with a gun was the most frequent circumstance. The person responsible for pulling the trigger was equally likely to be a friend, a family member, or the victim. Head or neck were injured in most cases. The urban mortality rate was nearly twice that of the rural rate. More than half of the deaths in urban counties occurred indoors and involved handguns, whereas in rural counties only a third were due to handguns and the location was more often outdoors. Deaths in rural counties showed a seasonal variation that corresponded with the hunting season; by contrast, a peak in early summer was noted in the urban deaths. Defective guns or guns unsafe in design caused several deaths. (Semiautomatic pistols, which can be fired after unloading the ammunition magazine, are conspicuous examples of guns unsafe in design.) An important observation of this study is that medical examiners vary considerably in their classification of accidental manner, particularly when children are involved. Furthermore, medical examiner reports need to include much more information than is currently recorded if they are to be useful in guiding public policy to reduce firearm injuries.

Accidents↗

Enhancing knowledge of colorectal cancer among African Americans: why are we waiting until age 50?

Because of low rates of colorectal cancer screening among African Americans, it may be beneficial to begin educating persons about this disease before age 50. Using the Patient/Provider/System Theoretical Model for cancer screening, this study compared knowledge of colorectal cancer, sources of information, and awareness of programs among participants of age 20-29, 30-49, and 50-75 years. The majority (n = 354) were women and African American (mean age = 37 years, mean education = 12th grade). Younger participants tended to know less about the disease, but there were few differences in knowledge between the two older groups. Persons in the 40-49-year age group were more likely to be familiar with the role diet plays in the risk of colorectal cancer. Participants associated the need for screening with the presence of symptoms. Television and radio were listed as the most frequent source of information about cancer. The Internet was the least used. The majority were not familiar with selected national programs and services focused on increasing awareness of cancer. Findings suggest that colorectal cancer-related information should be targeted toward this population before age 50, using multiple sources such as TV/radio, providers, magazines, and cancer-related organizations. An estimated 104,950 colon and 40,340 rectal cancer cases will be diagnosed in 2005 with an estimated 56,290 deaths from the disease (American Cancer Society [ACS], 2005). Despite a stabilization of colorectal cancer (CRC) incidence rates since the 1980s, African American males and females have higher incidence and mortality rates associated with this disease compared to Whites. The 5-year survival rate for CRC among African Americans improved to 54% during the years 1995-2000, but lagged well behind the 64% survival rate for Whites during the same time period. Screening and early detection of CRC followed by effective treatment is crucial to reducing these mortality rates.

Adult↗

America's best medical schools: a critique of the U.S. News & World Report rankings.

Rankings of American medical schools published annually by the news magazine U.S. News & World Report are widely used to judge the quality of the schools and their programs. The authors describe and then critique the rankings on methodologic and conceptual grounds, arguing that the annual U.S. News medical school evaluation falls short in both areas. Three categories of program quality indicators different from those used by U.S. News are presented as alternative ways to judge medical schools. The authors conclude that the annual U.S. News & World Report rankings of American medical schools are ill-conceived; are unscientific; are conducted poorly; ignore medical school accreditation; judge medical school quality from a narrow, elitist perspective; and do not consider social and professional outcomes in program quality calculations. The medical school rankings have no practical value and fail to meet standards of journalistic ethics.

Bias↗

A tailored minimal self-help intervention to promote condom use in young women: results from a randomized trial.

OBJECTIVE: To evaluate the efficacy of a theory-based tailored minimal self-help intervention to increase condom use among young women at risk for HIV/sexually transmitted disease (STD). DESIGN: Randomized controlled trial on an intent-to-treat basis in two managed care plans, in Washington state and North Carolina, with follow-up at 3 and 6 months. PARTICIPANTS: A proactively recruited sample of 1210 heterosexually active, non-monogamous, non-pregnant women, aged 18-24 years recruited June 1999-April 2000; 85% completed the 6-month follow-up. METHOD: Arm 1 received usual care. Arm 2 received a mailed computer-generated self-help magazine, individually tailored on survey items including stage of readiness to use condoms, barriers to condom use, partner type; condom samples and a condom-carrying case were included in the packet; this was followed 3 months later by a tailored 'booster' newsletter. The a priori 6-month main outcomes were percentage of women using condoms during the previous 3 months (overall and by partner type) and proportion of total episodes of intercourse during which condoms were used in the previous 3 months. RESULTS: Relative to usual care, intervention group women reported significantly more condom use overall [adjusted odds ratio (OR), 1.86; 95% confidence interval (CI), 1.32-2.65; P = 0.0005] and with recent primary partners (OR, 1.97; 95% CI, 1.37-2.86; P = 0.0003). They also reported using condoms for a higher proportion of intercourse episodes (52.7% versus 47.9%; P = 0.05). Significantly more intervention women carried condoms, discussed condoms with partners, and had higher self-efficacy to use condoms with primary partners. CONCLUSIONS: Tailored cognitive/behavioral minimal self-help interventions hold promise as HIV/STD prevention strategies for diverse populations of young at-risk women.

Adult↗

Candidate selection and psychosocial considerations of in-vitro fertilization procedures.

The psychological impact of the new reproductive technology should not be understated. The history of infertility treatment and failure to achieve pregnancy that most couples bring to the program, along with their hopes and expectations for success, makes them extremely vulnerable to anxiety, unrealistic expectations, and grief reactions. When a cycle of IVF fails, the intensity of the experience and the disappointment may be overwhelming for a while, but most couples are willing to try it again. One patient wrote about her feelings after IVF treatment after having read comments in a popular magazine which implied that medical science was taking control of reproduction. Those of us who go through in-vitro fertilization think long and hard about what we are doing. Most of us weigh the pros and cons very thoroughly. We weigh the risks to our potential children just as people who have genetically linked diseases do before they conceive. (Our fetuses are not "bombarded" by ultrasound procedures any more than many other pregnant women's fetuses are these days.) Most of us are thankful that the technology is now available to us, if we choose to participate. Physicians who work with IVF patients do realize that the procedure is stressful. Often the stress is viewed as primarily the patients', and we are asked to study the level of stress. To a large extent that is the subject matter of this chapter. Nevertheless, the stress is perceived because the physicians and staff are also under stress. The failure of an IVF cycle is immediately known to the health care givers.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

A synopsis of urban firearm ballistics: Washington, DC model.

Although current statistics are available pertaining to weapon retrieval rates, the evolution of ballistics in most metropolitan areas has not been critically examined and correlated with the resultant impact on public health. Of special concern to law enforcement agencies and urban Level 1 trauma centers is the unabated increase in the availability of firearms with accelerated firepower capable of increased kinetic energy and reduced time to exhaust the weapon's magazine. The firearms statistics from the Washington, DC area were examined retrospectively by review of the records of the Firearms and Toolmark Examination section of the Metropolitan Police Department. The data from 1999 indicate that 57% of the firearms confiscated during criminal apprehension and prosecution were semiautomatic weapons. However, 51% of the firearms recovered during amnesty programs were revolvers and 23% were semiautomatic weapons. In the District of Columbia, during a 4.5-month period in 1999, the cost of medical treatment of patients with gunshot wound injuries averaged 15,000.00 US dollars per patient with costs of rehabilitation reaching an estimated 40,000.00 US dollars per patient.

District of Columbia↗

A poll of radiation health scientists.

A sampling of 210 university-employed radiation health scientists randomly selected from the membership lists of the Health Physics Society and the Radiation Research Society was polled in a secret ballot. The results support the positions that the public's fear of radiation is substantially greater than realistic, that TV, newspapers and magazines substantially exaggerate the dangers of radiation, that the amount of money now being spent on radiation protection is sufficient, and that the openness and honesty of U.S. government agencies about dangers of radiation were below average before 1972 but have been above average since then. Respondents give very high credibility ratings to BEIR, UNSCEAR, ICRP, and NCRP and to the individual scientists associated with their reports, and very low credibility ratings to those who have disputed them.

Costs and Cost Analysis↗

Help seeking and satisfaction with care in 641 women with eating disorders. I. Patterns of utilization, attributed change, and perceived efficacy of treatment.

Help-seeking patterns and satisfaction with care were described by 641 women with eating disorders participating in a national magazine survey. Between 60.6% and 92.9% of respondents in three diagnostic groups sought professional treatment. Professional treatments most often entered were individual psychotherapy (52.9%), behavioral therapy (28.0%), group therapy (24.6%), and nutritional therapy (18.6%). Treatments were generally seen as helping "a little." Only bulimic anorexia nervosa respondents perceived any interventions to be more harmful than helpful, specifically Overeaters Anonymous and self-help groups, both nonprofessional interventions. Caregivers selected as "experts" regarding eating disorders were rated as more efficacious than others, helping "a little" to "somewhat."

Anorexia Nervosa↗

Handgun safety features: a review for physicians.

OBJECTIVE: Handguns are a ubiquitous consumer product in the United States, which annually cause significant morbidity and mortality. Handgun safety devices are often proposed as potential solutions to this problem. Their effectiveness at reducing handgun injuries and deaths is intensely debated. However, to effectively analyze the potential utility of handgun safety devices, physicians need to be aware of the safety devices available in the consumer market and how they operate. METHODS: A wide variety of safety devices are available in the consumer market, which vary in terms of their ease of operation, cost, and the types of injuries they may prevent. We reviewed several types of handgun safety devices, including loaded chamber indicators, manual thumb safeties, grip safeties, magazine disconnectors, drop safeties, built-in locks, trigger locks, lockboxes, and personalized handguns. Each device is described within the context of reducing unintended discharge and unauthorized use. RESULTS: This review is not exhaustive. There are other types of safety devices that limit access to handguns. Many of these devices, such as barrel locks and chamber locks, work in a similar manner as trigger locks and have the same limitations. The user of any type of safety device should think about the types of injuries the device is designed to prevent and be aware of its limitations. CONCLUSION: Physicians have the potential to reduce the risk of firearm injuries with their patients and communities. Providing accurate information on firearm safety devices and their limitations is important, just as it is for other aspects of health care advice. Armed with accurate information, physicians can hopefully be effective in firearm injury prevention.

Firearms↗

A segmentational analysis of prescription drug information seeking.

Drug information-seeking proclivities were examined using data from a telephone survey of 835 individuals who had obtained new outpatient prescriptions within the previous 4 weeks. Factor analytic and clustering techniques were used to segment patients based on the source and nature of drug information received in conjunction with the prescription. A four-cluster solution appeared to represent the most stable, distinct, yet homogeneous solution for the data. The groups were named "physician reliant" (40%), "pharmacist reliant" (19%), "questioners" (7%), and "uniformed" (34%). The four groups were compared for demographic, situational, and attitudinal differences. The physician-reliant group appeared most satisfied with the direct counseling of the doctor. Although this group may have sought additional information, the information appeared to reinforce the physician's directions. The pharmacist-reliant group often obtained prescriptions at independent pharmacies and tended not to rely on magazines or reference books for additional information. The questioners were often taking multiple medications. This group tended to seek out reference information from nonprofessional sources and reported several barriers to seeking information from professionals. The uninformed group was the oldest, tended to receive little information, and was more likely than the other groups to agree that one need not ask questions if one trusts the doctor. Different types of patient education programs were recommended as appropriate for each of the four groups. Motivational messages directed to the uninformed segment appeared to be the largest unmet need in patient-oriented prescription drug education.

Adult↗

Physician advertising revisited.

This article examines the determinants of physician advertising using a nationally representative sample of 2,573 self-employed physicians. In contrast to a previous study by Folland, this article identifies a number of physician characteristics that are strongly related to the advertising decision. In particular, female physicians and foreign medical graduates (FMGs) are significantly less likely to advertise than are males and non-FMGs, respectively. Board certified physicians are less likely to advertise than are uncertified physicians. Also in contrast to previous results, primary care physicians are not necessarily more likely to advertise than nonprimary care physicians. For example, advertising propensity is strongest among plastic surgeons, whereas the propensity to advertise in such primary care specialties as internal medicine and pediatrics are quite close to advertising propensities for general surgeons. Furthermore, the relationship between practice size and advertising propensity is shown to be much stronger than previous research in this area has indicated. Finally, the results suggest that a number of physician characteristics associated with advertising through written media (newspapers or magazines) are also associated with advertising through audiovisual media (television or radio).

Advertising↗

Quest for ideal weight: costs and consequences.

The quest to achieve the ideal weight comes with notable costs. Dieting carries the financial costs of professional consulting, low-calorie foods, books and materials, and diet programming. Club memberships, clothing, equipment, and time all contribute to the cost of exercise. Cosmetic surgery to achieve the desired physique carries a significant financial, and sometimes psychological, burden. Women often pursue thinner bodies despite already being at a healthy weight. This pursuit is motivated primarily to enhance appearance. The ideal body portrayed in the media has stabilized in thinness, but it is becoming increasingly tubular, i.e., taller with slimmer hips and thicker waist. This ideal is presented to adult and adolescent women in their popular magazines, and to little girls with their dolls. Exercise is promoted as an optimal means to achieve the ideal physique. Young American women tend to idealize an athletic body shape, especially with upper-body muscularity. This shape can be attained only through sustained exercise and upper-body strength training. High-level exercise may be a precursor to eating disorders. Women who exercise to excess, who are highly preoccupied with weight, and who are characterized by perfectionism and an obsessive compulsive personality are at risk for eating disorders. When body weight and shape are kept in perspective and realistic goals are set, the physical, psychological, and financial costs of achieving or maintaining a healthy weight may be minimized.

Adolescent↗

Accommodative hysteresis of refractive errors in light and dark fields.

We investigated the accommodative hysteresis of the refractive error in the light and also in the dark in 19 healthy young women. We measured refractive error under light and dark conditions using the Nidek Autorefractometer AR 1600 with its target light on or off. Then we measured refractive error in the light and in the dark again after they performed nearwork. Post-task refractive error was measured after reading a magazine for 15 min wearing glasses -3.0 D over their distance correction. Nearwork produced a myopic shift of 0.21 D in the refractive error in the light but no shift in the refractive error in the dark. Refractive error in the dark increased significantly by the near task in eyes with more than 2.0 D of myopia, but it did not increase in eyes with less than 2.0 D of myopia. These apparent differences in the accommodative hysteresis are due to the different pre-task baseline values. If the post-task refractive error is evaluated with the same pre-task baseline value, the accommodative hysteresis does not differ among different refractive errors whether measured in the light or in the dark.

Accommodation, Ocular↗

"The Reading Assistant": user-friendly technology for the visually impaired.

One important way in which optometry must respond to the needs of persons with visual disabilities is to develop innovative applications of technologies that will allow these people to function productively in the workplace, where their performance depends on the ability to read at reasonable rates: to read such documents as letters, memos, contracts, instruction manuals, newspapers, magazines, and the like. In this paper I will describe one example of such an effort, a system that is being developed jointly by the SUNY College of Optometry, the National Eye Institute, and MerlinVision Industries, Inc., a company in Yorktown Heights, NY. I have an interest in what is reported here: I hold a part-time position as Director of Clinical Research at MerlinVision.

Humans↗