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PubMed2001

Quality-of-life assessment of morbidly obese patients who have undergone a Lap-Band operation: 2-year follow-up study. Is the MOS SF-36 a useful instrument to measure quality of life in morbidly obese patients?

BACKGROUND: Quality of life (QoL) was tested in a 2-year postoperative study using the Medical Outcome Study Short Form 36 (MOS SF-36) to assess preoperative and 1 and 2 year postoperative QoL among one group of female patients (group 1, n = 42) and a 2 year postoperative QoL study in a second group of female patients (group 2, n = 9) who underwent a stomach reduction operation involving open surgical placement of a Lap-Band during the year 1997. METHODS: The QoL of 42 patients (group 1) was assessed at most 20 hours before surgery and 1 and 2 years (12 and 24 months) postoperatively using a randomized pre-test/post-test design. The QoL of 9 patients (group 2) was assessed 2 years (24 months) postoperatively using a randomized post-test design only. The results were compared with the standardized Dutch norm datascale. Statistical data were analyzed with SPSS versions 10.0. RESULTS: The placement of a Lap-Band in group 1 resulted in a significant reduction in Body Mass Index (BMI) in the first and second-year follow-up. Mean BMI declined significantly from 40.7 kg/m2 preoperatively to 33.1 kg/m2 at the 1-year follow-up, to 31.3 kg/m2 at 2-year follow-up. In group 2 BMI also declined significantly from 43.0 kg/m2 preoperatively to 34.2 kg/m2 at 1-year follow-up to 32.1 kg/m2 at the 2-year follow-up. Compared to the MOS SF-36 standardized Dutch norm data, a significant improvement in the QoL was seen on the effect variable bodily pain, mental health and general health perceptions in group 1. Although the bodily pain, general health and mental health perceptions increased significantly 2 years postoperatively (group 1) compared with the Dutch standardized norm data, the preoperative general health and mental health perceptions of morbidly obese patients were, like all other preoperative effect variables, not significantly different from the scores on the Dutch standardized norm scale. CONCLUSION: Although other authors found that QoL improves after surgical-induced weight loss, showing significant improvements on patients' perception of their health status, these findings were not confirmed in the present study. The findings show only a significant difference in bodily pain, general health and mental health perception before and after surgical intervention and preoperatively in group 1 compared to the Dutch standardized norm data. Because of small sample size (n = 9), no significant results were found in group 2 compared to the Dutch Standardized norm data. Based on earlier and present findings, further study is recommended to ascertain whether the MOS SF-36 is valid in morbidly obese patients and whether the response set has an influence on QoL studies of these patients.

Adult↗
PubMed1998

Values of mothers of low birth weight infants in the NICU.

The research reported in this article explored the concept of values as operationalized by the mothers of infants requiring neonatal intensive care. In the study, which used an exploratory design, data were collected from mothers (n = 14) of infants admitted to the neonatal unit with a primary diagnosis of low birth weight. Participants were interviewed using a semistructured interview guide. Transcripts were analyzed using the constant comparative method. Four themes illustrating the value perceptions of mothers related to their low birth weight infants and the neonatal intensive care experience were identified. The emergent themes describe the mothers' desire to parent their children and the mothers' values related to the integration of technology and human interaction in the environment of the neonatal intensive care unit.

Adolescent↗
PubMed2006

How well do adolescents determine portion sizes of foods and beverages?

In the present study, we examined how well adolescents (12-13 years) are able to select the correct dietary aid portion sizes after having been shown different food items. We also evaluated the effectiveness of two-dimensional life-size drawings and three-dimensional food models, used as dietary aids in this process. Fifty black children and 42 white children from Johannesburg participated in the study (N = 92). Trained interviewers individually tested each child following a prescribed sequence, throughout. Each participant was shown a plate of actual food of a pre-determined weight. The participant was required to select a two-dimensional drawing, and thereafter a three-dimensional food model, which most closely resembled the real food portion. In this manner, portion size estimation was evaluated with respect to 11 different food items. Correlations between nutrients calculated from actual weight of food portions and estimates ranged from 0.842 to 0.994 (P < 0.0001), indicating a significant positive linear association between the actual and estimated nutrients, using either of the dietary aids. However, findings also suggest that the drawings provided a better estimate of actual energy, fat and carbohydrates than did the food models (with respect to lying within the limits of agreement). On the other hand, the food models were more frequently selected correctly than the drawings. Hence, both methods had advantages and disadvantages. Overall, it was found that there were no gender differences (P < 0.05) when using either the models or drawings to estimate portion size, however, there were significant ethnic differences (P < 0.05). With two exceptions, black children selected the correct aids (drawings and models), more often compared with white children. It is recommended that in dietary interviews undertaken in black children in urban areas one could use either aid; while in white adolescents the use of the food models is recommended.

Adolescent↗
PubMed1993

European consensus statement on the prevention of venous thromboembolism. European Consensus Conference, Windsor, U.K., November, 1991.

Since the Consensus Conference of the National Institute of Health in 1986, the developments in the field of prevention of venous thromboembolism were mainly characterized by a more specific and extended use of new prophylactic agents such as low molecular weight heparins as well as the perception that outpatients may be at risk for thromboembolic complications, too. Therefore, in November 1991, a European Consensus Conference on the prevention of thromboembolism was held in Windsor, UK, in order to analyse the risk constellation of various patient populations and to give recommendations for primary prophylaxis in general surgery, urology, neurosurgery, orthopaedic and trauma surgery, obstetrics and gynaecology and medical patients. In addition, the cost-effectiveness of the various methods was highlighted, and the question of secondary prevention addressed. The meeting was organized under the patronage of the European Economic Commission, and experts from 15 different countries were invited to participate. The conference was organized according to acknowledged guidelines of consensus conference organization, i.e. each expert had to formulate his provisional standpoint, the working documents were compiled by the organizer, and this file was sent to the delegates before the conference. During the first part of the meeting, the delegates presented their views in plenary sessions. Controversial points were discussed in working groups, and the results were discussed in plenary sessions. Consensus or lack of accord was documented and the open questions were formulated in order to be answered by future studies. The published statements and recommendations are based on different levels of evidence.(ABSTRACT TRUNCATED AT 250 WORDS)

Clinical Trials as Topic↗
PubMed2005

Validation of the Children's OMNI-Resistance Exercise Scale of perceived exertion.

PURPOSE: This investigation examined concurrent validity of the Children's OMNI-Resistance Exercise Scale (OMNI-RES) of perceived exertion for 10- to 14-yr-old females (N = 25) and males (N = 25) performing unilateral biceps curl (BC) and knee extension (KE) isotonic exercises. METHODS: The criterion variable was total weight lifted (Wt(tot)), determined separately for females and males during BC and KE. Subjects performed three separate sets of 6, 10, and 14 repetitions for BC and KE at 50% 1-RM. Ratings of perceived exertion for the active muscles (RPE-AM) and overall body (RPE-Overall) were measured during the final repetition. RESULTS: For both female and male groups across the three sets: (a) RPE-AM ranged from 2.9 to 8.3 for BC and 4.5 to 9.6 for KE, and (b) RPE-O ranged from 1.9 to 7.0 for BC and 3.6 to 7.7 for KE. Positive linear regression coefficients ranged from r = 0.72 to 0.88 (P < 0.01) between Wt(tot) and RPE-AM and RPE-Overall for BC and KE in both gender groupings. RPE did not differ between females and males at any measurement point within each set for BC and KE. RPE-AM was greater (P < 0.01) than RPE-Overall in the three sets of BC and KE. CONCLUSION: Findings provided concurrent validation of the Children's OMNI-RES to measure RPE for the active muscle and overall body in 10- to 14-yr-old females and males performing upper and lower body resistance exercise.

Adolescent↗
PubMed1989

Preserved learning and memory in amnesia: intact adaptation-level effects and learning of stereoscopic depth.

Amnesic patients and control Ss performed similarly on 2 memory tests. In Experiments 1A and 1B, amnesic patients exhibited intact adaptation-level effects: An experience lifting and judging a group of weights influenced their judgments of a 2nd group of weights 20-25 min later. The effect did not depend on peripheral accommodation, because Ss used 1 hand during their 1st encounter with the weights and the opposite hand during their 2nd encounter. In Experiment 2, amnesic patients acquired at a normal rate the ability to perceive binocular depth using random-dot stereograms. In both experiments, amnesic patients benefited from recent experience, despite the fact that they could not remember their prior experience accurately. The preserved memory abilities demonstrated here appear to be examples of implicit, or nondeclarative, memory.

Adaptation, Psychological↗
PubMedDate not supplied

Vulnerability and temperament in very low birth weight school-aged children.

The purpose of this study was to investigate parental perception of vulnerability, parental subjective stress concerning children's premature birth, and child temperament in families of very low birth weight (VLBW) and normal birth weight (NBW) children. The subjects were 39 VLBW children and 30 NBW 7-year-old children and their caregivers. Data on child temperament and parental perception of vulnerability was provided by the 69 families. Families of the VLBW group rated their degree of current stress concerning their children's premature birth. There were no differences between the NBW and VLBW caregivers in their perceptions of their child's vulnerability status. Caregivers of VLBW children had significantly lower scores on degree of subjective stress specific to the premature birth than the value reported on the standardization population. Child temperament made a significant contribution to parental perception of child vulnerability status in both VLBW and NBW parents.

Birth Weight↗
PubMed2004

Scaling affordances for human reach actions.

A methodology developed by Cesari and Newell [Cesari, P., & Newell, K. M. (1999). The scaling of human grip configuration. Journal of Experimental Psychology: Human Perception and Performance 25, 927-935; Cesari, P., & Newell, K. M. (2000). The body-scaling of grip configurations in children aged 6-12 years. Developmental Psychobiology 36, 301-310] was used to delineate the roles of an object's weight (W) and distance (D) as well as the actor's strength (S) in determining the macroscopic action used to reach for the object. Participants reached for objects of five different weights placed at 10 distances. The findings of a single discriminant analysis revealed that when object weight is scaled in terms of each individual's strength and reach distance is scaled in terms of each individual's maximum-seated reach distance, a single discriminant analysis was able to predict 90% of the reach modes used by both men and women. The result of the discriminant analysis was used to construct a body-scaled equation, K=lnD+ln(W/S)/36, similar in form to the one derived by Cesari and Newell, accurately predicted the reach action used. Our findings indicate that Cesari and Newell's method can identify a complex relationship between geometric and dynamic constraints that determine the affordances for different reach actions.

Adult↗
PubMed1993

Developmental onset of eating related color-naming interference.

The current study was an investigation into the possible developmental aspects of the "Eating Stroop" effect, as produced by non-eating disordered subjects. The subject pool comprised male and female subjects, ranging in age from 9 to 14 years. Their task was to color-name a series of Stroop arrays, comprising food-related words, body shape-related words, and two sets of neutral matched control words. It was found that there were significant performance decrements for both food and shape-related words with the 14-year-old girls. The results indicated a possible color-naming decrement with food-related words for the 11-year-old girls, but not shape words. No color-naming decrements were found with the 9-year-old group, or the male subjects. The results are interpreted in terms of cultural pressures on women to diet to attain an "ideal" body shape and the different developmental stages at which such pressures exert themselves.

Adolescent↗
PubMed2001

Deficits in haptic perception and right parietal theta power changes in patients with anorexia nervosa before and after weight gain.

OBJECTIVE: Our goal was to investigate whether patients with anorexia nervosa (AN) show deficits in haptic exploration tasks before and after weight gain. METHOD: The haptic exploration tasks consisted of palpating the structure of six sunken reliefs in sequence with both hands, eyes closed. After each exploration, the structure was reproduced on a piece of paper. A 19-channel digital electroencephalogram (EEG; linked ears) was continuously recorded during rest and haptic tasks for 10 AN patients (females, mean age: 15.90) and 10 healthy controls (CO; females, mean age: 16.14). Mean spectral power density was calculated as the mean amplitude of the spectral lines of the theta band (4-8 Hz). The AN patients were examined again after weight gain (T(0) and T(1)). RESULTS: The reproductions submitted by the AN patients were of notably poorer quality than those of the CO. Reproduction quality was unchanged after weight gain and independent of body mass index and intelligence. Mean exploration time was similiar in AN patients and CO. The analysis of spectral EEG power of both groups showed significant decrease in power data in the theta frequency band during haptic exploration compared with the rest intervals. The comparison of the theta power between CO and AN patients during haptic exploration showed major differences between the groups in both T(0) and T(1). Theta power was lower in AN patients than in the CO over the right hemisphere and right parietal regions. DISCUSSION: The quality of reproduction of the haptic stimuli and the theta-power changes indicate a cortical dysfunction and deficits in somatosensory integration processing of the right parietal cortex in AN patients even after weight gain.

Adolescent↗
PubMed2005

Grip forces when passing an object to a partner.

The goal of the present study was to investigate how grip forces are applied when transferring stable control of an object from one person to another. We asked how grip forces would be modified by the passer to (1) control for inertial forces as the object was transported toward the receiver and (2) control for the impending perturbation when the receiver made contact with the object. Twelve volunteers worked in pairs during this experiment. One partner, playing the role of passer, transported an object with embedded load cells forward or held the object at an interception location. The second partner, playing the role of receiver, waited at an interception location or reached toward the passed object. Kinematic results indicated that while passers performed a stereotypical movement, receivers were sensitive to the motion of the object as they reached to make contact. Grip force results indicated that passers' grip forces and grip/load force ratios were variable on a trial-to-trial basis, suggesting that a refined internal model of the passing task was not achieved within the timeframe of the experiment. Furthermore, a decoupling of the temporal and magnitude characteristics of the grip and inertial forces was noted in conditions where passers transported the object toward the receiver. During object transfer, it was noted that passers used visual feedback-based anticipatory control to precisely time initial grip force release, while somatosensory control was used by both the passer and receiver to precisely coordinate transfer rate.

Adolescent↗
PubMed2005

Proactive stability control while carrying loads and negotiating an elevated surface.

In this study, proactive stability control while handling loads and negotiating an elevated surface was examined. Ten young healthy males completed two gait-mode conditions--level walking and negotiating a raised surface. Load-handling conditions were: no load, empty box (reduced visual information), and loaded box (reduced visual information combined with increased inertial load). The lower limb trajectory in the sagittal plane was not modified as a function of reduced visual information or increased inertial load. The step width decreased while stepping over the surface and carrying the loaded box. The trunk pitch angle was biased backwards for both the empty box and the loaded box. When carrying the empty box and negotiating the surface, the trunk pitch range of motion (ROM) increased which may have been a strategy to increase visual exteroceptive information. As increased net trunk pitch could destabilize the system, concurrent stabilizing strategies--decreased gait velocity and reduced net trunk roll velocity--were observed. To meet the equilibrium goals when carrying the loaded box, the trunk pitch ROM and net pitch velocity were reduced during both level walking and surface accommodation. Trunk roll ROM was reduced when carrying the load and negotiating the surface. This study extends our knowledge regarding whole body coordination strategies during anticipatory locomotor adaptations.

Adult↗
PubMed2006

Growth hormone replacement in hypophysectomized rats affects spatial performance and hippocampal levels of NMDA receptor subunit and PSD-95 gene transcript levels.

Clinical studies have demonstrated that growth hormone (GH) promotes learning and memory processes in GH-deficient (GHD) patients. In animal studies, GH also influences the N-methyl-D-aspartate (NMDA) receptor system in the hippocampus, an essential component of long-term potentiation (LTP), which is highly involved in memory acquisition. This study was designed to examine the beneficial effects of recombinant human GH (rhGH) on cognitive function in male rats with multiple hormone deficiencies resulting from hypophysectomy (Hx). The performance of an rhGH-treated group and an untreated control group was appraised in the Morris water maze (MWM). The rhGH-treated group performed significantly better in the spatial memory task than the control animals on the second and third trial days. Further training eliminated this difference between the groups. Hippocampal mRNA expression of the NMDA subunits NR1, NR2A and NR2B, insulin-like growth factor type 1 receptor (IGF-1R), and postsynaptic density protein-95 (PSD-95) was then measured in the animals by Northern blot analysis. The results suggest that there may be a relationship between the NMDA receptor subunit mRNA expression levels and learning ability, and that learning is improved by rhGH in Hx rats. Furthermore, a link between MWM performance and PSD-95 was also suggested by this study.

Animals↗
PubMed1995

Changes in patients' taste acuity after Roux-en-Y gastric bypass for clinically severe obesity.

OBJECTIVE: Patients who have undergone Roux-en-Y gastric bypass (RYGB) for clinically severe obesity often report an aversion to sweet foods and meat. This study was designed to determine whether changes in taste acuity occur after RYGB. DESIGN: This prospective, repeated measures trial evaluated acuity for sweet (sucrose) and bitter (urea) tastes, zinc status, and reported changes in taste perceptions in patients undergoing RYGB for weight reduction. SUBJECTS: Taste acuity and serum zinc level were measured in 14 subjects, 6 men and 8 women (mean preoperative body mass index [calculated as kg/m2] = 60.8 +/- 11.8 and mean age = 38.4 +/- 6 years), before surgery and 6 and 12 weeks after surgery. Inquiries regarding taste preferences were made at each postoperative visit with specific reference to sweets and meat. Serum zinc level was measured at the same visit. A noncontrolled comparison group of 4 subjects who were consuming a very-low-calorie diet also underwent taste acuity testing at similar intervals. MAIN OUTCOME MEASURES: The main outcome measures were recognition taste thresholds, serum zinc levels, and taste preference changes. STATISTICAL ANALYSIS: Analysis of variance with repeated measures over time, Pearson correlation coefficients, and post hoc analysis of variance were used to analyze data. RESULTS: Mean recognition thresholds for sucrose were 0.047 +/- 0.03 mol/L preoperatively and fell significantly to 0.024 +/- 0.01 and 0.019 +/- 0.01 mol/L at 6 and 12 weeks postoperatively, respectively. Overall, there were no significant differences in taste thresholds for urea over time; a significant difference was noted, however, in the pattern of change for urea between patients who reported an aversion to meats and those who did not. Zinc concentrations did not change during the study. APPLICATION/CONCLUSIONS: At 6 weeks postoperatively, all patients reported that foods tasted sweeter, and they modified food selection accordingly. Six patients reported an aversion to meats associated with increased nausea and vomiting. Acuity for sweet and bitter tastes may need to be considered when planning dietary modifications for patients undergoing RYGB.

Adult↗
PubMed1990

Adolescent contraceptive behavior: an assessment of decision processes.

The utility of a rational model of contraceptive use in adolescents was evaluated in a cohort of 325 sexually active adolescents aged 14 to 19 years. Adolescents were interviewed regarding their beliefs about the consequences of using each of four methods of contraception, evaluation of those consequences, perception of the wishes of others regarding use of each method, motivation to comply with those wishes, general attitude toward using the method, view of general social expectations regarding their use of the method, and their intention to use the method during the next year. They were reinterviewed 1 year later to determine actual use. The results support the utility of this model for understanding adolescent behavior. Significant associations were found between intentions to use contraceptive methods and their actual use. Intentions were significantly related to adolescents' attitudes toward using the methods and their perception of social expectations regarding use. General attitudes were significantly related to a summary score reflecting the adolescents' beliefs about specific consequences of use weighted by their evaluations of them. General social perceptions were significantly related to a summary score of perceived desires of specific individuals multiplied by the adolescent's desire to comply with those desires. These findings indicate that physicians can be more effective in clinical practice by querying adolescents about their beliefs and intentions and about their perceptions of significant individuals in their lives.

Adolescent↗
PubMed2003

Number processing after stroke: anatomoclinical correlations in oral and written codes.

Calculation and number-processing abilities were studied in 49 patients with chronic single vascular brain lesions by means of a standardized multitask assessment battery (EC301), as well as through other tasks, testing functions thought to be implicated in calculation such as language, visuo-perceptive abilities, verbal and spatial working memory, planning, and attention. The results show that (1) lesions involving parietal areas-particularly left parietal lesions-are prone to alter calculation processing. A more detailed analysis showed that patients with lesions involving left parietal areas were impaired in both digital (i.e., comprehension and production of numbers written in Arabic code) and oral (i.e., comprehension and production of numbers heard or expressed orally) processing while lesions involving right parietal areas lead to an impairment in digital processing only. However, linguistically related alphanumerical processing (i.e., comprehension and production of numbers written orthographically) was not influenced by parietal lesions. (2) Semantic representations (knowledge of the magnitude related to a given number) as well as rote arithmetical knowledge are also impaired following damage to parietal and particularly left parietal lesions, suggesting that these areas are also implicated in magnitude comparisons and in the retrieval of arithmetical facts. (3) Performance in calculation is highly correlated with language. (4) Moreover, we found a highly significant correlation between performances in oral calculation and verbal working memory, and between written-digit calculation and visuospatial working memory. Performances in regard to visuo-perceptive abilities, planning, and attention were less consistently correlated with calculation. These results stress the close correlation, but relative independence between calculation and language, as well as a dissociated sensitivity of oral and digital processing to brain lesions.

Adult↗
PubMed1992

Selective processing of eating-, shape-, and weight-related words in persons with bulimia nervosa.

The Stroop color-naming task was used to investigate selective information processing in people with bulimia nervosa. Three cards were used: a target card consisting of words related to eating, weight, and shape; a control word card; and the standard conflicting-color card. Thirty-six patients with bulimia nervosa were compared with a group of age-matched female controls. It was found that the amount of disruption caused to color naming by the target card was significantly greater in the bulimia nervosa group than in the female control group, whereas that caused by the color card was similar in the two groups. The Stroop color-naming task may be a useful objective measure of one aspect of the cognitive disturbance of patients with bulimia nervosa.

Adult↗