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At least 163 records · Page 9Linked to original sources

Evaluation of stroke performance in tennis.

In the present studies, the Leuven Tennis Performance Test (LTPT), a newly developed test procedure to measure stroke performance in match-like conditions in elite tennis players, was evaluated as to its value for research purposes. The LTPT is enacted on a regular tennis court. It consists of first and second services, and of returning balls projected by a machine to target zones indicated by a lighted sign. Neutral, defensive, and offensive tactical situations are elicited by appropriately programming the machine. Stroke quality is determined from simultaneous measurements of error rate, ball velocity, and precision of ball placement. A velocity/precision (VP) an a velocity/precision/error (VPE) index are also calculated. The validity and sensitivity of the LTPT were determined by verifying whether LTPT scores reflect minor differences in tennis ranking on the one hand and the effects of fatigue on the other hand. Compared with lower ranked players, higher ones made fewer errors (P < 0.05). In addition, stroke velocity was higher (P < 0.05), and lateral stroke precision, VP, and VPE scores were better (P < 0.05) in the latter. Furthermore, fatigue induced by a prolonged tennis load increased (P < 0.05) error rate and decreased (P < 0.05) stroke velocity and the VP and VPE indices. It is concluded that the LTPT is an accurate, reliable, and valid instrument for the evaluation of stroke quality in high-level tennis players.

Adult↗

Factors related to self-concept of elderly residing in a retirement center.

The purpose of this study was to explore the self-concept of elderly adults residing in retirement centers as well as its relationship to other variables, including function of activities of daily living (ADL), subjective well being, etc. Selected demographic attributes (sex, age, years of education etc.) were also examined for their relationship to self-concept. The subjects were a convenience sample of people aged 65 or older who were recruited from a retirement center in the south of Taiwan (N = 42), and a control group of elderly living with their family (N = 33). The Tennessee Self-Concept Scale (TSCS) was used to measure self-concept. The Multidimensional Functional Assessment Questionnaire- Chinese Version (MFAQ) was applied to measure the function of activities of daily living. A total of 37 subjects from the retirement center group and 28 subjects from the home group completed these questionnaires. The data were analyzed using SPSS/PC software version 10.0. After multiple linear regression analysis, the results showed that the elderly residing in the retirement center had significantly lower Personal Self and Family Self scores. The variables of ADL, sex and subjective well-being had effects on the total self-concept. Female elderly individuals also revealed significant higher scores than males in the subscales of Moral- Ethical, Family Self, Social Self, Identity, Satisfaction Self. These results suggest we should design appropriate programs to increase elderly people's interaction with others and establish new social networks for them which may enhance a sense of positive self-concept.

Activities of Daily Living↗

Decubitus ulcers and rehabilitation medicine.

The approach to management of decubitus ulcers is challenging and complex. Management should be targeted to prevention. Many factors will influence the development of ulcers and their healing. These factors include physiologic as well as sociologic elements. The physician's approach must be to consider all potential contributing factors and to translate these into an appropriate program of prevention and education and treatment where necessary. The treatment program should be based on physiologic principles, but should also take into account the full patient and his psycho-social emotional needs. Patient cooperation is very important. With good medical care and full cooperation of the patient, management can achieve a healed wound and a restored patient. If either of these elements are not present, the complications may include chronic local infection with abscess formation, osteomyelitis, sepsis, amyloidosis, and death.

Anemia↗

Barriers to health promotion activities in public hospitals.

Despite the central role hospitals have in the health care system, relatively few health promotion activities are conducted in Australian public hospitals. This study investigated the types of obstacles that were perceived to inhibit health promotion activities in hospitals. A questionnaire for self-completion was sent to medical superintendents in all public hospitals in Queensland and 112 questionnaires were returned (92.6 per cent response rate). The results indicated that lack of finance, lack of interest by relevant others, and needs (for appropriate programs, training and patient receptivity) were the barriers reported by superintendents. The barriers of 'interest' and 'needs' were related to a lack of written policies in some areas, but not directly to levels of other health promotion activities being conducted in the hospitals. Success in facilitating health promotion programs in hospitals will need to include a change in the environment, in particular the views of medical superintendents. The combination of attitude change and the availability of a motivated person (such as a health promotion officer) to lead the activities may be needed in order to produce an increase in the level of health promotion in public hospitals.

Chi-Square Distribution↗

Observations on the psychopharmacology of the aged.

Psychotropic drugs are discussed under the descriptive categories of antipsychotic, antidepressive, antimanic, anti-anxiety, and cognitive acting. In the antipsychotic classification, special attention is given to side effects (extrapyramidal motor signs, tardive dyskinesias, akathisis) and to dosage for the elderly. The section on congenitive acting drugs includes some pertinent observations on cognitive ability in the aging, the importance of correct diagnosis, and therapeutic strategy. The aged are a population at risk for not only disease, but iatrongenic illness due to direct and indirect drug action. Rational therapy involves understanding the underlying dynamics of the disease and thus the selection of the most effective treatment. Psychotropic drugs in an appropriate program are valuable therapeutic assets.

Aged↗

One-year follow-up of automatic adaptation of the rate response algorithm of the QT sensing, rate adaptive pacemaker.

Optimal functioning of a rate adaptive pacemaker depends upon reliable sensing of the sensor and appropriate programming of the rate of response algorithm. QT sensing pacemakers use data derived from the endocardial electrogram in the programming of the rate response algorithm. In the latest versions of these pacemakers, programming of the rate response algorithm may be performed using either a semiautomatic Fast Learn (FL) procedure or by using the newly developed, fully Automatic Slope Adaptation (ASA) mechanism. We report our experience in a prospective study of 17 patients in the first year postimplantation. ASA was characterized by significant changes only in the values of the slope settings at the lower rate limit (3.7 msec/msec at time 0 to 5.77 msec/msec at 2 weeks, P less than 0.001) during the first 2 weeks after its enablement. Further adaptation between weeks 2 to 4 was observed (5.77 msec/msec to 6.4 msec/msec, P = 0.2) but this was not significant. The slope settings derived using the FL procedure were also checked at 2 and 4 weeks and were reproducible. They were closest in value to the values attained by the automated mechanism at 4 weeks. This suggests that the final value of the slope setting at the lower rate limit using ASA is reached between weeks 2 to 4. Both methods of slope determination result in satisfactory and similar rate response profiles but the time to achieve slope stability will necessarily be slower with ASA.

Algorithms↗

Age and sex related changes in heart rate to ventilation coupling: implications for rate adaptive pacemaker algorithms.

Minute ventilation (VE) controlled rate adaptive pacemakers determine the paced rate increase during exercise by measuring changes in transthoracic impedance that have been shown to correlate well with VE. To determine the normal coupling of heart rate (HR) to VE this relationship was evaluated in 30 younger and 25 older, healthy subjects using peak cardiopulmonary exercise testing. After determining the anaerobic threshold (AT), the linear HR to VE slope was determined both below and above the AT. In addition, the entire curve of the HR to VE relationship was assessed by a "best fit" regression analysis method. The relationship of HR to VE was more often logarithmic in younger as compared to older subjects. The HR to VE slope below the AT was always steeper than above the AT in younger subjects. Females of both age subgroups demonstrated a significantly greater slope below and above the AT. For the appropriate programming of VE controlled, rate responsive pacemakers, one should take into consideration age- and sex-specific differences in the HR to VE relationship throughout exercise. Therefore, age- and sex-specific programmable features for rate responsive parameters should be incorporated into pacemakers using VE controlled rate adaptive algorithms.

Adult↗

Creating a community of caring for families with special needs.

When parents are faced with the realization that their child has a disability or chronic illness, life is significantly changed. There can be tremendous emotional and economic stress as families seek diagnosis and treatment and face a bewildering search for appropriate programs. Uncertainty about the future and frustration with the present often leave caregivers overwhelmed. For these fragile families, a philosophy of family-centered care in their community is important. Ideally, this seamless system should offer continuity of care from birth through the childhood years and bridge medical, educational, and social services. Only in this environment can we assure that we are saving not only the infant but also the family.

Child↗

Malignant lymphoma of the gastrointestinal tract. Erskine Memorial Lecture, 1979.

This paper reviews the literature concerning malignant lymphoma of the gastrointestinal tract. The diagnosis, pattern of dissemination, histologic data, prognosis, and results of treatment are discussed. The results suggest that localized lymphoma of the gastrointestinal tract is compatible with long-term survival and possible cure. A more careful look at the staging of the disease is warranted, as well as the development of appropriate programs of surgery, chemotherapy, and radiotherapy to maximize the potential for control of the disease while minimizing damage to normal tissue.

Adolescent↗

Overview: deinstitutionalization of psychiatric patients, a critical review of outcome studies.

The authors performed a critical review of experimental studies on the outcomes for psychiatric patients of 1) alternatives to hospital admission, 2) modifications of conventional hospitalization, and 3) alternatives to continued long-term hospitalization. The internal validity of many of the studies was compromised by shortcomings in design and performance and generalizability limited by selection of patient populations. With these qualifications experimental alternatives to hospital care of patients have led to psychiatric outcomes not different from and occasionally superior to those of patients in control groups. This conclusion is best supported for alternatives to admission and for modifications of conventional hospitalization. The available studies do not permit firm conclusions regarding alternatives to continued long-term hospitalization of chronically ill patients or for a critical analysis of the optimal management of specific subpopulations of psychiatric patients. Satisfactory deinstitutionalization appears to depend on the availability of appropriate programs for care in the community.

Adult↗

Depression and the ability to work.

OBJECTIVE: Depression can have a serious impact on a person's ability to work. The purpose of this study was to describe depressed persons who work and depressed persons who do not work and to identify factors related to depressed persons' working. METHODS: The combined 1994 and 1995 National Health Interview Survey Disability Supplement was used to identify persons aged 18 to 69 with depression. Sociodemographic, health, functional, and disability characteristics of working depressed persons and nonworking depressed persons were compared with use of a chi square test of significance. After adjustment for sociodemographic variables, multiple logistic regression analysis was used to identify factors associated with work among depressed persons. RESULTS: Approximately half of the persons who reported major depression were in the labor force. Compared with nonworking depressed persons, working depressed persons tended to be younger, to be male, to be better educated, to have a higher income, to live alone or with a nonrelative, and to live in an urban or suburban location. They less often perceived themselves as unable to work or as disabled and were healthier and less impaired by social, cognitive, and physical limitations than their nonworking counterparts. After sociodemographic factors were controlled for, health and functional characteristics were strongly associated with depressed persons' working. CONCLUSIONS: Depressed persons who work and who do not work differed across sociodemographic, health, functional, and disability factors. Understanding the factors associated with depressed persons' working and not working may help policy makers, employers, and clinicians shape health care benefits packages, employee assistance programs, disability programs, and treatment programs appropriately. In particular, it may be important to focus on individuals with depression and comorbid general health conditions.

Adolescent↗

Towards better nutrition: lip service or a realistic fight?

Progress towards the objective of the World Food Conference of 1974 that "no child should go to bed hungry" is reviewed. The low market price of primary products keeps developing countries poor. Yet in these countries industry rather than agriculture has been supported by governments. All regions are increasing total food production but population growth threatens to offset this increase. In some areas there is decrease in food production per head of population. In many countries the social situation of women affects the nutrition of families. Other causes of malnutrition are discussed and future policies are recommended.

Africa↗

Potential for community relocation among residents of Alberta's psychiatric facilities: a needs assessment.

OBJECTIVE: To identify the proportion of residents in Alberta's psychiatric hospitals who would be relocatable to community-based alternatives to care if appropriate programs were made available. METHODS: A Survey of a representative sample of residents in all psychiatric hospitals and care centres was undertaken, excluding patients in specialized programs for forensic psychiatry, brain injury, and substance abuse. RESULTS: Findings indicate that 11% of institutionalized patients could be considered good candidates for relocation to community-based alternative care. A further 35% were considered to have potential for relocation provided an intensive and complex array of services was first made available. CONCLUSION: Results support a phased-in approach to hospital downsizing and the need for considerable transitional funding. Because hospital downsizing is unlikely to save dollars, at least in the short term, reforms must remain guided by humanitarian motivations to improve quality of life for persons with severe and persistent mental illnesses.

Activities of Daily Living↗

Satisfaction of senior citizens in a nutrition education program with and without computer-assisted instruction.

This study assessed the receptiveness of senior citizens to the use of microcomputers in a nutrition education program at participating senior citizen subsidized housing sites. Participants in group A received the nutrition education program with computer-assisted instruction (CAI). Group B participants received the same nutrition education program, but without CAI. A validated Program Satisfaction Questionnaire was administered to assess overall satisfaction, satisfaction with the method of instruction, and satisfaction with the dietary analysis printout. Independent t-test analysis showed that group A was as satisfied as group B. The majority in group A indicated that learning to use the computer was not difficult and was "somewhat enjoyable" to "very enjoyable." These results indicated that senior citizens were receptive to CAI. Additionally, the use of the microcomputer with older adults was deemed possible for health-related educational programming. Appropriate modification of software was recommended to meet the physical limitations which occur with this age group.

Aged↗

Health policy and implementations in Tanzania.

This paper describes the current health policy in Tanzania and its implementations. The present health policy in Tanzania originated from Arusha declaration of 1967, the country's most popular national policy after independence. Arusha declaration proclaims socialism and self-reliance, which has had important impact on the form and content of the present country's health policy in mainland Tanzania. Much of the wide-spread health care services infrastructure that is evident now in rural areas of Tanzania mainland is a result of the re-emphasis of the Arusha declaration in 1971. In Tanzania, the Ministry of Health has the responsibility for elaborating the health policy, ensuring that strategies and appropriate program are developed to give effect to the policy. In the present health policy discussed, the goal is seen to have shifted from having one dispensary in each village to one primary health unit in each village. One dispensary is intended to serve several villages together. In Tanzania, according to the present health policy, the village primary health care are mainly preventive oriented and only being managed by short term trained health staff. The candidate for training in each village is selected, among the village residents, by the villagers themselves. The primary health care system adopted by Tanzania is viewed as the only way through which it can achieve the social goal of health for everyone by the year 2000, provided the present political will which is evident continue, and enough availability of, human, financial and material resources.(ABSTRACT TRUNCATED AT 250 WORDS)

Delivery of Health Care↗

Vestibular evoked responses in man: methodological aspects.

We have developed a stimulation method where the subject is sitting and the head is rotated with shock bursts elicited by a shaker with a repetition rate of 2 Hz. The head movement is monitored with an accelerometer mounted on the cheek by a head band. The maximum amplitude of the head movement is 3 degrees. The electrodes were places on vertex with a negative electrode on the mastoid. During stimulation, 90 dB white noise was applied to the ears to mask the noise generated by the stimulus. We recorded following responses: i) VER from ipsilateral ear, ii) VER from contralateral ear, iii) eye movement with EOG, and iv) movement of the head. Amplification and averaging of the signal were made with an evoked response recorder (Nihon Kohden, Neuropac four). From 200 to 2,000 averaged responses were collected and stored for further analysis on a floppy disc. During second stage filtering the data were fed into a microcomputer where appropriate programs were used to eliminate the EMG and movement artifacts.

Acceleration↗