Poor Physical Condition Research Articles

Life is Movement (Aristotle, 4th century BC).

Life is Movement (Aristotle, 4th century BC).

Predicting the Basal Metabolic Rate in Adolescents: A Correlated (Re)-Analysis

A basal metabolic rate(BMR) that is too low is an indicator of a poor physical condition, and could be one of the reasons for overweight. Measuring BMR though, is a time-consuming exercise, and there has long been interest in developing statistical models to predict BMR from demographic and anthropometric measurements. Poh et al. [1] developed ordinary linear regression models on a cohort of 139 Malaysian children measured three years bi-annually. However, since each child contributed six times to the total data set, these models ignore the correlated nature of the data. We re-analyzed these data using correlated linear models. We show that our approach taking correlation into account is important to establish important covariates, but does not improve prediction. Keywords: Basal metabolic rate; correlated data linear model; linear mixed model 2010 Mathematics Subject Classification: 62P10

Abstract 1379: A novel therapy for esophageal cancer: improved thoracoscopic esophagectomy and analysis of 361 cases.

Abstract Esophageal cancer is one of the common cancers worldwide, and Anyang and Linzhou areas in Northern China are the highest incidence areas of esophageal cancer. The prognosis is poor and five-year survival is very low. Several therapeutic strategies have been used for decades; esophagectomy is still the best way to treat esophageal cancer. In the past several years, a novel therapy for esophageal cancer - thoracoscopic esophagectomy has been developed, which has minimal invasion and less operative time and complications, compared to conventional esophagectomy, but there are also some limitations. This report is to introduce a modified thoracoscopic esophagectomy for esophageal cancer therapy recently developed in our hospitals. We also analyzed the outcomes of the 361 esophageal cancer patients. The widely used thoracoscopic esophagectomy needs two holes locating at the eighth and ninth intercostal, respectively, for observation and operation simultaneously. In our procedure, first, we put patient at prone position, we cut 4 holes, one 1-cm hole for observation is located at the 8th or 7th intercostal of right chest axillary line, one 2-cm hole for operation is located at the 9th or 8th intercostals of the subscapularis. Two additional holes are cut for auxiliary operation, one is located at 6th intercostals of subscapularis; another one is located at 4th intercostal of axillary line. The esophagus is separated using ultrasound knife, mediastinal lymph nodes are cleaned, thoracic duct is tied. Second, we put the patient into supine position, separate the stomach using a small cut right next to the midline of the upper abdomen, and make a tubular stomach. Finally, we cut a hole at the front of the right neck sternocleidomastoid, and connect the residual esophagus and stomach neck using anastomosis. We have used the modified method on 300 esophageal cancer patients. The operative time is 2 - 4 h, significantly reduced the operative time. Blood loss is between 100-400 ml. There are only 34 cases of post-operation complication, including 11 anastomosis leaking, 7 thoracic duct leaking, 7 recurrent laryngeal nerve injury, and 3 respiratory infection. No any death occurs. Conclusion: surgical esophagectomy is the first option for esophageal cancer, and the modified thoracoscopic esophagectomy with 4 holes provides more observation fields, facilitate dissection. The minimal invasive operation reduces operative time and hospital stay time, minimizes post-operation complication. Thus, the improved thoracoscopic esophagectomy will benefit to esophageal cancer patients, particularly to senior patients and the patients with poor physical conditions. The limitation is that this method is good for the patients without distance metastasis or obvious extra-esophagus invasion. Citation Format: Weimin Zhang, Jianbin Hou, Xiansheng Fan, Kefeng Shi, Ran Yang, Xiaodong Zheng, Wancai Yang. A novel therapy for esophageal cancer: improved thoracoscopic esophagectomy and analysis of 361 cases. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 1379. doi:10.1158/1538-7445.AM2013-1379 Note: This abstract was not presented at the AACR Annual Meeting 2013 because the presenter was unable to attend.

Usefulness of Transesophageal Bronchoscopic Ultrasound-guided Fine-Needle Aspiration in the Pathologic and Molecular Diagnosis of Lung Cancer Lesions Adjacent to the Esophagus

The discovery of driver oncogenes has increased the need to obtain a sufficient amount of tissue specimens for lung cancer diagnosis. Although endoscopic ultrasound (with bronchoscope)-guided fine-needle aspiration (EUS-B-FNA) is reportedly a feasible and well-tolerated modality, additional advantages of EUS-B-FNA are yet to be thoroughly investigated. The purpose of this study was to evaluate the ability of EUS-B-FNA to obtain sufficient tissue specimens for pathologic and molecular diagnoses of lung cancer. Among lung cancer patients who were diagnosed between December 2010 and December 2012 in our institute, patients who underwent EUS-B-FNA to diagnose lung cancer were enrolled (n=26). EUS-B-FNA was performed when bronchoscopic diagnosis was impossible or difficult to obtain sufficient samples. Epidermal growth factor receptor (EGFR) mutations and echinoderm microtubule-associated protein-like 4 and the anaplastic lymphoma kinase (EML4-ALK) fusion gene were evaluated using EUS-B-FNA samples of non-small cell lung cancer. EUS-B-FNA was performed on 28 lesions in 26 patients. Among the target lesions, 23 were mediastinal lymph nodes including nodal stations 2L, 4L, 7, 8, and 10L. The remaining 5 were intrapulmonary lesions. EUS-B-FNAs were completed without complications in all the patients. The diagnostic yield of EUS-B-FNA in diagnosing lung cancer was 100% (26/26). Additional diagnostic gain of EUS-B-FNA was 69.2% (18/26) as compared to bronchoscopy alone. EGFR mutations and EML4-ALK fusion gene could be evaluated in all patients with non-small cell lung cancer (n=20) using EUS-B-FNA samples. One case with EGFR mutation and 1 case with ALK fusion gene were diagnosed. Six non-small cell carcinomas were also diagnosed by bronchoscopy, but all bronchoscopic samples were insufficient to evaluate mutation analyses. EUS-B-FNA is a practical and feasible method to obtain abundant tumorous tissue samples for pathologic diagnosis and molecular analysis, particularly when the target lesions are inaccessible by other modalities because of their locations or because of the patient's poor physical condition.

Longitudinal predictors of reading achievement among at-risk children

Early exposure to multiple risk factors is related to an elevated risk for academic difficulty. Thus, it is important to promote academic resilience as early as possible and to identify factors that support resilience. Given the positive relation between early literacy skills and later academic outcomes, examining resilience in reading is important. This study examined, first, whether the reading gap widens or narrows for below-average and above-average, at-risk children during the first four years of school; and, second, what protective factors predict reading achievement over time from kindergarten through the end of third grade. Results indicated that as a group, low-achieving children made smaller gains in reading than high-achieving children over the first four years of school. In addition, participation in center-based prekindergarten care, plus more access to books in the home, better interpersonal skills, and fewer poor physical conditions immediately surrounding elementary schools served as prote...

Physical condition and maintenance of mosquito bed nets in Kwale County, coastal Kenya

BackgroundDespite the extensive ownership and use of insecticide-treated nets (ITNs) over the last decade, the effective lifespan of these nets, especially their physical integrity, under true operational conditions is not well-understood. Usefulness of nets declines primarily due to physical damage or loss of insecticidal activity.MethodsA community based cross-sectional survey was used to determine the physical condition and to identify predictors of poor physical condition for bed nets owned by individuals from communities in Kwale County, coastal Kenya. A proportionate hole index (pHI) was used as a standard measure, and the cut-offs for an ‘effective net’ (offer substantial protection against mosquito bites) and ‘ineffective nets’ (offer little or no protection against mosquito bites) were determined (pHI ≤88 (about ≤500 cm2 of holes surface area) and pHI of >88 (≥500 cm2 of holes surface area), respectively).ResultsThe vast majority (78%) of the surveyed nets had some holes. The median pHI was 92 (range: 1–2,980). Overall, half of the nets were categorized as ‘effective nets’ or ‘serviceable nets’. Physical deterioration of nets was associated with higher use and washing frequency. Young children and older children were found to use ineffective bed nets significantly more often than infants, while the physical integrity of nets owned by pregnant women was similar to those owned by infants. Estuarine environment inhabitants owned nets with the worst physical condition, while nets owned by the coastal slope inhabitants were in fairly good physical condition. The results suggest that bed nets are optimally utilized when they are new and physically intact. Thereafter, bed net utilization decreases gradually with increasing physical deterioration, with most net owners withdrawing physically damaged nets from routine use.This withdrawal commonly happens following 1.5 years of use, making bed net use the most important predictor of physical integrity. On average, the nets were washed twice within six months prior to the survey. Washing frequency was significantly influenced by the bed net colour and bed net age. Lack of knowledge on reasons for net retreatment and the retreatment procedure was evident, while net repair was minimal and did not seem to improve the physical condition of the nets. The “catch-up” bed net distribution strategies are sufficient for ensuring adequate ownership and utilization of ‘effective nets’ in the targeted groups, but bi-annual mass distribution is necessary to provide similar ownership and utilization for the other groups not targeted by “catch-up” strategies.ConclusionsMonitoring and maintenance strategies that will deliver locally appropriate education messages on net washing and repair will enhance the effectiveness of malaria control programmes, and further research to assess ineffective nets need is needed.

Back pain during growth

It is wrong to believe that back pain only burdens adults: the yearly incidence during growth ranges from 10-20%, continuously increasing from childhood to adolescence. Rapid growth-related muscular dysbalance and insufficiency, poor physical condition in an increasingly sedentary adolescent community or - vice versa - high level sports activities, account for the most prevalent functional pain syndromes. In contrast to adults the correlation of radiographic findings with pain is high: the younger the patient, the higher the probability to establish a rare morphologic cause such as benign or malignant tumours, congenital malformations and infections. In children younger than 5 years old, the likelihood is more than 50%. The following red flags should lower the threshold for a quick in-depth analysis of the problem: Age of the patient <5 years, acute trauma, functional limitation for daily activities, irradiating pain, loss of weight, duration >4 weeks, history of tumour, exposition to tuberculosis, night pain and fever. High level sport equals a biomechanical field test which reveals the biologic individual response of the growing spine to the sports-related forces. Symptomatic or asymptomatic inhibitory or stimulatory growth disturbances like Scheuermann disease, scoliosis or fatigue fractures represent the most frequent pathomorphologies. They usually occur at the disk-growth plate compound: intraspongious disk herniation, diminuition of anterior growth with vertebral wedging and apophyseal ring fractures often occur when the biomechanical impacts exceed the mechanical resistance of the cartilaginous endplates. Spondylolysis is a benign condition which rarely becomes symptomatic and responds well to conservative measures. Associated slippage of L5 on S1 is frequent but rarely progresses. The pubertal spinal growth spurt is the main risk factor for further slippage, whereas sports activity - even at a high level - is not. Therefore, the athlete should only be precluded from training if pain persists or in case of high grade slips. Perturbance of the sagittal profile with increase of lumbar lordosis, flattening of the thoracic spine and retroflexion of the pelvis with hamstrings contractures are strong signs for a grade IV olisthesis or spondyloptosis with subsequent lumbosacral kyphosis. Idiopathic scoliosis is not related to pain unless it is a marked (thoraco-) lumbar curve or if there is an underlying spinal cord pathology. Chronic back pain is an under recognised entity characterised by its duration (>3 months or recurrence within 3 months) and its social impacts such as isolation and absence from school or work. It represents an independent disease, uncoupled from any initial trigger. Multimodal therapeutic strategies are more successful than isolated, somatising orthopaedic treatment. Primary and secondary preventive active measures for the physically passive adolescents, regular sports medical check-up's for the young high level athletes, the awareness for the rare but potentially disastrous pathologies and the recognition of chronic pain syndromes are the cornerstones for successful treatment of back pain during growth.

Exercise behaviors and barriers to exercise in adult burn survivors: A questionnaire survey.

Exercise is a key component of burn rehabilitation across all phases of care. Supervised outpatient exercise programs have been shown to improve outcomes following burn injury. However, little is known about the exercise behaviors of burn survivors who do not undertake such programs. This study aimed to investigate self-reported exercise behaviors and barriers to exercise in adult burn survivors. A short questionnaire survey was conducted on adult burn survivors attending the ambulatory burns clinic of a tertiary hospital over a 6-week period. The collected data were subjected to paired t-tests and Pearson’s correlation test. A total of 63 adult burn survivors (mean age 36.5 years) completed the questionnaire. Participants reported exercising less frequently and engaged in fewer different types of exercise compared with pre-burn (P < 0.05). Poor physical conditions and low motivation and enthusiasm were the major barriers to exercise. Participation in supervised exercise programs can be limited by a range of factors including the availability of resources and access to facilities. This preliminary study suggests that there is a need to improve compliance with outpatient exercise programs. Burn survivors appear to exercise less frequently after burn injury. Barriers to exercise following burn injury include poor physical condition and reduced motivation. Further investigation into overall physical activity following burn injury and potential physical and psychological limitations is warranted. Burn clinicians should highly encourage injury survivors to participate in supervised exercise programs when available or to do exercises at home to maximize post-burn injury recovery.

Comparison of breakfast consumption in rural and urban among Inner Mongolia Medical University students

Objective: The aim of current study was to investigate breakfast consumption between rural and urban among Inner Mongolia Medical University students, China. Method: From December 2010 to January 2011, a cross-sectional survey was conducted among medical students in the Inner Mongolia Medical University using a self-administered questionnaire. X2 was used to identify the differences between rural and urban. Result: The prevalence of breakfast consumption was 70.95%. The prevalence of breakfast in rural was higher than that in urban (72.09% vs. 69.78%). Breakfast consumption prevalence among male students in rural was higher 7.4% than those of students in urban. Students in Mongolian ethnic in rural were more likely to eat breakfast than Mongolian students in urban. The prevalence of breakfast decreases with grade increase both urban and rural. Students with good physical condition were more likely to eat breakfast compared with students with poor physical condition. Conclusion: The prevalence of regular breakfast consumption in rural was higher than that in urban. However, the prevalence of eating breakfast declined faster in rural than that in urban. Our study findings could help health care professionals develop targeted interventions designed to increase breakfast consumption.

Recurrent pulmonary embolism in a boy with antiphospholipid syndrome

We report a 14-year-old patient with recurrent pulmonary embolism due to catastrophic antiphospholipid syndrome (APS) with severe pulmonary inflammation. We considered elevated antibodies against cardiolipin and anti-beta2-glycoprotein-1, but no clinical nor laboratory manifestations of systemic lupus erythematosus (SLE). Pulmonary embolism had been the first manifestation of catastrophic APS in this patient. We prescribed warfarin and systemic corticosteroids. A second embolism appeared during anticoagulation with warfarin. This event led to a marked decrease of his physical performance due to his obstructive and restrictive lung disease. Anticoagulation was changed from enteral warfarin to subcutaneous enoxaparine. We also prescribed inhaled corticosteroid which led to an improvement of his respiratory symptoms and overall poor physical condition.

Weight gain, metabolic disturbances, and physical health care in a Brazilian sample of outpatients with schizophrenia

BackgroundIn the last few decades, a large number of studies have produced compelling evidence that patients with schizophrenia are at increased risk for developing several medical conditions and diseases, including obesity, metabolic disturbances, and cardiovascular diseases. Several protocols have been designed with the aim of reducing such risk.Objective:To investigate current physical health status in a population of outpatients with schizophrenia.Methods:A cross-sectional study was conducted in our outpatient clinic, selecting subjects who met DSM-IV diagnosis criteria for schizophrenia. Data were collected regarding clinical characteristics, lifestyle, medication in use, and biometric and laboratory parameters.Results:A total of 261 patients were included. We found a high prevalence of elevated body mass index (BMI . 25) (70%), dyslipidemia (73.2%), and metabolic syndrome (28.7%). Patients’ ages were associated with worsened lipid profiles, but other variables, such as disorder duration or type of antipsychotic in use, were not associated with any metabolic disturbance. Despite the increased prevalence of these conditions, only a small portion of the sample was under regular medical treatment.Conclusion:Outpatients with schizophrenia show signs of poor physical health conditions. These findings reinforce the need for an intensive and appropriate approach to assure that these patients receive adequate clinical referral and treatment.

Sociomateriality of Corruption: Technology as a Lens onto Materialization of Power/Knowledge

Recent scholarship has inaugurated the social practices perspective on corruption. In particular, via power/knowledge dynamics the organizational embeddedness of situated work practices and the commensurate craft-knowledge can endow focal actors with power to engage in corruption. However, in the latter context, how the “material arrangements” of work undergird this power/knowledge to enable corruption has been under-theorized and under-explored. How these material arrangements “matter” to corruption are the focus of this paper. Using a case of technology change, transitioning from paper maps to digital maps, we study how corruption (re-) materializes via artifactual and physical means. We focus on an almost invisible organizational practice, called “compensation” which was synonymous with corruption, and its intended elimination by way of the introduction of digital maps. Our analysis shows that the latter practice was highly intertwined with the material arrangements of work —i.e., poor physical map conditions and highly improvisational calculation methods. The findings also show that manual compensation and its material means were largely eliminated due to digital maps. However, subsequently corruption re-materialized albeit in a new form. The paper contributes to the literature by showing that: there is a significant “material” component to corruption; that the latter materiality is “consequential”; that “corruption as a sociomaterial accomplishment” is a credible theoretical perspective; and that corruption can “metastasize” and evolve though in an emergent and unpredictable manner.

Emergency Homeless Shelters in North America: An Inventory and Guide for Future Practice

One of the most contentious issues in many cities is the fierce debate over the location, management and quality of homeless shelters. While these debates rage in places around North America, little research has been done on housing policy concerning homeless shelters. The purpose of this research was to provide an inventory of a broad cross-section of cities in North America in order to develop recommendations for more effective policies, practices, regulations and standards of operation for emergency homeless shelters. This study documents trends and regulations for homeless shelters in Canada and the United States. We used two separate independent surveys to see how 98 cities managed the relatively recent emergence of homeless shelters. One national survey examined 51 of the 100 largest cities’ homeless shelter policies and another survey reviewed 47 selective cities that are small, medium, and large. Emergency homeless shelters are often criticized for poor physical condition, overcrowding, lack of privacy, crime, health concerns, and negative impacts on neighborhood property values and businesses. Our research documents the wide range of practices that are being implemented in efforts to respond to these problems, some of the limitations of these practices, and broader structural forces that nurture homelessness and undercut efforts to respond.

The effect of sodicity on cotton: Does soil chemistry or soil physical condition have the greater role?

Soil sodicity is widespread in the cracking clays used for irrigated cotton (Gossypium hirsutum L.) production in Australia and worldwide and sometimes produces nutrient imbalances and poor plant growth. It is not known whether these problems are due primarily to soil physical or to soil chemical constraints. We investigated this question by growing cotton to maturity in a glasshouse in large samples of a Grey Vertosol in which the exchangeable sodium percentage (ESP) was adjusted to 2, 13, 19, or 24. A soil-stabilising agent, anionic polyacrylamide (PAM), was added to half the pots and stabilised soil aggregation at all ESPs. Comparison of the effect of ESP on cotton in the pots with and without PAM showed that, up to ESP of 19, the soil physical effects of sodicity were mainly responsible for poor cotton performance and its ability to accumulate potassium. At ESP &gt;19, PAM amendment did not significantly improve lint yield, indicating that soil chemical constraints, high plant sodium concentrations (&gt;0.2%), and marginal plant manganese concentrations limited plant performance. Further research into commercial methods of amelioration of poor physical condition is warranted rather than application of more fertiliser.

Ontario Government Funding and Supervision of Infants’ Homes 1875–1893

Prior to 1893, the Ontario government did not accept direct responsibility for the care of neglected and dependent infants. However, charitable infants’ homes received government grants for the infants and for their nursing mothers, and from 1874 were inspected annually or twice annually. Most of these infants were illegitimate, most of their mothers were poor, and many were in poor physical condition, and thus their chances of survival outside such homes was poor. The success of these homes and the effectiveness of government inspection can thus be judged in part by the mortality rate among the infants admitted.

Salvage hepatectomy for perihilar malignancy treated initially with biliary self-expanding metallic stents

A salvage hepatectomy for an "inoperable" advanced perihilar tumor initially treated with a self-expanding metallic stent (SEMS) is challenging, and its safety and survival benefits remain unclear. The aim of this study was to report our experiences with this difficult resection. This study involved 10 consecutive patients with suspected perihilar cholangiocarcinoma who underwent SEMS placement at a local hospital and were referred to our clinic for possible resection as their last option. Their medical records were analyzed retrospectively. Tumor extent was first reevaluated using multidetector-row computed tomography. Of the 10 patients, 4 were diagnosed as inoperable owing to locally advanced tumors (n = 3) or poor physical condition (n = 1). In the remaining 6 patients, after additional biliary drainage, a salvage hepatectomy was performed, including a right hepatectomy with a caudate lobectomy in 5 patients and a central bisectionectomy with a caudate lobectomy in 1. A combined portal vein resection was required in 3 patients, and a combined pancreatoduodenectomy was performed in 2 patients. R0 resection was achieved in 5 patients, and all patients tolerated the resection. Three patients died of recurrence, and the remaining 3 were alive without recurrence at the time of publication, 1 of whom has survived >10 years. Pre-resection SEMS placement does not preclude a subsequent hepatectomy for patients with advanced perihilar tumors. Salvage hepatectomy, although technically demanding, is feasible and can revise the palliative scenario and benefit selected patients treated initially with an SEMS.

Controlling Highly Pathogenic Avian Influenza, Bangladesh

Controlling Highly Pathogenic Avian Influenza, Bangladesh

Sick building syndrome (SBS) and sick house syndrome (SHS) in relation to psychosocial stress at work in the Swedish workforce

Medical symptoms called sick building syndrome (SBS) and sick house syndrome (SHS) are usually investigated separately: in this study, SBS and SHS were explored simultaneously. The significance of personal factors, perceptions of air quality, and psychosocial work situation in explaining SBS and SHS were investigated. A random sample of 1,000 subjects (20-65 year) received a postal questionnaire including questions on personal factors, medical symptoms, and the psychosocial demand-control-support model. The response rate was 70 % (n = 695), of which 532 were occupationally active. In logistic regression models, atopy, poor air quality at work, and low social support, especially low supervisor support, were associated with both SBS and SHS when age, gender, smoking, and BMI were introduced. The general work-related symptoms (headache, tiredness, nausea, and sensation of a cold) were also related to low control over work. The perception of poor physical environmental conditions is associated with common medical symptoms that are both work and home related. The associations between medical symptoms and poor air quality are still present, even when controlling for the psychosocial environment.

Prevention of Anterior Cruciate Ligament Injuries

These authors reported a significant decrease in the occurrence of sports-related injuries in the trained group compared with the untrained controls. They believed that increasing the strength of the bone, muscle, and supporting connective tissue in preseason training increased the relative resistance of these tissues to mechanical stresses experienced during practice and competition, thus protecting against injury. These ideas have been applied to the recent epidemic of noncontact ACL injuries in adolescent female athletes. Researchers have identified potentially modifiable fac tors that place young women at risk for ACL injury: extended hip and knee-joint postures upon landing from a jump; decreased hamstring-to-quadriceps strength ratios; overall poor physical conditioning; poor core, trunk, and hip strength; and increased valgus (“knock-kneed”) postures with landing and squatting. 2

Selection, implementation and cost of restorations in lowland streams: A basis for identifying restoration priorities

Abstract Restorations have been conducted in Danish lowland streams for almost 30 years to combat the poor physical conditions resulting from decades of channelisation, flood plain drainage and other impacts. Despite this effort, the recently drafted River Basin Management Plans show that physical improvements are still required in more than 7000 km of stream in order to comply with the Water Framework Directive. In this study we used published studies and expert knowledge to describe the restoration approaches most likely to achieve the environmental goals. In addition, we collected information about the economic costs of the different restoration approaches based on Danish experiences. For heavily impacted lowland streams (channelised and deeply incised streams) we described only two different restoration methods, both of which are relatively expensive. For lesser impacted streams (channelised but not deeply incised streams) we described six different options for improving ecological quality, varying significantly in cost. Our analysis showed that the cost may increase dramatically if several remedial actions are required or if land owners are entitled to large monetary compensations. Consequently, stream managers face an important challenge in the future prioritisation of restoration efforts aimed to obtain ecological improvements within tight budgets. The information presented in this paper can help the decision-making of managers.