Objective: Although a range of studies have documented impaired sexual function among women with ... more Objective: Although a range of studies have documented impaired sexual function among women with breast cancer, few studies focus on younger women with breast cancer or on the strategies used by women to improve their sexual function. The purpose of this study was to use a reliable and valid measure to examine the sexual function of women who were younger than 50 at the time of their breast cancer diagnosis, and to explore their interest in sexual enhancement products. Design and method: Data were collected from 115 women who were younger than 50 at the time of breast cancer diagnosis as part of a cross-sectional, paper-based survey administered at a conference for young survivors of breast cancer. The survey was anonymous and women responded to items related to their demographics, health history, breast cancer status and completed the Sexual Function Questionnaire. Results: Participants scored significantly lower, indicating lower functioning, on most subscales of the Sexual Function Questionnaire (SFQ) and the overall measure with the exception of the masturbation subscale, on which women with breast cancer scored significantly higher. Most participants indicated moderate or strong interest in sexual enhancement products (e.g., lubricants, vibrators) and comfort purchasing sexual enhancement products through various venues. Conclusions: Sex therapists and other sexual health professionals (e.g., educators, healthcare providers) might consider collaborations with entities of the adult retail industry to provide survivors with information about sexual enhancement products and their therapeutic potential.
British Journal of Therapy and Rehabilitation, 1998
Quantitative studies are most commonly used to evaluate cardiac rehabilitation. However, certain ... more Quantitative studies are most commonly used to evaluate cardiac rehabilitation. However, certain effects, such as psychological measures, are hard to quantify. This study used qualitative methods to assess the effectiveness of exercise-based cardiac rehabilitation by examining the patients' perspectives of its success and how it could be improved. Recommendations based on this information are now being implemented.
Background: Iodine deficiency remains a significant health problem in developing countries, inclu... more Background: Iodine deficiency remains a significant health problem in developing countries, including Nepal. Objective: This study was conducted to measure the iodine status of school children in two districts Dhankuta and Tehrathum of Eastern Nepal by estimating median urinary iodine concentration (UIC) as a population parameter in the school children. Materials and Methods: This cross-sectional study was conducted from August 2010 to July 2011 in school children (6-12 years of age) of two hilly districts of Eastern Nepal, Dhankuta and Tehrathum. A total of 154 school age children from the two districts were chosen for the study after obtaining written consent from their guardians and school authority. UIC was estimated in these school children by ammonium persulphate digestion microplate method. Results: Among the school age children selected for the study median inter-quartile range (IQR) of urinary iodine in Dhankuta (n=63) and Tehrathum (n=91) districts were 214.04 (126.44; 3...
Heart rate variability (HRV) is a known risk factor for mortality in both healthy and patient pop... more Heart rate variability (HRV) is a known risk factor for mortality in both healthy and patient populations. There are currently no normative data for short-term measures of HRV. A thorough review of short-term HRV data published since 1996 was therefore performed. Data from studies published after the 1996 Task Force report (i.e., between January 1997 and September 2008) and reporting short-term measures of HRV obtained in normally healthy individuals were collated and factors underlying discrepant values were identified. Forty-four studies met the pre-set inclusion criteria involving 21,438 participants. Values for short-term HRV measures from the literature were lower than Task Force norms. A degree of homogeneity for common measures of HRV in healthy adults was shown across studies. A number of studies demonstrate large interindividual variations (up to 260,000%), particularly for spectral measures. A number of methodological discrepancies underlined disparate values. These include a systematic failure within the literature (a) to recognize the importance of RR data recognition/editing procedures and (b) to question disparate HRV values observed in normally healthy individuals. A need for largescale population studies and a review of the Task Force recommendations for short-term HRV that covers the full-age spectrum were identified. Data presented should be used to quantify reference ranges for short-term measures of HRV in healthy adult populations but should be undertaken with reference to methodological factors underlying disparate values. Recommendations for the measurement of HRV require updating to include current technologies.
The purpose of the study was to determine a safe and effective aerobic training threshold based o... more The purpose of the study was to determine a safe and effective aerobic training threshold based on heart rate for post-myocardial infarction patients which would be simple to administer. This was required because of the concerns about using existing age-related formulae, which were inappropriate for this clinical group. Thirty male recent post-myocardial infarction patients with beta blockade therapy (aged 60 + 8.9 years) and 40 male recent post-myocardial infarction patients without beta blockade therapy (aged 63.4 + 8.2 years) performed a graded exercise test (modified Bruce protocol) on a motorized treadmill until volitional cessation or reaching any of the American College of Sports Medicine criteria. Ratings of perceived exertion, blood lactate, oxygen uptake, angina score, dyspnoea score and blood pressure were recorded every 3 min during the exercise. Oxygen uptake, volume of expired gas and heart rate were recorded every 30 s during the exercise and a 12-lead electrocardiograph was monitored continuously. The results showed that the patients did not achieve the age-related maximum heart rates predicted from 220-age, showing early signs of myocardial ischaemia at about 90% of their peak heart rate. Patients using beta blockade had a significantly lower (P < 0.01) heart rate both at rest and at peak work rate compared with the non-blockade group. Peak heart rate can be predicted from age for the two distinct groups and this enabled the optimal aerobic training thresholds to be determined for post-myocardial infarction patients aged 50-70 years separately for those who do or do not require beta-blockade therapy.
The purpose of this study was to assess the agreement and consistency between gas exchange variab... more The purpose of this study was to assess the agreement and consistency between gas exchange variables measured by two online metabolic systems during an incremental exercise test. After obtaining local ethics approval and informed consent, 15 healthy subjects performed an incremental exercise test to volitional fatigue using the Bruce protocol. The Innocor (Innovision, Denmark) and CardiO2 (Medical Graphics, USA) systems were placed in series, with the Innocor mouthpiece attached to the pneumotach of the CardiO2. Metabolic data were analysed during the last 30 seconds of each stage and at peak exercise. There were non- significant differences (p > 0.05) between the two systems in estimation of oxygen consumption (VO2) and in minute ventilation (VE). Mean Cronbach's alpha for VO2 and VE were 0.88 and 0.92. The Bland-Altman analysis revealed that limits of agreement were -0.52 to 0.55 l.min(-1) for VO2, and -8.74 to 10.66 l.min(-1) for VE. Carbon dioxide production (VCO2) and co...
The effects of different recovery protocols on heart rate recovery (HRR) trend through fitted hea... more The effects of different recovery protocols on heart rate recovery (HRR) trend through fitted heart rate (HR) decay curves were assessed. Twenty one trained male athletes and 19 sedentary male students performed a submaximal cycle exercise test on four occasions followed by 5 min: 1) inactive recovery in the upright seated position, 2) active (cycling) recovery in the upright seated position, 3) supine position, and 4) supine position with elevated legs. The HRR was assessed as the difference between the peak exercise HR and the HR recorded following 60 seconds of recovery (HRR60). Additionally the time constant decay was obtained by fitting the 5 minute post-exercise HRR into a first-order exponential curve. Within-subject differences of HRR60 for all recovery protocols in both groups were significant (p < 0.001) except for the two supine positions (p > 0.05). Values of HRR60 were larger in the group of athletes for all conditions (p < 0.001). The time constant of HR decay...
ObjectivesClinical guidelines recommend regular physical activity for patients with heart failure... more ObjectivesClinical guidelines recommend regular physical activity for patients with heart failure to improve functional capacity and symptoms and to reduce hospitalisation. Cardiac rehabilitation programmes have demonstrated success in this regard; however, uptake and adherence are suboptimal. Home-based physical activity programmes have gained popularity to address these issues, although it is acknowledged that their ability to provide personalised support will impact on their effectiveness. This study aimed to identify barriers and facilitators to engagement and adherence to a home-based physical activity programme, and to identify ways in which it could be integrated into the care pathway for patients with heart failure.DesignA qualitative focus group study was conducted. Data were analysed using thematic analysis.ParticipantsA purposive sample of 16 patients, 82% male, aged 68±7 years, with heart failure duration of 10±9 years were recruited.InterventionA 12-week behavioural int...
Background. This study was carried out to establish the prevalence of cardiovascular risks such a... more Background. This study was carried out to establish the prevalence of cardiovascular risks such as hypertension, obesity, and diabetes in Eastern Nepal. This study also establishes the prevalence of metabolic syndrome (MS) and its relationships to these cardiovascular risk factors and lifestyle.Methods. 14,425 subjects aged 20–100 (mean 41.4 ± 15.1) were screened with a physical examination and blood tests. Both the International Diabetic Federation (IDF) and National Cholesterol Education Programme’s (NCEP) definitions for MS were used and compared.Results. 34% of the participants had hypertension, and 6.3% were diabetic. 28% were overweight, and 32% were obese. 22.5% of the participants had metabolic syndrome based on IDF criteria and 20.7% according to the NCEP definition. Prevalence was higher in the less educated, people working at home, and females. There was no significant correlation between the participants’ lifestyle factors and the prevalence of MS.Conclusion. The high in...
International Journal of Nursing Studies - INT J NURS STUD, 2004
Research has identified a number of negative societal perceptions of nursing related to gendered ... more Research has identified a number of negative societal perceptions of nursing related to gendered stereotyping, subordination to doctors, low academic standards, limited career opportunities and poor pay and conditions, and importantly how these perceptions may affect levels of recruitment into nursing. Focusing specifically on nurses, research has also considered the extent to which these societal perceptions are realities in their workplaces, and the direct experiences that contribute to attrition from both nursing courses and jobs. However, to date, few research has actually bridged the above approaches and considered the perceptions that nursing students hold as they first enter their education and how these change, or are confirmed, as a result of their experiences. In this context, the current study uses a combined questionnaire (n=650), interview (n=30) and focus group (n=7) methodology to investigate the experiences of students based at two British Universities. The findings ...
We have compared the finger hyperextensometer (Jobbins et al., 1978) and the scoring system of Ca... more We have compared the finger hyperextensometer (Jobbins et al., 1978) and the scoring system of Carter and Wilkinson (1964), modified by Beighton et al. (1973), in the quantification of joint laxity in a population selected to demonstrate a wide range of joint movement. Both systems correlated well (P less than 0.001) with a &#39;global index&#39; of joint laxity derived by adding the arcs of movement recorded at most joints in the body by the method of the American Academy of Orthopaedic Surgeons (1965). The Carter and Wilkinson system produced better correlations and is the method of choice for assessing generalized joint laxity.
We have applied the Cavalieri method of modern design stereology with magnetic resonance imaging ... more We have applied the Cavalieri method of modern design stereology with magnetic resonance imaging for estimating the volume of whole-body muscle and fat compartments in four patients with muscular dystrophy, a patient with myopathy, five controls, an anorexic subject, and a body builder. Detailed systematic series (ie, 50) of axial MR images (T1-weighted, TR/TE 400/10 msec) were obtained throughout the whole body of each subject. The results showed that 15, 20, and 35 axial sections through the body are sufficient to secure coefficients of error (CEs) on the estimates of total muscle and fat volume of around 10%, 5%, and 3% respectively in muscular dystrophy patients and controls. The mean normalized volumes of muscle in four muscular dystrophy patients were decreased by 27% (t-test: P &amp;amp;lt; 0.05), and those of total fat were increased by 12% (t-test: P &amp;amp;gt; 0.05) relative to controls. The Cavalieri method provides a direct, efficient, and mathematically unbiased approach for studying human body compartments and may have application in assessing treatment efficacy in patients with muscular dystrophy. J. Magn. Reson. Imaging 2000;12:467-475.
This is a well presented, compact colour atlas detailing the majority of rheumatological conditio... more This is a well presented, compact colour atlas detailing the majority of rheumatological conditions which are amenable to photography. Each chapter begins with a resume of the condition under discussion followed by a mixture of clinical and X-ray pictures, each accompanied by an appropriate legend. The longest chapter deals with rheumatoid arthritis and emphasises the multi-system nature of this disease. The following chapter on juvenile chronic arthritis was the only disappointment, in that it utilised the term Still's disease more frequently than one would in clinical practice today. After dealing with inflammatory condition the author covers degenerative arthopathies, crystal arthopathies and connective tissues diseases. A picture of an LE cell is perhaps unnecessary since this test would now be obsolete in most laboratories but suppose may turn up in an examination situation. Rarer arthopathies and miscellaneous conditions are then covered. Generally the quality of the photographs is good, although a few of the X-rays have not been well reproduced. This book is recommended to fit in the pocket of any clinician, whatever their specialty or stage of career, and has the value of providing a spectrum of rheumatology that can be covered in a matter of minutes.
Data of 30 men and 30 women in college show similar body-image perception which is associated wit... more Data of 30 men and 30 women in college show similar body-image perception which is associated with abnormalities of eating or psychological instability.
This is a well presented, compact colour atlas detailing the majority of rheumatological conditio... more This is a well presented, compact colour atlas detailing the majority of rheumatological conditions which are amenable to photography. Each chapter begins with a resume of the condition under discussion followed by a mixture of clinical and X-ray pictures, each accompanied by an appropriate legend. The longest chapter deals with rheumatoid arthritis and emphasises the multi-system nature of this disease. The following chapter on juvenile chronic arthritis was the only disappointment, in that it utilised the term Still's disease more frequently than one would in clinical practice today. After dealing with inflammatory condition the author covers degenerative arthopathies, crystal arthopathies and connective tissues diseases. A picture of an LE cell is perhaps unnecessary since this test would now be obsolete in most laboratories but suppose may turn up in an examination situation. Rarer arthopathies and miscellaneous conditions are then covered. Generally the quality of the photographs is good, although a few of the X-rays have not been well reproduced. This book is recommended to fit in the pocket of any clinician, whatever their specialty or stage of career, and has the value of providing a spectrum of rheumatology that can be covered in a matter of minutes.
Loneliness and isolation can be a major cause of unhappiness and can contribute towards depressio... more Loneliness and isolation can be a major cause of unhappiness and can contribute towards depression and mental illness in older age. These associations are recognised by academics, policy makers and older…
The purpose of this study was to assess the effect of three different body positions on HRV measu... more The purpose of this study was to assess the effect of three different body positions on HRV measures following short-term submaximal exercise. Thirty young healthy males performed submaximal cycling for five minutes on three different occasions. Measures of HRV were obtained from 5-min R to R wave intervals before the exercise (baseline) and during the last five minutes of a 15 min recovery (post-exercise) in three different body positions (seated, supine, supine with elevated legs). Measures of the mean RR normal-to-normal intervals (RRNN), the standard deviation of normal-to-normal intervals (SDNN), the root mean square of successive differences (RMSSD) and the low-frequency (LF) and the high-frequency (HF) spectral power were analyzed. Post-exercise RRNN, RMSSD were significantly higher in the two supine positions (p < 0. 01) compared with seated body position. Post-exercise ln LF was significantly lower in the supine position with elevated legs than in the seated body positio...
Tests of change of direction as measurement of different kinds of motor ability in boys of the 7t... more Tests of change of direction as measurement of different kinds of motor ability in boys of the 7th, 8th, and 9th grades". Research Quarterly 11 (3): 136-147. Gayle, R. C., 1978 "The department of energy physical fitness qualifications test for security inspectors: analysis and recommendations". Union Carbide Corporation, Oak Ridge, TN. Jaeger, R. M., 1985 "Self-esteem scale". (Unpublished data), University of North Carolina at Greensboro, NC.
Objective: Although a range of studies have documented impaired sexual function among women with ... more Objective: Although a range of studies have documented impaired sexual function among women with breast cancer, few studies focus on younger women with breast cancer or on the strategies used by women to improve their sexual function. The purpose of this study was to use a reliable and valid measure to examine the sexual function of women who were younger than 50 at the time of their breast cancer diagnosis, and to explore their interest in sexual enhancement products. Design and method: Data were collected from 115 women who were younger than 50 at the time of breast cancer diagnosis as part of a cross-sectional, paper-based survey administered at a conference for young survivors of breast cancer. The survey was anonymous and women responded to items related to their demographics, health history, breast cancer status and completed the Sexual Function Questionnaire. Results: Participants scored significantly lower, indicating lower functioning, on most subscales of the Sexual Function Questionnaire (SFQ) and the overall measure with the exception of the masturbation subscale, on which women with breast cancer scored significantly higher. Most participants indicated moderate or strong interest in sexual enhancement products (e.g., lubricants, vibrators) and comfort purchasing sexual enhancement products through various venues. Conclusions: Sex therapists and other sexual health professionals (e.g., educators, healthcare providers) might consider collaborations with entities of the adult retail industry to provide survivors with information about sexual enhancement products and their therapeutic potential.
British Journal of Therapy and Rehabilitation, 1998
Quantitative studies are most commonly used to evaluate cardiac rehabilitation. However, certain ... more Quantitative studies are most commonly used to evaluate cardiac rehabilitation. However, certain effects, such as psychological measures, are hard to quantify. This study used qualitative methods to assess the effectiveness of exercise-based cardiac rehabilitation by examining the patients' perspectives of its success and how it could be improved. Recommendations based on this information are now being implemented.
Background: Iodine deficiency remains a significant health problem in developing countries, inclu... more Background: Iodine deficiency remains a significant health problem in developing countries, including Nepal. Objective: This study was conducted to measure the iodine status of school children in two districts Dhankuta and Tehrathum of Eastern Nepal by estimating median urinary iodine concentration (UIC) as a population parameter in the school children. Materials and Methods: This cross-sectional study was conducted from August 2010 to July 2011 in school children (6-12 years of age) of two hilly districts of Eastern Nepal, Dhankuta and Tehrathum. A total of 154 school age children from the two districts were chosen for the study after obtaining written consent from their guardians and school authority. UIC was estimated in these school children by ammonium persulphate digestion microplate method. Results: Among the school age children selected for the study median inter-quartile range (IQR) of urinary iodine in Dhankuta (n=63) and Tehrathum (n=91) districts were 214.04 (126.44; 3...
Heart rate variability (HRV) is a known risk factor for mortality in both healthy and patient pop... more Heart rate variability (HRV) is a known risk factor for mortality in both healthy and patient populations. There are currently no normative data for short-term measures of HRV. A thorough review of short-term HRV data published since 1996 was therefore performed. Data from studies published after the 1996 Task Force report (i.e., between January 1997 and September 2008) and reporting short-term measures of HRV obtained in normally healthy individuals were collated and factors underlying discrepant values were identified. Forty-four studies met the pre-set inclusion criteria involving 21,438 participants. Values for short-term HRV measures from the literature were lower than Task Force norms. A degree of homogeneity for common measures of HRV in healthy adults was shown across studies. A number of studies demonstrate large interindividual variations (up to 260,000%), particularly for spectral measures. A number of methodological discrepancies underlined disparate values. These include a systematic failure within the literature (a) to recognize the importance of RR data recognition/editing procedures and (b) to question disparate HRV values observed in normally healthy individuals. A need for largescale population studies and a review of the Task Force recommendations for short-term HRV that covers the full-age spectrum were identified. Data presented should be used to quantify reference ranges for short-term measures of HRV in healthy adult populations but should be undertaken with reference to methodological factors underlying disparate values. Recommendations for the measurement of HRV require updating to include current technologies.
The purpose of the study was to determine a safe and effective aerobic training threshold based o... more The purpose of the study was to determine a safe and effective aerobic training threshold based on heart rate for post-myocardial infarction patients which would be simple to administer. This was required because of the concerns about using existing age-related formulae, which were inappropriate for this clinical group. Thirty male recent post-myocardial infarction patients with beta blockade therapy (aged 60 + 8.9 years) and 40 male recent post-myocardial infarction patients without beta blockade therapy (aged 63.4 + 8.2 years) performed a graded exercise test (modified Bruce protocol) on a motorized treadmill until volitional cessation or reaching any of the American College of Sports Medicine criteria. Ratings of perceived exertion, blood lactate, oxygen uptake, angina score, dyspnoea score and blood pressure were recorded every 3 min during the exercise. Oxygen uptake, volume of expired gas and heart rate were recorded every 30 s during the exercise and a 12-lead electrocardiograph was monitored continuously. The results showed that the patients did not achieve the age-related maximum heart rates predicted from 220-age, showing early signs of myocardial ischaemia at about 90% of their peak heart rate. Patients using beta blockade had a significantly lower (P < 0.01) heart rate both at rest and at peak work rate compared with the non-blockade group. Peak heart rate can be predicted from age for the two distinct groups and this enabled the optimal aerobic training thresholds to be determined for post-myocardial infarction patients aged 50-70 years separately for those who do or do not require beta-blockade therapy.
The purpose of this study was to assess the agreement and consistency between gas exchange variab... more The purpose of this study was to assess the agreement and consistency between gas exchange variables measured by two online metabolic systems during an incremental exercise test. After obtaining local ethics approval and informed consent, 15 healthy subjects performed an incremental exercise test to volitional fatigue using the Bruce protocol. The Innocor (Innovision, Denmark) and CardiO2 (Medical Graphics, USA) systems were placed in series, with the Innocor mouthpiece attached to the pneumotach of the CardiO2. Metabolic data were analysed during the last 30 seconds of each stage and at peak exercise. There were non- significant differences (p > 0.05) between the two systems in estimation of oxygen consumption (VO2) and in minute ventilation (VE). Mean Cronbach's alpha for VO2 and VE were 0.88 and 0.92. The Bland-Altman analysis revealed that limits of agreement were -0.52 to 0.55 l.min(-1) for VO2, and -8.74 to 10.66 l.min(-1) for VE. Carbon dioxide production (VCO2) and co...
The effects of different recovery protocols on heart rate recovery (HRR) trend through fitted hea... more The effects of different recovery protocols on heart rate recovery (HRR) trend through fitted heart rate (HR) decay curves were assessed. Twenty one trained male athletes and 19 sedentary male students performed a submaximal cycle exercise test on four occasions followed by 5 min: 1) inactive recovery in the upright seated position, 2) active (cycling) recovery in the upright seated position, 3) supine position, and 4) supine position with elevated legs. The HRR was assessed as the difference between the peak exercise HR and the HR recorded following 60 seconds of recovery (HRR60). Additionally the time constant decay was obtained by fitting the 5 minute post-exercise HRR into a first-order exponential curve. Within-subject differences of HRR60 for all recovery protocols in both groups were significant (p < 0.001) except for the two supine positions (p > 0.05). Values of HRR60 were larger in the group of athletes for all conditions (p < 0.001). The time constant of HR decay...
ObjectivesClinical guidelines recommend regular physical activity for patients with heart failure... more ObjectivesClinical guidelines recommend regular physical activity for patients with heart failure to improve functional capacity and symptoms and to reduce hospitalisation. Cardiac rehabilitation programmes have demonstrated success in this regard; however, uptake and adherence are suboptimal. Home-based physical activity programmes have gained popularity to address these issues, although it is acknowledged that their ability to provide personalised support will impact on their effectiveness. This study aimed to identify barriers and facilitators to engagement and adherence to a home-based physical activity programme, and to identify ways in which it could be integrated into the care pathway for patients with heart failure.DesignA qualitative focus group study was conducted. Data were analysed using thematic analysis.ParticipantsA purposive sample of 16 patients, 82% male, aged 68±7 years, with heart failure duration of 10±9 years were recruited.InterventionA 12-week behavioural int...
Background. This study was carried out to establish the prevalence of cardiovascular risks such a... more Background. This study was carried out to establish the prevalence of cardiovascular risks such as hypertension, obesity, and diabetes in Eastern Nepal. This study also establishes the prevalence of metabolic syndrome (MS) and its relationships to these cardiovascular risk factors and lifestyle.Methods. 14,425 subjects aged 20–100 (mean 41.4 ± 15.1) were screened with a physical examination and blood tests. Both the International Diabetic Federation (IDF) and National Cholesterol Education Programme’s (NCEP) definitions for MS were used and compared.Results. 34% of the participants had hypertension, and 6.3% were diabetic. 28% were overweight, and 32% were obese. 22.5% of the participants had metabolic syndrome based on IDF criteria and 20.7% according to the NCEP definition. Prevalence was higher in the less educated, people working at home, and females. There was no significant correlation between the participants’ lifestyle factors and the prevalence of MS.Conclusion. The high in...
International Journal of Nursing Studies - INT J NURS STUD, 2004
Research has identified a number of negative societal perceptions of nursing related to gendered ... more Research has identified a number of negative societal perceptions of nursing related to gendered stereotyping, subordination to doctors, low academic standards, limited career opportunities and poor pay and conditions, and importantly how these perceptions may affect levels of recruitment into nursing. Focusing specifically on nurses, research has also considered the extent to which these societal perceptions are realities in their workplaces, and the direct experiences that contribute to attrition from both nursing courses and jobs. However, to date, few research has actually bridged the above approaches and considered the perceptions that nursing students hold as they first enter their education and how these change, or are confirmed, as a result of their experiences. In this context, the current study uses a combined questionnaire (n=650), interview (n=30) and focus group (n=7) methodology to investigate the experiences of students based at two British Universities. The findings ...
We have compared the finger hyperextensometer (Jobbins et al., 1978) and the scoring system of Ca... more We have compared the finger hyperextensometer (Jobbins et al., 1978) and the scoring system of Carter and Wilkinson (1964), modified by Beighton et al. (1973), in the quantification of joint laxity in a population selected to demonstrate a wide range of joint movement. Both systems correlated well (P less than 0.001) with a &#39;global index&#39; of joint laxity derived by adding the arcs of movement recorded at most joints in the body by the method of the American Academy of Orthopaedic Surgeons (1965). The Carter and Wilkinson system produced better correlations and is the method of choice for assessing generalized joint laxity.
We have applied the Cavalieri method of modern design stereology with magnetic resonance imaging ... more We have applied the Cavalieri method of modern design stereology with magnetic resonance imaging for estimating the volume of whole-body muscle and fat compartments in four patients with muscular dystrophy, a patient with myopathy, five controls, an anorexic subject, and a body builder. Detailed systematic series (ie, 50) of axial MR images (T1-weighted, TR/TE 400/10 msec) were obtained throughout the whole body of each subject. The results showed that 15, 20, and 35 axial sections through the body are sufficient to secure coefficients of error (CEs) on the estimates of total muscle and fat volume of around 10%, 5%, and 3% respectively in muscular dystrophy patients and controls. The mean normalized volumes of muscle in four muscular dystrophy patients were decreased by 27% (t-test: P &amp;amp;lt; 0.05), and those of total fat were increased by 12% (t-test: P &amp;amp;gt; 0.05) relative to controls. The Cavalieri method provides a direct, efficient, and mathematically unbiased approach for studying human body compartments and may have application in assessing treatment efficacy in patients with muscular dystrophy. J. Magn. Reson. Imaging 2000;12:467-475.
This is a well presented, compact colour atlas detailing the majority of rheumatological conditio... more This is a well presented, compact colour atlas detailing the majority of rheumatological conditions which are amenable to photography. Each chapter begins with a resume of the condition under discussion followed by a mixture of clinical and X-ray pictures, each accompanied by an appropriate legend. The longest chapter deals with rheumatoid arthritis and emphasises the multi-system nature of this disease. The following chapter on juvenile chronic arthritis was the only disappointment, in that it utilised the term Still's disease more frequently than one would in clinical practice today. After dealing with inflammatory condition the author covers degenerative arthopathies, crystal arthopathies and connective tissues diseases. A picture of an LE cell is perhaps unnecessary since this test would now be obsolete in most laboratories but suppose may turn up in an examination situation. Rarer arthopathies and miscellaneous conditions are then covered. Generally the quality of the photographs is good, although a few of the X-rays have not been well reproduced. This book is recommended to fit in the pocket of any clinician, whatever their specialty or stage of career, and has the value of providing a spectrum of rheumatology that can be covered in a matter of minutes.
Data of 30 men and 30 women in college show similar body-image perception which is associated wit... more Data of 30 men and 30 women in college show similar body-image perception which is associated with abnormalities of eating or psychological instability.
This is a well presented, compact colour atlas detailing the majority of rheumatological conditio... more This is a well presented, compact colour atlas detailing the majority of rheumatological conditions which are amenable to photography. Each chapter begins with a resume of the condition under discussion followed by a mixture of clinical and X-ray pictures, each accompanied by an appropriate legend. The longest chapter deals with rheumatoid arthritis and emphasises the multi-system nature of this disease. The following chapter on juvenile chronic arthritis was the only disappointment, in that it utilised the term Still's disease more frequently than one would in clinical practice today. After dealing with inflammatory condition the author covers degenerative arthopathies, crystal arthopathies and connective tissues diseases. A picture of an LE cell is perhaps unnecessary since this test would now be obsolete in most laboratories but suppose may turn up in an examination situation. Rarer arthopathies and miscellaneous conditions are then covered. Generally the quality of the photographs is good, although a few of the X-rays have not been well reproduced. This book is recommended to fit in the pocket of any clinician, whatever their specialty or stage of career, and has the value of providing a spectrum of rheumatology that can be covered in a matter of minutes.
Loneliness and isolation can be a major cause of unhappiness and can contribute towards depressio... more Loneliness and isolation can be a major cause of unhappiness and can contribute towards depression and mental illness in older age. These associations are recognised by academics, policy makers and older…
The purpose of this study was to assess the effect of three different body positions on HRV measu... more The purpose of this study was to assess the effect of three different body positions on HRV measures following short-term submaximal exercise. Thirty young healthy males performed submaximal cycling for five minutes on three different occasions. Measures of HRV were obtained from 5-min R to R wave intervals before the exercise (baseline) and during the last five minutes of a 15 min recovery (post-exercise) in three different body positions (seated, supine, supine with elevated legs). Measures of the mean RR normal-to-normal intervals (RRNN), the standard deviation of normal-to-normal intervals (SDNN), the root mean square of successive differences (RMSSD) and the low-frequency (LF) and the high-frequency (HF) spectral power were analyzed. Post-exercise RRNN, RMSSD were significantly higher in the two supine positions (p < 0. 01) compared with seated body position. Post-exercise ln LF was significantly lower in the supine position with elevated legs than in the seated body positio...
Tests of change of direction as measurement of different kinds of motor ability in boys of the 7t... more Tests of change of direction as measurement of different kinds of motor ability in boys of the 7th, 8th, and 9th grades". Research Quarterly 11 (3): 136-147. Gayle, R. C., 1978 "The department of energy physical fitness qualifications test for security inspectors: analysis and recommendations". Union Carbide Corporation, Oak Ridge, TN. Jaeger, R. M., 1985 "Self-esteem scale". (Unpublished data), University of North Carolina at Greensboro, NC.
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