Interactive vs. non-interactive electronically delivered motivational materials for physical activity initiation and enhancement among adults with physical disabilities

Participation in physical activity has important health benefits among individuals with disabilities, whereas inactive lifestyles may lead to secondary limiting health conditions. However, few people with disabilities regularly participate in the recommended amount of health-related physical activities. Low rate of participation may be related to low motivation due to interconnected psychosocial factors. The Transtheoretical Model is a contemporary motivational theory incorporating several theoretical constructs that can facilitate physical activity initiation and adherence. There is lack of empirical evidence related to the development and delivery of physical activity motivational programs toward people with disabilities. The current literature identifies the need for theory-driven and appealing physical activity intervention programs. Therefore, the purpose of this study was to compare web-based interactive (i.e., group discussions) vs. non-interactive physical activity motivational materials tailored to mainly inactive adults with physical disabilities. This was a true experimental design with two experimental and one control group. The results of the study demonstrated that the intervention program was effective in increasing leisure-type physical activity for the experimental non-interactive group that received only the web-based materials (F(2,72)=3.3, p=.04). Similarly, statistical significance was approached for total physical activity scores (F(2,72)=2.8, p=.07) in the web only (i.e., non-interactive) group (Effect Size=.34) from pre- to post-intervention. On the contrary, the control group decreased their leisure-type physical activity level between pretest and posttest (Effect Size=-.30). There were neither statistically significant interaction nor main effects for processes of change, decisional balance, and self-efficacy. Lastly, the proportion of people in the web only group (59%) who progressed in their stages of change was higher than the proportion who progressed in the control group (27.6%) (X² [1,N= 51] = 5.l3, p=.02). The results of this study partially support the development and delivery of web based physical activity motivational materials for the posited population. Such materials may be applicable to other populations of different disability types, ages, cultural and ethnic backgrounds

Η οχύρωση της Χαλκίδας. Η ανασκαφή στο χώρο ανέγερσης του Νέου Γενικού Νοσοκομείου.

In 2012-2014, research resumed on the eastern limit of the construction site of the new General Hospital of Chalkis, and a section of defensive wall was uncovered. Research was centred on the area that stretches to the north foothills of Vathrovouni and is widely known as Pedio Volis (‘Shooting Range’) because it was used by the army as a firing range for decades. To the north of this hill extends a lower crest, 90 m high, known by the name Kalogritsa, on the low slopes of which a section of the city and the defensive wall were excavated. Sections of domestic remains and the defensive wall were partly visible and had already been located in the 1970s during surface exploration. However, since the area was the property of the Greek Army, excavations could only be launched after the construction of the new General Hospital was approved. One of the issues which puzzled the researchers of the topography of the ancient city more than anything else—whether the asty was enclosed by a defensive wall or not—was resolved by the latest archaeological research. In the documents of ancient authors, such as Aeneas Tacticus, Heraclides Criticus, Strabo and Titus Livius, the existence of a defensive enclosure is clearly recorded. The wall that was recently discovered forms part of the urban fortification of the ancient city. Regardless of what the research does not take into account (e.g. whether the entire headland was fortified or not), the latest archaeological evidence attests to the existence of at least one section with north-south orientation that encloses the city from the east, taking advantage of the geomorphological features of Vathrovouni

SULT1A1 rs9282861 polymorphism-a potential modifier of efficacy of the systemic adjuvant therapy in breast cancer?

<p>Abstract</p> <p>Background</p> <p>Sulfotransferase 1A1 (SULT1A1) participates in the elimination of 4-hydroxy-tamoxifen (4-OH-TAM), which is one of the major active metabolites of tamoxifen (TAM). Homozygous <it>SULT1A1 </it>variant allele genotype has been associated with lower catalytic activity and thermostability of the enzyme. Previous clinical studies suggest that the <it>SULT1A1 </it>rs9282861 polymorphism may influence the survival of breast cancer patients treated with TAM in the adjuvant setting. We investigated the effect of rs9282861 genotypes on the survival of Finnish breast cancer patients treated with adjuvant chemotherapy or TAM.</p> <p>Methods</p> <p>The rs9282861 genotypes of 412 Finnish breast cancer patients with early breast cancer were identified by using PCR-RFLP method. Seventy six patients were treated with adjuvant cyclophosphamide based chemotherapy only, 65 patients received adjuvant TAM, and four patients were treated with both adjuvant chemotherapy and TAM. Overall long-term survival (OS), breast cancer specific survival (BCSS), and relapse-free survival (RFS) by rs9282861 genotypes were evaluated by the Kaplan-Meier method and Cox regression analysis.</p> <p>Results</p> <p>The multivariate analysis of 145 patients receiving either adjuvant TAM or chemotherapy showed a statistically significantly improved OS in patients with the rs9282861 homozygous variant AA genotype (hazard ratio [HR] = 0.50, 95% confidence interval [CI] = 0.29-0.88, <it>P </it>= 0.015). In the separate analyses of patients receiving only chemotherapy or adjuvant TAM, there were no statistically significant differences in survival.</p> <p>Conclusions</p> <p>In this prospective study, we observed a previously unreported association between the <it>SULT1A1 </it>rs9282861 genotype and OS of breast cancer patients treated with adjuvant chemotherapy or TAM. This novel finding suggests that the rs9282861 polymorphism modifies the long-term clinical outcome of patients receiving adjuvant TAM or chemotherapy.</p

Predictors of ADL Disability in Culturally Diverse Older Adults

The purpose of this study was to utilize the disablement pathway model to examine the contribution of physical function, dyspnea, and pain to disability in activities-of-daily-living (ADL) in culturally diverse older adults. Participants were 51 older adults (age = 69.0 years ± 9.7; 76.5% African-American, 51.0% \u3c high school education, 52.9% \u3c $20,000 annual income) from an urban community center and an independent living housing facility for seniors. Participants completed the Functional Status Index (FSI), which provides ratings of need for assistance (FSIA) and pain (FSIP) with ADL, the Continuous Scale Physical Functional Performance 10-item Test (CS-PFP10), and an analog dyspnea scale. Hierarchical multiple regression analyses revealed that facility, physical function, pain, and dyspnea accounted for 50.5% of the variance in disability and that pain (β = .43, p \u3c .01) and physical function (β = -.39, p \u3c .01) were the only significant predictors. In the second model, facility, dyspnea, and pain explained 27.6% of the variance in physical function, and facility (β = .39, p \u3c .01) and dyspnea (β = -.26, p = .05) were the only significant predictors. Based on the disablement pathway model, physical functional improvement and pain prevention and management should be targeted when designing culturally appropriate strategies for delaying disability and maintaining independent life

Results of preventive radioiodine therapy in euthyroid patients with history of hyperthyroidism prior to administration of amiodarone with permanent atrial fibrillation — a preliminary study

Wstęp: Terapia radiojodem (RAI) jest standardowym postępowaniem w leczeniu nadczynności tarczycy. Jednakże stosowanie RAI w stanie eutyreozy u pacjentów wymagających przewlekłego podawania amiodaronu (AM), w przypadku braku skuteczności innych leków przeciwarytmicznych, jest kontrowersyjne. Celem pracy była ocena bezpieczeństwa i skuteczności profilaktycznego zastosowania RAI, przed podaniem AM, u pacjentów w eutyreozie z utrwalonym migotaniem przedsionków (PAF), w przeszłości leczonych z powodu nadczynności tarczycy.Materiał i metody: przeprowadzono analizę retrospektywną. Chorych oceniano na początku badania oraz 2, 6, 8 i 12 miesięcy po zastosowaniu RAI. 17 pacjentów z eutyreozą z towarzyszącym PAF zostało zakwalifikowanych do RAI (kobiety/ mężczyźni 3/14; wiek: 65–87, mediana 71 lat). Pacjenci wymagali przewlekłego stosowania AM jako profilaktyki nagłego zgonu sercowego.Wyniki: Każdy pacjent otrzymał dawkę ablacyjną 131I {800 MBq (22 mCi)}. Po podaniu RAI, jak również w okresie obserwacji nie zaobserwowano powikłań. Subkliniczna nadczynność tarczycy wystąpiła w 2 przypadkach (11,8%) po 2 miesiącach od podania RAI i 5 tygodniach od włączenia AM. W tej sytuacji leczenie RAI przeprowadzono ponownie. Trzech pacjentów (17,6%) po 6 miesiącach oraz 2 (11,8%) po 8 miesiącach wymagało podania dodatkowej dawki 131I z powodu nadczynności tarczycy indukowanej AM. Dwunastu pacjentów (70,6%), powróciło do spontanicznego rytmu zatokowego w ciągu dwóch miesięcy. Po 6 i 12 miesiącach leczenia 14 pacjentów (82,4%) wykazało rytm zatokowy w badaniu kontrolnym.Wnioski: Prewencyjne zastosowanie RAI przed włączeniem AM u pacjentów w eutyreozie (w wywiadzie: nadczynność tarczycy) z PAF, gdy terapia innymi lekami antyarytmicznymi okazuje się nieskuteczna, może być rozważana jako metoda z wyboru. Jest to szczególnie ważne w przypadku pacjentów wymagających stałego podawania AM jako leku ratującego życie. (Endokrynol Pol 2014; 65 (4): 270–274)Introduction: Radioiodine (RAI) therapy is a standard procedure in the treatment of hyperthyroidism. However, the use of RAI in euthyroid patients requiring chronic administration of amiodarone (AM) where other antiarrhythmic drugs may lack efficacy is still controversial.Objective: The aim of this study was to assess the safety and efficacy of an AM therapy prior to treatment with radioiodine therapy in euthyroid patients with permanent atrial fibrillation (PAF), who had been treated for hyperthyroidism in the past.Material and methods: This was a retrospective observational study. Patients were assessed at baseline and two, six, eight, and 12 months after RAI therapy. 17 euthyroid patients with PAF were qualified to the RAI (female/male 3/14; age range 65 to 87, median 71). The patients required chronic administration of AM as a prophylaxis against sudden death.Results: Each patient received an ablative dose of 800 MBq (22 mCi) of 131I. At baseline and during follow-up, no side effects of the therapy and no signs of drug intolerance were observed. Subclinical hyperthyroidism occurred in two (11.8%) cases after two months of RAI and five weeks of AM administration. In this situation, RAI therapy was repeated. Three patients (17.6%) after six months, and another two (11.8%) after eight months, required an additional dose of 131I due to amiodarone-induced thyrotoxicosis (AIT). Twelve patients (70.6%) returned to spontaneous sinus rhythm within two months. Fourteen patients (82.4%) had sinus rhythm during follow-up after six and 12 months of treatment.Conclusions: Preventive RAI in euthyroid (but previously hyperthyroid) patients with PAF before administration of AM may be the method of choice. This is particularly important for patients who will require permanent AM administration as a life-saving drug. (Endokrynol Pol 2014; 65 (4): 269–274

Wartość diagnostyczna wybranych markerów biochemicznych w diagnostyce wznowy raka rdzeniastego tarczycy — porównanie kalcytoniny, prokalcytoniny, chromograniny A i antygenu karcynoembrionalnego

Introduction: Medullary thyroid cancer (MTC) is a malignancy of the thyroid gland, which derives from parafollicular C cells. Periodic measurement of biochemical markers of MTC remains a crucial part of patient follow-up and disease monitoring. The aim of the study was to compare the diagnostic value of four selected markers — calcitonin (Ct), procalcitonin (PCT), chromogranin A (CgA), and carcinoembryonic antigen (CEA). Material and methods: Patients with histopathologically confirmed MTC hospitalised in a single department between January 2015 and December 2015 were included in the study. Patients were subdivided into two groups: a remission group and an active disease group, based upon serum markers of MTC and imaging. Levels of Ct, PCT, CgA, and CEA were compared between the groups. Results: Forty-four patients were included; 20 patients presented active disease and 24 were in remission. All patients with active disease had Ct exceeding the upper limit of normal range (10 pg/mL) — for that threshold the sensitivity was 100.0% and the specificity was 73.9%; for the best-fit threshold of 121.0 pg/mL the specificity was 95.8% with sensitivity 100.0%. There was significant correlation between Ct and PCT — p &lt; 0.000001, r = 0.93. All patients with active disease exceeded the upper limit of the normal range (0.5 ng/mL) — for that threshold the sensitivity was 100.0% and the specificity was 83.3%; for the best-fit threshold of 0.95 ng/mL the specificity was 95.8% with sensitivity 100.0%. In case of CEA for the best-fit threshold of 12.66 ng/mL the specificity was 100.0% with sensitivity 57.9%; for CgA the best-fit threshold was 75.66 ng/mL with specificity 83.3% and sensitivity 75.0%. Conclusions: Our study confirms that PCT can be considered as an equivalent alternative for measurement of calcitonin. On the other hand, it is also worth noting that MTC can be a rare cause of very high levels of PTC not resulting from infectious diseases. The diagnostic value of CEA and chromogranin A is much lower and can be within the normal range even in patients with advanced, metastatic MTC. They should be used only as accessory markers.Wstęp: Rak rdzeniasty tarczycy (RRT) to nowotwór złośliwy tarczycy wywodzący się z przypęcherzykowych komórek C. Okresowa kontrola markerów biochemicznych RRT stanowi kluczowy element prowadzenia pacjenta i monitorowania choroby. Celem obecnej pracy było porównanie wartości diagnostycznej czterech wybranych markerów — kalcytoniny (Ct), prokalcytoniny (PCT), chromograniny A (CgA) i antygenu karcynoembrionalnego (CEA). Metody: Do badania włączono pacjentów z histopatologicznie potwierdzonym RRT hospitalizowanych w jednym oddziale szpitalnym w 2015 roku. Pacjentów podzielono na dwie podgrupy — grupę pacjentów w remisji oraz z aktywną chorobą zależnie od wartości markerów osoczowych oraz wykonanej diagnostyki obrazowej. Wyniki: Włączono czterdziestu czterech pacjentów; 20 pacjentów prezentowało cechy aktywnej choroby, 24 było w remisji. Wszyscy pacjenci z aktywną chorobą wykazywali stężenia Ct przekraczające górną granicę normy (10 pg/ml); dla optymalnego punktu odcięcia 121,0 pg/ml swoistość wyniosła 95,8% przy czułości 100,0%. Wykazano istotną korelację pomiędzy Ct i PCT- p &lt; 0.000001, r = 0.93. Dla optymalnego punktu odcięcia wynoszącego 0.95 ng/ml swoistość wyniosła 95.8% przy czułości 100.0%. W przypadku CEA dla najlepiej dopasowanego progu 12,66 ng/ml swoistość wyniosła 100,0% przy czułości 57,9%; dla CgA optymalny punkt odcięcia wyniósł 75,66 ng/ml przy swoistości 83,3% i czułości 75,0%. Wnioski: Nasze badanie potwierdza, że PCT może być uważana za równoważną alternatywę dla oznaczenia kalcytoniny. Wartość diagnostyczna CEA i chromograniny A jest znacznie mniejsza i parametry te mogą pozostawać w granicach normy nawet u pacjentów z zaawansowanym RRT z przerzutami odległymi. Powinny być one traktowane jedynie jako pomocnicze markery

The TREAT-NMD DMD global database: Analysis of more than 7,000 duchenne muscular dystrophy mutations

Analyzing the type and frequency of patient-specific mutations that give rise to Duchenne muscular dystrophy (DMD) is an invaluable tool for diagnostics, basic scientific research, trial planning, and improved clinical care. Locus-specific databases allow for the collection, organization, storage, and analysis of genetic variants of disease. Here, we describe the development and analysis of the TREAT-NMD DMD Global database (http://umd.be/TREAT_DMD/). We analyzed genetic data for 7,149 DMD mutations held within the database. A total of 5,682 large mutations were observed (80% of total mutations), of which 4,894 (86%) were deletions (1 exon or larger) and 784 (14%) were duplications (1 exon or larger). There were 1,445 small mutations (smaller than 1 exon, 20% of all mutations), of which 358 (25%) were small deletions and 132 (9%) small insertions and 199 (14%) affected the splice sites. Point mutations totalled 756 (52% of small mutations) with 726 (50%) nonsense mutations and 30 (2%) missense mutations. Finally, 22 (0.3%) mid-intronic mutations were observed. In addition, mutations were identified within the database that would potentially benefit from novel genetic therapies for DMD including stop codon read-through therapies (10% of total mutations) and exon skipping therapy (80% of deletions and 55% of total mutations)

The Mediating Role of Intention and Stages of Change in Physical Activity Among Adults with Physical Disabilities: An Integrative Framework

The study’s purpose was to identify the mediating role of intention and the stages of change (SOC) in physical activity (PA) over a 6-month period using two models (Theory of Planned Behavior [TPB] and TPB/SOC). Participants were 143 adults with physical disabilities (70.68% response rate; M age = 46.03). The TPB constructs, SOC (time 1), and PA (time 2) were assessed using standardized self-report questionnaires. Based on path analyses, attitude had the highest effect on intention and SOC followed by perceived behavioral control within both well-fit models. The variance in PA explained by the first (TPB) and second (TPB/SOC) models was 16% and 28% respectively. In the just identified model of TPB/SOC, the direct effect of SOC on physical activity remained strong (γ[subscript soc·pa] = .45) and SOC approached full mediation through attitude. Health promotion interventions need to include both intention and behavior elements (SOC) reinforcing increased PA value and barrier elimination.This is the publisher’s final pdf. The published article is copyrighted by Human Kinetics, Inc. and can be found at: http://journals.humankinetics.com/jsep.Keywords: Theory of planned behavior, Web-based study, Prospective design, Transtheoretical mode

Rozpiętość rozkładu objętości erytrocytów — nowy marker zaostrzenia niewydolności krążenia u pacjentów z niedoczynnością tarczycy po leczeniu jodem promieniotwórczym

Introduction: Cardiovascular diseases constitute a major cause of health problems and death in developed countries across the world. The increased value of the index of distribution of red blood cells volume (RDW) may be a prognostic marker in patients diagnosed with chronic heart failure (CHF). Hypothyroid patients present higher RDW values if compared to healthy controls. Taking into consideration that RDW might be both affected by thyroid status and CHF, we decided to determine the effect of concomitant hypothyroidism following radioiodine therapy (RIT) and CHF on hematological parameters. Materials and methods: Patients with toxic nodular goiter and heart failure with concomitant anemia were included. Patients underwent treatment with radioiodine before the planned heart transplant or pacemaker implantation (combined ICD/CRT-D). After RIT patients were divided into the three subgroups: with overt hypothyroidism (TSH ≥ 10µIU/mL, Group I), subclinically hypothyroid patients (TSH 4.3-9.0 µIU/mL, Group II) and with high-normal level of TSH (2.6-4.2 µIU/mL, Group III). Results: Significant correlation between TSH and RDW was observed (r=0.46; P < 0.0001) after RIT, whereas no correlation between serum TSH levels and TIBC and Fe was observed. In Group I significant correlation between TSH and RDW (r= 0.48; P = 0.002) after RIT was observed, whereas in two other subgroups there were no significant correlation. Conclusions: Subclinical hypothyroidism or high-normal levels of TSH did not affect RDW in a significant manner in the studied population. Our results demonstrates that overt hypothyroidism may contribute to deterioration of CHF reflected in changes of RDW value. Wstęp: Choroby sercowo-naczyniowe stanowią główną przyczynę problemów zdrowotnych i zgonów w krajach wysoko uprzemysłowionych na całym świecie. Podwyższona wartość rozpiętości rozkładu objętości erytrocytów (RDW) może stanowić marker prognostyczny u pacjentów z przewlekłą niewydolnością serca (PNS). Pacjenci z niedoczynnością tarczycy mają wyższe wartości RDW w porównaniu z osobami zdrowymi. Biorąc pod uwagę, że RDW może być zmienione zarówno przez stan czynnościowy tarczycy, jak i PNS, autorzy niniejszej pracy postanowili ustalić wpływ współistniejącej niedoczynności tarczycy spowodowanej terapią jodem promieniotwórczym (RIT) i PNS na parametry hematologiczne. Materiały i metody: Włączono pacjentów z wolem guzkowym toksycznym, PNS oraz towarzyszącą niedokrwistością. U pacjentów prze­prowadzono RIT przed planowanym przeszczepieniem serca lub implantacją urządzenia resynchronizującego lub defibrylatora (ICD/CRT-D). Po RIT pacjentów podzielono na 3 podgrupy: z jawną niedoczynnością tarczycy (TSH ≥ 10 μIU/mL — grupa I), z subkliniczną niedoczynnością (TSH 4,3–9,0 μIU/mL — grupa II) oraz z TSH w górnej granicy normy (2,6–4,2 μIU/mL — grupa III). Wyniki: Zaobserwowano istotną korelację między TSH i RDW (r = 0,46; P &lt; 0,0001) po RIT, podczas gdy nie zaobserwowano kore­lacji między stężeniem TSH i stężeniem żelaza oraz TIBC. W grupie I zaobserwowano istotną korelację między TSH i RDW (r = 0,48; P = 0,002) po RIT, jakkolwiek w dwóch pozostałych podgrupach nie zaobserwowano istotnej korelacji. Wnioski: Subkliniczna niedoczynność tarczycy, jak i wartości TSH w górnej granicy normy nie wpływały na RDW w sposób istotny w grupie badanej. Wyniki wskazują, że jawna niedoczynność tarczycy może przyczynić się do zaostrzenia PNS odzwierciedlonej zmianą wartości RDW

Wpływ kanabinoidów na układ wydzielania wewnętrznego

Kanabinnoidy stanowią pochodne konopii, najbardziej aktywnym biologicznie wśród nich jest tetrahydrokannabinol (THC). Najczęściej stosowanymi narkotykami są marihuana, haszysz i olej haszyszowy. Te mieszaniny związków wywierają swój efekt poprzez interakcję z receptorami kannabinoidowymi CB1 i CB2. Receptory typu pierwszego (CB1) zlokalizowane są głównie w ośrodkowym układzie nerwowym oraz w tkance tłuszczowej oraz narządach, w tym większości gruczołów wydzielania wewnętrznego. Receptory typu drugiego (CB2) znajdują się głównie w obwodowym układzie nerwowym (obwodowe zakońćzenia nerwowe) oraz na powierzchni komórek ukłądu immunologicznego. Obecnie coraz większą wagę przywiązuje się do roli endogennych ligandów oddziałujących ze wspomnianymi receptorami, jak i roli samych receptorów. Dotychczas udowodniono udział endogennych kannabinoidów w regulacji ilości przyjmowanego pokarmu, homeostazy, mają także istotny wpływ na układ wydzielania wewnętrznego, w tym aktywność przysadki, kory nadnerczy, tarczycy, trzustki i gonad. Wzajemne powiązania pomiędzy układem endokannabinoidowym i aktywnością układu wydzielania wewnętrznego może stanowić punkt uchwytu dla licznych leków, któych skuteczność wykazano w przypadku leczenia niepłodności, otyłości, cukrzycy cz nawet zapobieganiu chorobom układu sercowo-naczyniowego.