Linda M Smith-Resar, M.D.
- Professor of Medicine
https://www.hopkinsmedicine.org/profiles/results/directory/profile/0004790/linda-smith-resar
Such evidence includes beneficial effects on physiologic risk factors for disease skin care solutions purchase dapsone 100mg without prescription, such as high blood pressure and blood lipoproteins skin care zamrudpur cheap dapsone 100mg fast delivery, as well as beneficial effects on circulatory system functioning skin care natural tips purchase dapsone 100mg on line, blood-clotting mechanisms acne 6 dpo buy cheap dapsone 100mg online, insulin production and glucose handling, and caloric balance. The information reviewed in this chapter shows that the inverse association between physical activity and several diseases is moderate in magnitude, consistent across studies that differed substantially in methods and populations, and biologically plausible. A dose-response gradient has been observed in most studies that examined more than two levels of activity. For most of the diseases found to be inversely related to physical activity, the temporal sequence of exposure preceding disease has been demonstrated. Although controlled clinical trials have not been conducted (and are not likely to be conducted) for morbidity and mortality related to the diseases of interest, controlled trials have shown that activity can improve physiologic risk factors for these diseases. From this large body of consistent information, it is reasonable to conclude that physical activity is causally related to the health outcomes reported here. Population Burden of Sedentary Living Given that the relationship between activity and several diseases is likely to be causal, it follows that a large number of Americans unnecessarily become ill or die each year because of an inactive way of life. Published estimates of the number of lives lost in a year because of inactivity have ranged from 200,000 for inactivity alone to 300,000 for inactivity and poor diet combined (Hahn et al. Such estimates are inherently uncertain because they do 145 Physical Activity and Health not take into account the reality that some people have more than one risk factor for a disease; for these people, the elimination of a single risk factor. Similarly, the health benefits of improved mood, quality of life, and functional capacity have not been quantified. Although the total population burden of physical inactivity in the United States has not been quantified, sedentary living habits clearly constitute a major public health problem. It is often asked how little physical activity a person can obtain and still derive health benefit. Although the dose-response relationship appears not to have a lower threshold, thereby indicating that any activity is better than none, some quantitation of a target "dose" of activity is helpful for many people. It has been shown that total amount of physical activity (a combination of intensity, frequency, and duration) is related to health outcomes in a dose-response fashion, but the absolute difference in amount of physical activity in kilocalories of energy expended between exposure categories has not been estimated routinely. Several studies, however, have estimated average caloric expenditure for the activity categories studied and thus allow quantitation of amount of physical activity associated with improved health outcomes. Furthermore, in the majority (62 percent) Dose Using the epidemiologic literature to derive recommendations for how much and what kind of physical activity a person should obtain is problematic, in part because the methods for measuring and classifying physical activity in epidemiologic studies are not standardized. Responses to questions or occupational activity categories are usually transformed, using a variety of methods, into estimates of calories expended per week, minutes of activity per week, categories of total activity, or other types of composite scores. Numerous studies have used this type of information to estimate total amount of activity, and many have been able to explore dose-response relationships across categories of activity amount. For the most part, these studies demonstrate that amount of benefit is directly related to amount of physical activity (see Tables 4-1 through 4-8), rather than showing a threshold level of activity necessary before health benefits accrue. Such studies are less helpful, 146 the Effects of Physical Activity on Health and Disease of that study population, no vigorous activity was reported. Based on these studies, it is reasonable to conclude that activity leading to an increase in daily expenditure of approximately 150 kilocalories/day (equivalent to about 1,000 kilocalories/week) is associated with substantial health benefits and that the activity does not need to be vigorous to achieve benefit. It should be emphasized that this is an estimate based on few studies, and that further research will be required to refine it. For example, it is not clear whether it is the total amount of caloric expenditure or the amount of caloric expenditure per unit of body weight that is important. Nonetheless, this amount of physical activity can be obtained in a variety of ways and can vary from day to day to meet the needs and interests of the individual. An average expenditure of 150 kilocalories/day (or 1,000 kilocalories/week) could be achieved by walking briskly for 30 minutes per day, or by a shorter duration of more vigorous activity. In addition to the health effects associated with a moderate amount of physical activity, the doseresponse relationships show that further increases in activity confer additional health benefits. Thus people who are already meeting the moderate activity recommendation can expect to derive additional benefit by increasing their activity.
Background Absorption Error in Determination of Copper in Plants by Flame Atomic Absorption Spectrometry skin care at home generic dapsone 100 mg with mastercard. The Determination of Cadmium in Soils acne 9 year old daughter cheap 100 mg dapsone mastercard, Plants and Fertilizers by Dithizone Extraction and Atomic Absorption Spectroscopy skin care questions order dapsone 100mg visa. The feed samples are usually digested in glass beakers using a mixture of nitric and perchloric acids skin care cheap dapsone 100mg with visa, filtered into a volumetric flask and then brought to volume with deionized water. Instead of using beakers, samples can also be digested directly in volumetric flasks to eliminate losses from spattering and sample transfer (2). Since the levels of cadmium and lead are normally very low in feeds, a procedure for the concentration of these elements by solvent extraction is needed (4). Analysis Determine the concentration of the elements of interest by using the standard conditions listed in the "Standard Conditions" pages. If calcium is being determined, be sure the final sample solution and standards contain 1% lanthanum. Minimum Sample Preparation for the Determination of Ten Elements in Pig Feces and Feeds by Atomic Absorption Spectrophotometry and a Spectrophotometric Procedure for Total Phosphorus. Official Methods of Analysis, "Minerals in Feeds by Atomic Absorption Spectrophotometry-Official Final Action," Association of Official Analytical Chemists, Washington D. This method cannot be used for elements that are volatile below the ashing temperature. Up to 10 g of sample may be used depending on the concentration of the elements present. Typical Analytical Procedure Sample Preparation Place 2 g of feed sample in a well-glazed porcelain dish. Cool, filter into a 100-mL volumetric flask, and dilute to volume with deionized water. If calcium is to be determined, be sure that the final dilution contains 1% lanthanum solution. Analysis Determine the concentration of the elements of interest using the conditions listed on the "Standard Conditions" pages for each element. Be sure that a reagent blank is made and that 1% La is added to standards and samples when determining calcium. Collaborative Study of Copper, Sodium and Potassium in Feeds by Atomic Absorption Spectrophotometry and Sodium and Potassium by Flame Emission Spectrophotometry. Official Methods of Analysis, "Minerals in Feeds by Atomic Absorption Spectrophotometry-Official Final Action," Association of Official Analytical Chemists, Washington, D. Filter the solution through a fast filter paper into a 100-mL volumetric flask, washing the filter paper thoroughly with deionized water. Determine the concentrations of the elements of interest using the standard conditions listed on the "Standard Conditions" pages. A Modification in the Official Methods for the Determination of Metals in Feeds and Fertilizers by Atomic Absorption Spectrophotometry. Official Methods of Analysis, "Minor Nutrients by Atomic Absorption Spectrophotometry - Official Final Action," Association of Official Analytical Chemists, Washington, D. Typical Analytical Procedure Sample Preparation Place 1 g of sample in a 150-mL beaker. Filter through fast filter paper into a 100-mL volumetric flask, washing the paper and residue thoroughly with deionized water. Analysis Determine the elements of interest using the standard conditions listed in the "Standard Conditions" pages. If zinc is being determined, do not use rubber stoppers, as these will contaminate the sample. For samples containing less than 20% K2O, transfer a 25-mL aliquot to a 100-mL flask, dilute to volume, and shake thoroughly. Determine the concentration of potassium in the samples using the conditions listed on the "Standard Conditions" pages. Direct Determination of Potash in Fertilizers by Atomic Absorption Spectrophotometry.
Unless statewide or nationwide secular trends show a decline of similar magnitude during this period (data not yet available) skin care guru order dapsone 100mg with visa, this study suggests that a wellfunded skin care 10 year old dapsone 100 mg without a prescription, intensive antitobacco mass media campaign can have an effect in the setting Monograph 19 skin care 777 buy 100mg dapsone amex. One community of each pair was then randomly assigned (to the extent possible acne 4 days before period dapsone 100 mg on-line, as determined by media markets) to the intervention condition. Within the intervention communities, newly designed radio and television spots were placed on stations with predominantly AfricanAmerican adult audiences. Copies of these spots were also disseminated through community-based organizations. During the campaign, African Americans made 82% of the calls in the intervention communities but only 26% of the calls in the control communities. Call volume for African Americans fell to near baseline levels just before the second wave of the campaign, but during the second wave, call volume for African Americans increased to 40. Slightly more of the African Americans said their calls were prompted by radio spots than by television. Enrollment in Quit Centre programs at Sydney Hospital also was higher 533 Media and Calls to Cessation Information Centers and Quitlines Mass media messages have sometimes been "tagged" with phone numbers for interested viewers to call for information about cessation services or to get cessation help directly. It can be argued that prompting a smoker to make a call for information or help is a behavioral outcome for a media campaign. Quitlines can be an effective mode for the delivery of cessation services for a number of reasons, including accessibility and convenience to the smoker. This campaign appeared to be effective in prompting smokers who possibly already were motivated to take an action that might help them quit. An estimated 63% of the television-viewing audience saw a tagged announcement, but no 12. Since 1994, the Health Education Authority for England has funded a mass media campaign aimed at getting smokers to quit. Although the quitline receives about one-half million calls per year, more than 70% of calls occurred during the three months of the advertising campaign. In 2004, quitline call volume increased fourfold compared with the average, coincident with the media blitz associated with the United Kingdom No Smoking Day. In periods when media use was minimal, a higher proportion of callers cited other sources of referral to the helpline. However, calls from people making counseling requests occurred more when rating points were lower; counseling was not suggested proactively during times 534 of high call volume. Some of the callers during lower call-volume periods may have been specifically referred. In contrast to the egalitarian reach of the California quitline, a study in Victoria, Australia, found lower response in low socioeconomic areas;163 however, the increase in quitline call volume161 coincident with increased media messages was the same regardless of socioeconomic area. This evidence provided the impetus to investigate further the effects of well-defined media interventions aimed at national and statewide populations. Often, the evaluation of these media campaigns has taken place within the framework of a multicomponent tobacco control program. In many instances it is not possible to separate the effects of the media component from the other components of the tobacco control program. When studies have related various measures of exposure to media from these campaigns to behavioral outcomes, the evidence has been very consistent. The findings described above suggest that antismoking media campaigns can influence attitudes toward tobacco within a short period, followed by longer-term effects on smoking behavior. Moreover, these studies highlight the validity of modern health behavior change Monograph 19. The Role of the Media theories that predict that health-marketing campaigns bring about behavior changes by first influencing behavior-related attitudes, beliefs, and intentions. This evidence also highlights the importance of identifying in the formative stages of campaign development the attitudinal constructs that health marketing advertisements are likely to influence, and then using those constructs to inform and enhance the evaluation of health marketing campaigns. As in the controlled experimental studies, methodological issues (similar and unique) related to population studies deserve attention. Repeated cross-sectional surveys to establish preexisting secular trends and track progress during the program need to take into account changing population demographics. Longitudinal surveys need to investigate the possible effects of differential attrition. Selection of a comparison group for evaluating a state-level program is complicated by spillover of media and other program elements from other states and programs, however modest, within the comparison states.
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