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admin | Supplements To Gain Muscle | 23.09.2013
Young Arnold Stressed Symmetry In His Physique Got a Question for The Frugal Fitness Guru? I only watch it a few times a year now, I still love it for the nostalgia, entertainment factor, humor, and athleticism (I'll be posting an in-depth article soon on why I think Pro Wrestling can be considered an actual sport).
He was also infamous as the spokesman for Slim Jim and is pretty much synonymous with the brand even years after his last commercial.
What is more tragic, however, is that at age 58 (still pretty young by today's standards), Macho Man has outlived dozens if not hundreds of other great pro wrestlers that have died early due to drug abuse.
A lot of wrestlers, especially the older ones or less famous, have no health benefits so they primarily self-treat themselves.
Unfortunately, the list goes on and on with countless numbers of other famous or forgotten wrestlers. New York NYC Crime Bronx Brooklyn Manhattan Queens Education Obituaries Sports Yankees Mets Giants Jets Knicks Nets Rangers Islanders Football Basketball Baseball Hockey Soccer College High School The Score News Crime U.S. Follow Us Facebook Twitter Instagram Pinterest YouTube Subscribe Follow UsNewsletter App Subscriptions Subscribe Get Our Newsletter A daily blend of the most need-to-know Daily News stories, delivered right to your inbox. Congress has asked baseball commissioner Bud Selig and the Players Association to implement Human Growth Hormone testing on the major-league level and ban smokeless tobacco in the dugout and on the field.
Nearly four years after congressional hearings were held on the Mitchell Report and baseballa€™s performance-enhancing drug history, two U.S. In a letter to Selig and Players Association executive director Michael Weiner Wednesday, anti-PED watchdog Henry Waxman (D-Calif.) and Frank Pallone, Jr.
HGH testing has been in the sports forefront throughout the autumn, as the NFL and its union had agreed to test players at the start of the 2011 season after ratifying the new CBA in late July. Waxman and several congressmen recently wrote a letter to the chairman of the Energy and Commerce Committee, Fred Upton (R-Mich.), asking that Upton hold a hearing on the NFL-HGH testing stalemate. Waxman, a ranking member of the Energy and Commerce Committee, was on the Committee for Oversight and Government Reform when it held its hearings on baseball and PEDs in 2005 and 2008. Confirmatory factor analysis provides evidence supporting a second order factor solution for four subscales and a total IPAQ score. The total IPAQ score is a useful measure for evaluating ease of use and preference for injection pens in clinical trials among patient dyads receiving hGH. IntroductionHuman growth hormone (hGH) is produced and excreted by the anterior pituitary gland to help fuel growth during childhood and to maintain tissues and organs throughout life[1]. Study methodsInstrument developmentThe IPAQ was developed through a scientifically rigorous, systematic process[11].
Psychometric evaluation studyOne-hundred-thirty six parenta€“child dyads were recruited from 20 study sites across the United States into a Phase 3 trial to evaluate a new GenotropinA® disposable injection pen (a€?new disposable pena€?).
ResultsDyad characteristicsA total of 136 dyads were included in the psychometric analysis. 3Percentage based on the number of dyads who changed the dose (Na€‰=a€‰107) or used the needle guard (Na€‰=a€‰111). 3Percentage based on the number of dyads who changed the dose (Na€‰=a€‰26) or used the needle guard (Na€‰=a€‰107). Factor analysis and scoring algorithmCFA was conducted to substantiate a second order model, based on the conceptual framework for the IPAQ.
He had a famous cameo in the hit film Spiderman as "Bonesaw McGraw" where he was looking jacked as all hell. While everyone knows that pro wrestling is choreographed and scripted, some people still don't understand how physically demanding and debilitating it is for even the world's best athletes. Today pro wrestlers have the bar set exceedingly high for them and they often put themselves in even more physically demanding or destructive matches to entertain the crowd. Representatives urged baseball commissioner Bud Selig and the union to implement HGH testing on the major league level during the new collective bargaining agreement negotiations. But the NFLPA later backtracked on its agreement, citing several concerns, including the efficacy of the test. The IPAQ was subsequently tested in 136 parenta€“child dyads in a Phase 3, 2-month, open-label, multicenter trial for a new GenotropinA® disposable pen.
These factor analysis results support the conceptual framework developed from previous qualitative research in patient dyads using the reusable pen. The psychometric properties of the individual subscales, mainly the lower internal consistency reliability of some of the subscales and the predictive validity findings, do not support the use of subscale scores alone as a primary endpoint.


In recent decades, recombinant hGH has been used to treat short stature or growth failure in children, including the following: 1) growth hormone deficiency, 2) born small for gestational age, 3) Prader-Willi syndrome, 4) Turner syndrome, 5) chronic renal insufficiency, and 6) idiopathic short stature. First, four focus groups with parenta€“child dyads were conducted to identify key issues and concerns about use of injection pens to administer hGH, as well as to learn the language that dyads use to describe the attributes of injection pens. The trial was an open-label, non-comparative, single-arm, multi-center study with a duration of treatment of 2a€‰months. This included one dyad that completed the assessments for Visit 3 outside of the specified time window. Items 2a€‰g (a€?changing the dose when the doctor changes the prescriptiona€? and 2a€‰h (a€?using the needle guarda€?) followed a skip pattern, where subjects who did not have a dose change or did not use the needle guard skipped these items.
This model, based on qualitative data from the development of the IPAQ, shows individual items (injection pen attributes) fitting into 4 subscales (preparing the pen, setting the dose, injecting the medicine and maintaining the pen) and the 4 subscales fit under a total ease of use domain. They also have to be very strong, heal quick, and appear muscular so many of them resort to steroid and human growth hormone use as well. Luckily, for the few famous and successful wrestlers, there is better health coverage and education to prevent so much drug abuse, addiction, injury, depression, and suicide. The congressmen also asked baseball to eliminate smokeless tobacco use in the dugout and on the field. Factor analysis was performed to inform the development of a scoring algorithm, and reliability and validity of the IPAQ were evaluated using the data from this two months study. However, the IPAQ subscales did not consistently meet acceptable internal consistency reliability for some group level comparisons. Most children receive injections daily and treatment usually is carried out over several years, until the child achieves an acceptable adult height or maximum growth[2].In order to achieve optimal therapeutic results, adherence to long-term, continuous hGH administration is essential[3]. All subjects, based on the child member of the dyad, met the following inclusion criteria: 1) age a‰?8a€‰years and a‰¤18a€‰years, 2) currently on treatment with GenotropinA® Pen a‰?3a€‰months, 3) compliant with current GenotropinA® Pen treatment, 4) able to understand English, and 5) have a negative urine pregnancy test at screening, if of childbearing potential. Findings from the CFA suggest that Item 2a€‰k (a€?Handing the injection pen while preparing and injecting the medicinea€?) belongs in the subscale for injecting the medicine, rather than the subscale for maintaining the injection pen, as in the conceptual model based on dyad interviews. He died last week from a car accident, that may have been caused by a heart attack, at the age of 58. Combine all of that and you can understand why so many pro wrestlers die at such an early age.
Cronbacha€™s alphas for the total IPAQ score for both pens were 0.85, exceeding acceptable levels of reliability for group comparisons. Ease of use is recognized by parents, physicians and nurses as a key feature in device acceptance[3] with potential to improve adherence. Following this, one-on-one cognitive debriefing interviews were conducted with eight parenta€“child dyads with previous experience using a pre-specified injection pen to ensure that items in the working draft questionnaire were easy to complete, well understood and relevant to their experience. As such, Item 2a€‰k was included in the a€?injecting the medicinea€? subscale.CFA of the IPAQ showed evidence of a second order factor model (Tables5 and6). Injection devices, such as pre-filled syringes and manual injector pens, have been developed to make the process of preparing and administering hGH easier and more convenient. Findings obtained from each step in the item generation and selection process were reviewed by the research team, including two psychometricians and two clinicians (one endocrinologist), >and provided recommendations to ensure face validity.
Adult members of the dyad needed to: 1) provide written informed consent and 2) be able to read English and understand English.
For eight of the thirteen IPAQ items, greater than 50% of dyads scored at the ceiling (a€?very easya€?). In addition, a translation expert reviewed the draft questionnaire and provided feedback about words or phrases that may be structurally or culturally problematic when translated into different languages. In addition, dyads needed to be willing and able to comply with scheduled visits, treatment plan, and other study procedures. Several steps must be completed in order to prepare the pen and to inject the hGH, including inserting a cartridge, mixing the medicine, inserting a needle, getting rid of air bubbles, using the needle guard, choosing or dialing the dose and finally injecting hGH. A total of 29-items were included in the draft IPAQ: 1) fourteen items evaluating ease of use for a single injection pen, 2) fourteen items comparing ease of use between injection pens, and 3) one item evaluating preference for an injection pen. Dyads using other hGH injection devices other than the current reusable GenotropinA® Pen were excluded.Written informed consent was obtained for subjects prior to screening.
Depending on the age of the child, either the parent, the child, or both participate in preparing the injection pen and administering the medication.
The conceptual framework was established (Figure1) based on the results of the focus group and cognitive debrief activities.


As such, patient-reported outcomes (PRO) measures developed to assess these injection devices should include feedback from both parents and children to better reflect how these devices are used in practice.Another reason for obtaining parenta€“child opinions together is based on findings from the literature suggesting variability in perceptions of disease impact between parent and child in health-related quality of life (HRQL)[4a€“8].
Next, subjects and caregivers were instructed in the proper use of the new disposable pen and were asked to use the new pen for two months. A telephone follow-up contact (Visit 2) occurred at day 7 to assess safety and address any subject questions. However, a recent review of the literature suggests that levels of parenta€“child agreement may be influenced by the relevance of a domain to a disease and to the consequent parental involvement to care for the child[8], not merely by the objectivity of the domain. That is, parenta€“child agreement may be higher when the parent is more involved in caring for the child in a domain that is more influenced by disease. Instructions on questionnaire completion were provided to all dyads by trained personnel.Clinical and patient-reported outcome measuresThe IPAQ is a 29-item instrument that can be used to measure preference for an injection device from the perspective of the subject. For example, in patients with rheumatoid arthritis, in which physical function is impacted, parents may need to provide more assistance with physical activities and may be more aware of their childa€™s physical functioning, resulting in stronger agreement on domains that measure the physical impact of disease. Section I is designed to measure ease of use attributes (13 items) and a€?overall ease of usea€? (1 item) of a single pen. Although little research has been conducted to evaluate the parent-child dyad relationship in developing PRO questionnaires or in responding to PRO questionnaires, a qualitative analysis of parenta€“child dyad approach by Ungar and colleagues[10] suggests that a dyadic approach could be helpful to children in enabling them to answer questionnaire items as accurately as possible. Items in Section I are rated on 5 point scale from a€?very easya€? to a€?very difficulta€?.
When responding to HRQL questionnaires together, parents were a valuable resource to their children (ages 8a€“15a€‰years) and helped them overcome problems with recall or comprehension that they may have had with the questionnaire. Section II compares the ease of use of two pens and contains the same ease of use attributes (13 items) and overall ease of use (1 item) as Section I. It was noted that child participants would look to their parents to corroborate answers, help remember events and clarify the meaning of questions, words or phrases. The questionnaire was designed to be administered to parenta€“child dyads, where dyads together are asked to complete a single copy of the questionnaires. Responsiveness analyses were not conducted because subjects did not evaluate the same injection pen using the IPAQ at two time points during this trial, which is required for this type of analysis. Analyses were conducted: 1) using data from dyads that completed the IPAQ for at least one time point and 2) separately for the individual injection pens. Item analysis for Section II of the IPAQ examining item scores by injection pen preference was also conducted.Factor structure and scoringConfirmatory factor analysis (CFA) was used to examine the hypothesized structure of the IPAQ based on the conceptual framework developed through dyad interviews.
A CFA was conducted to fit a 4-factor model where each item was associated with one pre-defined factor. Overall model fit statistics were examined, as well as standardized regression coefficients (factor loadings) for each item. Distributional characteristics of the subscales were assessed, including means, floor and ceiling effects, and ranges.
The subscale to subscale correlations also were assessed.ReliabilityCronbacha€™s alpha was used to assess internal consistency of subscales generated by the CFA and total score for the IPAQ. The first analysis evaluated the relationship between preference for an injection pen at Visit 3 and subscale scores for the reusable injection pen at Visit 1.
Injection pen preference was categorized as a€?prefer reusable pena€? and a€?prefer new disposable pen or no preferencea€?. The regression model was: injection pen preferencea€‰=a€‰score for preparing the pena€‰+a€‰score for setting the dosea€‰+a€‰score for injecting the medicinea€‰+a€‰score for maintaining the pena€‰+a€‰agea€‰+a€‰gender. The second analysis evaluated the relationship between preference for an injection pen at Visit 3 and subscale scores for the new disposable pen at Visit 3. Injection pen preference was categorized as a€?prefer new disposable pena€? and a€?prefer reusable pen or no preferencea€?.
Injection pen preference was categorized as a€?prefer reusable pen or no preferencea€? or a€?prefer new disposable pena€? and ease of use items were categorized as a€?reusable pen easier to use or no differencea€? or a€?new disposable pen easier to usea€?. Visit 1 ratings were used for dyads who preferred reusable pen and were compared with Visit 3 ratings for those who preferred new disposable pen. Item responses were grouped into two categories: a€?very easya€? and a€?not very easya€?, which includes all other response options (a€?somewhat easya€?, a€?neither easy nor difficulta€?, a€?somewhat difficulta€? and a€?very difficulta€?).




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