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PubMed2026

Test-retest reliability of spatiotemporal, kinematic, and kinetic measures in marker-based 3D gait analysis: A systematic review.

BACKGROUND: Marker-based 3D gait analysis (3DGA) is widely used to quantify impairments and evaluate treatment effects. For longitudinal clinical interpretation, clinicians and researchers need reference values for inter-session measurement error. For this purpose, this systematic review synthesized Standard Error of Measurement (SEM) values for spatiotemporal, kinematic, and kinetic (moments) outcomes obtained from marker-based 3DGA studies. METHODS: PubMed and Scopus were searched (final search: 11 December 2025). Studies reporting inter-session test-retest SEM and/or MDC for steady-state overground or treadmill walking using marker-based motion capture were included. Two authors screened records and appraised methodological/reporting quality using a custom tool informed by COSMIN, GRRAS, and biomechanics-specific items. Due to heterogeneity, results were synthesized descriptively using study-level median SEM values, stratified by joint, plane, population (healthy, pathological, single subgroups), and walking condition. Minimal Detectable Change (MDC) values were computed for all available data. RESULTS: Thirty-four studies (762 participants, 44.2% females) were included, with substantially more evidence for overground than treadmill walking. Overground spatiotemporal outcomes showed low errors (walking speed SEM of 0.06 m/s; timing typically ≤0.03 s; spatial parameters generally ≤0.03 m). For joint kinematics during overground walking, median SEMs were 2.4° (sagittal), 1.9° (frontal), and 3.3° (transverse). The corresponding joint-kinetic SEMs were approximately 0.06, 0.04, and 0.03 Nm/kg, respectively. Treadmill data followed similar patterns. SIGNIFICANCE: Marker-based 3DGA allows for accurate assessment of spatiotemporal, kinematic, and kinetic gait features. We provided detailed SEM/MDC lookup tables to support clinical decision-making. Results further offer a benchmark for validating emerging gait assessment technologies (e.g., markerless systems) against realistic limits of marker-based 3DGA.

Humans↗
PubMed2003

Effect of training intensity on physical capacity, lipid profile and insulin sensitivity in early rehabilitation of spinal cord injured individuals.

STUDY DESIGN: Pre-post training intervention. OBJECTIVES: To evaluate the effect of training intensity on physical capacity, lipid profile and insulin sensitivity in early rehabilitation of spinal cord injured (SCI) patients, and to assess the correlation between peak aerobic capacity (VO(2Peak)) and insulin sensitivity. SETTING: Spinal Cord Rehabilitation Unit, Sunnaas Hospital, Nesoddtangen, Norway. METHOD: Six recently injured SCI individuals participated in the arm training intervention and were randomly admitted to a high-intensity (HI; 70-80% heart rate reserve (HRR)) and low-intensity (LI; 40-50% HRR) group. The 1 h interval training consisted of 3 min exercise bouts interspersed with 2 min of rest, three times a week for 8 weeks. In addition, a correlation coefficient was obtained between VO(2Peak) and insulin sensitivity in 11 SCI patients. RESULTS: The 8-week training program resulted in a significant increase in VO(2Peak) and maximal power output (PO(Max)) for the group as a whole (P<0.05). VO(2Peak) increased significantly more and total cholesterol/high-density lipoprotein cholesterol (TC/HDL-C) ratio and triglycerids decreased significantly more in the HI group than in the LI group (P=0.05). Training-induced changes in insulin sensitivity were significantly different between the groups (P=0.05), which was due to a nonsignificant decline in insulin sensitivity in the HI group and a nonsignificant improvement in the LI group. A significant positive correlation was found between VO(2peak) and insulin sensitivity (r=0.68, P=0.02). CONCLUSION: The interval arm training protocol as used in the present study enables recently injured SCI patients to do substantial work at a relatively high intensity. Results indicate that improvements in physical capacity and lipid profile were more pronounced in response to high-intensity training. The significant correlation between maximal oxygen consumption and insulin sensitivity indicates that, as in the able-bodied population, peak aerobic capacity is a predictive value with regard to insulin sensitivity in SCI. Future studies with larger groups assessing the role of exercise intensity on insulin sensitivity in SCI are suggested.

Activities of Daily Living↗
PubMed1991

Quality of life of community mental health program clients: validating a measure.

A quality of life theory is proposed as a framework for conceptualizing and evaluating mental health services. Quality of life consists of fulfilling needs, meeting social expectations, and accessing opportunities by using abilities. Abilities are impaired by mental illness. Mental health services moderate social demands, supplement opportunities, and restore abilities. A 263 item questionnaire was developed to assess the impact of mental health services on clients' quality of life. A 24 site study including 1,154 pre-tests, 758 post-tests, and 190 interviews with randomly selected community residents was conducted. Evidence for the reliability and validity of the questionnaire are presented. The instrument discriminates among four known client groups, client and community samples, communities with known quality of life differences, and pre- versus post-treatment samples of clients. The convergence between client's retrospective impressions of improvement and measured pre-post improvement is discussed.

Adolescent↗
PubMed2003

Influence of prolonged intermittent high-intensity exercise on knee flexor strength in male and female soccer players.

This study investigated the effect of an acute, prolonged, intermittent, high-intensity single-leg pedalling exercise task (PIHIET) on the isokinetic leg strength of the knee flexors in six male and seven female collegiate soccer players. Following determination of single-leg VO(2peak), subjects completed a PIHIET designed to simulate the energetics of soccer match play (approximately 90 min in total; approximately 70% single-leg VO(2peak)). Pre-, mid- and post-PIHIET gravity-corrected indices of knee flexion peak torque (PT) and range of motion-relativised torque at 15% of knee flexion (RRT(15%); 0% = full knee extension) were assessed at a lever-arm angular velocity of 1.05 rad.s(-1)for intervention and control limbs using an isokinetic dynamometer. Repeated measures ANOVAs revealed significant condition (PIHIET, control) x time (pre-, mid-, post-PIHIET) interactions for knee flexion PT (F([2,22])=26.2; P<0.001) and RRT(15%) (F([2,22])=20.1; P<0.001). Flexion PT and RRT(15% )were observed to decrease, pre- to post-intervention, from 92.8 (28.7) N.m to 72.1 (28.0) N.m and from 63.8 (17.5) N.m to 47.9 (18.4) N.m respectively, for the intervention limb alone. These data corresponded to 22.3% and 24.9% mean reductions pre-post intervention in PT and RRT(15%). Exploratory post hoc analysis of the pattern of the relative deterioration (%) of PT and RRT(15%), for the intervention limb alone, revealed a three-way interaction [group (male, female) x parameter (PT, RRT(15%)) x assessment phase (pre- to mid-PIHIET, mid- to post-PIHIET)] (F(1,11)=5.2; P<0.05). This interaction characterised a greater deterioration of strength performance during the mid- to post-PIHIET assessment phase, at the extremes of range of motion (RRT(15%)) for the female group. The greater percentage of mid-post phase strength loss observed in women near the end-range extension may potentially be implicated in the higher incidence of knee injury reported in female soccer players.

Adult↗
PubMed2004

Objective measurement of hyperactivity, impulsivity, and inattention in children with hyperkinetic disorders before and after treatment with methylphenidate.

PURPOSE: The purpose of this study was to investigate whether values of the respective parameters of the OPTAx test dependently differ due to the medication with methylphenidate (MPH) in children with hyperkinetic disorders (HD) suffering from hyperactivity, impulsivity, and attention deficits. METHODS: The OPTAx test is an infrared motion analysis to record the movement pattern during a continuous performance test. We tested 25 children between 6 and 12 years with HD (ICD-10: F90.0 or F90.1) before and after treatment with MPH. The parameters under investigation were activity (microevents and spatial scaling), impulsivity (errors of commission), and attentiveness (accuracy and variability). For statistical analysis a one-tailed matched pairs test (adj. p = 0.01) was conducted to discriminate differences found from those occurred at random. A post hoc partial correlation of absolute differences in the respective parameters and the daily dose of MPH (adj. for BMI) was performed if p < 0.01. RESULTS: Statistically significant results were found for microevents, spatial scaling, errors of commission, accuracy, and variability. The partial correlation showed significant results for microevents and variability. CONCLUSION: The mean pre-post changes found in all parameters investigated consistently correspond with benefits desired from medication with MPH in children with HD. Absolute differences in microevents and variability seem to depend on the daily dose of MPH after adjustment for BMI.

Attention↗
PubMed1995

The significance of belief and expectancy within the spiritual healing encounter.

Historically, traditional cultures recognized the importance of belief and expectancy within the healing encounter and created complex rituals and ceremonies designed to elicit or foster the expectancy and participation of both the healer and patient, as well as the community as a whole. This holistic approach to health care was a fundamental component in the spiritual healing rituals of virtually all traditional native cultures. The focus of the current study was to assess the impact of healer and patient expectations on mental and physical health parameters following a spiritual healing session. A pre-post methodological design which incorporated extensive psychophysiological health outcome measures along with independent medical diagnoses was utilized. The study was conducted in a northern California suburb of Marin County utilizing an American-born spiritual healer trained in the Philippines. The results indicated that there was a statistically significant difference between the pre-treatment and post-treatment scores for all fourteen dependent variables examined. The data also demonstrated a significant difference between the high versus low expectancy subjects for both patient and healer groups, as well as a significant relationship between high expectancy in patients and healer and the effectiveness of the spiritual healing encounter. The results of the study therefore suggest that high healer and patient expectancy may be important elements which can serve as both predictors as well as facilitators of the healing process. The degree of bonding or communication between the healer and patient was postulated as an important factor in this regard. Due to the fact that a majority of the conditions reported (75%) were organic disorders that would not commonly disappear within the 3 week time frame of the study, the significant results obtained suggest that spiritual healing in combination with traditional allopathic medicine may have the potential to be an effective treatment protocol for severe or long-term disorders. An important contributing feature of this study was that an independent means of assessing the patients' self-reports, i.e. an allopathic medical examination, was included in the experiment. There was a significant correlation between the patient's expectation level and their assessment of improvement, as well as a significant relationship between the patient's assessment of their condition and the objective evaluations provided by independent medical examinations.

Adult↗
PubMed2003

Comparison of Cawthorne-Cooksey exercises and sinusoidal support surface translations to improve balance in patients with unilateral vestibular deficit.

OBJECTIVE: To compare the effectiveness of vestibular rehabilitation by using Cawthorne-Cooksey exercises with that of instrumental rehabilitation. DESIGN: The main study (n=32) used a pre-post rehabilitation (A-B) design; the ancillary studies used a subset of 11 patients 1 month before rehabilitation versus pre-post rehabilitation (A-A-B design) and 9 patients pre-post rehabilitation versus 1 month after (A-B-B design). SETTING: Division of physical therapy and rehabilitation at a scientific institute in Italy. PARTICIPANTS: Patients (Cawthorne-Cooksey, n=17; instrumental rehabilitation, n=15) with a complete or incomplete unilateral vestibular lesion due to ischemic, inflammatory, cranial nerve VIII sectioning, or unknown cause. INTERVENTIONS: Cawthorne-Cooksey exercises or instrumental rehabilitation training consisting of standing with eyes open (EO) or closed (EC) on a platform moving, relative to the subjects, in the anteroposterior (AP) or mediolateral direction, at a sinusoidal translation frequency of 0.2 or 0.6Hz; training sessions for both interventions were twice daily, 30 minutes per session, for 5 days. MAIN OUTCOME MEASURES: Body sway and subjective score of sway during quiet stance with EO or EC, with feet 10cm apart (FA) or together (FT); the standard deviation of the AP displacement of the malleolus, hip, and head during AP platform translations; the Dizziness Handicap Inventory (DHI); and performance-oriented evaluation of balance and gait (according to Tinetti). RESULTS: Both interventions improved patients' balance. Under each postural and visual condition, both groups showed reduction in body sway, and the post rehabilitation sway values approached those observed in normal subjects; improvement was significantly better for instrumental rehabilitation under FA EO, FA EC, and FT EC conditions. All patients reported a subjective feeling of increased steadiness. Sway recorded 1 month before treatment did not differ from that at the start of treatment. The follow-up evaluation showed persistence of effect. Parallel to the improved stability, a decrease in the SD of the displacement of hip and head in balancing on the movable platform was present in both groups; improvement was better in the instrumental rehabilitation group than the Cawthorne-Cooksey group under the EC condition. Balance and gait assessment improved to the same extent in both groups. Scores on the physical, functional, and emotional questions of the DHI improved significantly in both groups after treatment, but to a larger extent in the instrumental rehabilitation patients. CONCLUSIONS: Both Cawthorne-Cooksey and instrumental rehabilitation are effective for treating balance disorders of vestibular origin. Improvement affects both control of body balance and performance of activities of daily living. The larger decrease in body sway and greater improvement of DHI after instrumental rehabilitation suggests that it is more effective than Cawthorne-Cooksey exercises in improving balance control.

Activities of Daily Living↗
PubMed2002

Ibandronate treatment decreases the effects of tumor-associated lesions on bone density and strength in the rat.

Bisphosphonate treatment is beneficial against symptoms of metastatic bone disease, although less is known about the effect of preventative treatment schedules. We investigated the effect of various treatment regimens of the bisphosphonate, ibandronate (IB), on the preservation of bone quality in a rat model of tumor-induced osteolysis. Osteolytic Walker 256 (W256) carcinosarcoma cells were implanted into the left femur of female Sprague-Dawley rats, resulting in a 10% reduction in bone mineral density (BMD), a 16% reduction in bone density (BD), and a 26% reduction in failure load compared with the right femur 28 days after implantation. IB was administered subcutaneously in five different treatment schedules: (1) IB PRE-POST received IB for 26 days, prior to implantation of W256 cells in the medullary canal of the femur, and for 28 additional days after surgery; (2) IB PRE-POST SHAM received the same IB administration, but with a sham operation; (3) IB PRE received IB injections before W256 cell insertion only; (4) IB PRE-0 received IB injections for 26 days and was then killed to serve as a time zero control; and (5) IB POST received sham injection with saline before W256 cell insertion, and then received IB injections for 28 days until killing. Controls (TUMOR ONLY) received sham injections with saline prior to W256 cell insertion, and then for 28 additional days until killing. We used dual-energy X-ray absorptiometry (DXA) to measure distal femur BMD and bone mineral content (BMC), peripheral quantitative computed tomography (pQCT) to measure distal femur BD, and torsion testing to obtain torsional failure load. Combined preventative and interventional IB treatment best preserved bone mass and strength, although all treatment schedules resulted in significant improvement compared with untreated controls (TUMOR ONLY). The possibility of reducing or even preventing skeletal morbidity in cancer patients with a high risk of developing metastatic spreading to bone is exciting, and warrants further exploration.

Animals↗
PubMed2000

Can iron status be improved in each of the three trimesters? A community-based study.

OBJECTIVE: Intervention with iron supplementation, deworming, and information, education and communication (IEC) to improve the haematological status among each of the three trimesters of pregnant women in a rural community. DESIGN: A community-based study was carried out using a two-group pre-post experimental design in a rural community. SETTING: Two rural blocks in Vellore district were selected for the study. KV Kuppam block with a population of 120,000 and the adjacent Gudiyatham block with a population of 132,000 served as study and control areas for the study. SUBJECTS: Using a multistage sampling, initially 50% of the panchayats, the local village administrative units, were randomly selected and all pregnant women were the subjects. In the pre-intervention survey 458 and 387 pregnant women had haemoglobin tested and the post-intervention survey covered 403 and 425 pregnant women in the study and control areas, respectively. Similarly serum ferritin was tested in a randomly selected sub-sample with 254 and 191 pregnant women before intervention and in 216 and 223 pregnant women after intervention in both study and control areas, respectively. INTERVENTION: Iron supplementation and deworming were provided to all pregnant women in the study area from the fourth month of their pregnancy. An intensive information, education and communication was carried out with facts on anaemia and diet modification to each pregnant woman, using a one-to-one approach in the community, and a group method in the mobile clinics. This was carried out for a period of 18 months. RESULTS: A significant decrease in the prevalence of anaemia was found, from 56.1% to 25.07% (P<0.001), 73. 4% to 49.2% (P<0.001) and 68.8% to 56.8% (P<0.01) among women in the first, second and third trimesters, respectively, in the intervention area. Significant (P<0.001) increases in the mean haemoglobin of 0.85 g/dl (95% CI 10.18-10.84, 11.09-11.63), 0.59 g/dl (95% CI 9.98-10.34, 10.55-10.95) and 0.36 g/dl (95% CI 9.93-10. 33, 10.25-10.73) were also observed in each of the groups. CONCLUSION: A comprehensive community-based intervention with iron supplementation, helminthic treatment and increase in knowledge using IEC through effective strategies can improve the haematological status of pregnant women in each trimester.

Anemia↗
PubMed2003

National immunisation days and vitamin A distribution in Mali: has the vitamin A status of pre-school children improved?

OBJECTIVES: The impact on vitamin A status of the distribution of vitamin A during national immunisation days (NIDs) has not been well established despite strong promotion by international agencies and donors. Using a pre-post design, the change in prevalence of vitamin A deficiency was examined in pre-school children in Mali. DESIGN: Two cross-sectional surveys were conducted in Mopti region, the first in March 1997 before this strategy was adopted and the second in March 1999, four-and-a-half months after a mass distribution of vitamin A during NIDs. SUBJECTS AND SETTING: We compared the vitamin A status of children aged 12 to 66 months targeted in 1999 by NIDs with the status of children in the same age group in 1997. Infectious events of the previous two weeks were concurrently recorded. Within the 1999 sample, the status of recipient and non-recipient children was also compared. RESULTS: In 1997, the prevalence of xerophthalmia (defined by the presence of night blindness and/or Bitot spots) was 6.9% (95% confidence interval (CI) 5.1-9.2) and the modified retinol dose response (MRDR) test proved abnormal in 77.8% of 12-66-month-old children (95% CI 68.27-85.17). In 1999 this picture had improved significantly, both for xerophthalmia prevalence, 3.3% (95% CI 2.1-5.2), and abnormal MRDR test response, 63.1% (95% CI 54.25-71.23). The infectious morbidity rates between 1997 and 1999 tended to decrease. No significant improvement was found among children older than those targeted by NIDs. In 1999, children who received vitamin A had a lower risk for xerophthalmia (3.0% for recipients vs. 8.7% for non-recipients) and experienced fewer infectious events. CONCLUSIONS: The clinical and biological vitamin A status of pre-school children improved between 1997 and 1999. Mass distribution of vitamin A appears to reduce the occurrence of xerophthalmia and would seem to be associated with a decrease in other related illnesses. Vitamin A supplementation during NIDs should be given a high priority when vitamin A deficiency remains a public health problem.

Anthropometry↗
PubMed2000

An evaluation of the impact of training Honduran health care providers in interpersonal communication.

OBJECTIVE: To evaluate the impact of interpersonal communication (IPC) training on practice and patient satisfaction and to determine the acceptability of this training to providers in a developing country. DESIGN: The study used a pre-post design with treatment and control groups. Data collection methods included interaction analysis of audio-taped clinical encounters, patient exit interviews, and a self-administered questionnaire for health providers. STUDY PARTICIPANTS: Interaction analysis was based on an experimental group of 24 doctors and a control group of eight with multiple observations for each provider). Exit interviews were carried out with 220 pre-test patients and 218 post-test patients. All 87 health providers who received training responded to the self-administered questionnaire. INTERVENTION: A brief in-service training programme on interpersonal communications was presented in three half-day sessions; these focused on overall socio-emotional communication, problem solving skills and counselling. MAIN OUTCOME MEASURES AND RESULTS: The IPC intervention was associated with more communication by trained providers (mean scores of 136.6 versus 94.4; P = 0.001), more positive talk (15.93 versus 7.99; P = 0.001), less negative talk (0.11 versus 0.59; P = 0.018), more emotional talk (15.7 versus 5.5; P = 0.021), and more medical counselling (17.3 versus 11.3; P = 0.026). Patients responded by communicating more (mean scores of 113.8 versus 79.6; P = 0.011) and disclosing more medical information (54.7 versus 41.7; P = 0.002). Patient satisfaction ratings were higher for providers who had received the training and providers reported training to be relevant and useful. CONCLUSIONS: Further validation of IPC skills and simplification of assessment methods are needed if IPC is to be an area for routine monitoring and quality improvement.

Ambulatory Care↗
PubMed1994

Cardiopulmonary resuscitation in elderly patients hospitalized in the 1990s: a favorable outcome.

OBJECTIVE: To compare the clinical characteristics and survival of elderly and younger hospitalized patients who sustain cardiac arrest and receive cardiopulmonary resuscitation (CPR) in the 1990's and to assess predictors of survival. DESIGN: Retrospective survey of cardiac arrest database and hospital charts, plus telephone follow-up. SETTING: 450-bed acute care teaching hospital. STUDY POPULATION: Seventy-eight hospitalized patients 70 years or older and 73 hospitalized patients under 70 years of age. MEASUREMENTS: Survey of cardiac arrest data base, hospital charts, and telephonic follow-up to allow (1) comparison of clinical characteristics, survival, and long-term follow-up between two age groups and (2) univariate and multivariate analysis of predictors of mortality. MAIN RESULTS: Pre-arrest clinical characteristics were not significantly different between the age groups. Prior to arrest the majority of patients were functionally active, and over one-third were hospitalized for acute coronary artery syndromes. In approximately 85% of the patients, the arrest was witnessed, and 70% of the patients had their cardiac rhythm monitored at onset of the arrest. Survival was not significantly different between the age groups; 26% of the total 151 patients were discharged. No significant difference was noted in pre-post arrest functional status of survivors. Survival at 1, 2, and 3 years in elderly and younger survivors was 86% versus 80%, 76% versus 67%, and 71% versus 61%, respectively. Multivariate analysis identified the presence of coronary artery disease, admission systolic blood pressure, and functional level to be independent pre-arrest predictors of mortality. At the time of the arrest, the initial cardiac rhythm and duration of CPR were found to be independent predictors of mortality. CONCLUSIONS: Elderly patients hospitalized in the 1990's who receive CPR have outcomes similar to younger patients who receive CPR. The favorable outcome in the elderly patients may reflect patient selection: the majority of our patients were functionally active prior to hospitalization, without multiple serious illnesses; many were hospitalized for acute coronary artery syndromes; and, in most cases, the arrest was witnessed with the patient's cardiac rhythm monitored at onset of the arrest.

Adult↗
PubMed2001

Collaborative writing: the effects of metacognitive prompting and structured peer interaction.

BACKGROUND: The structured system for peer assisted learning in writing named Paired Writing (Topping, 1995) incorporates both metacognitive prompting and scaffolding for the interactive process. AIM: This study sought to evaluate the relative contribution of these two components to student gain in quality of writing and attitudes to writing, while controlling for amount of writing practice and teacher effects. SAMPLE: Participants were 28 ten- and eleven-year-old students forming a problematic mixed ability class. METHODS: All received training in Paired Writing and its inherent metacognitive prompting. Students matched by gender and pre-test writing scores were assigned randomly to Interaction or No Interaction conditions. In the Interaction condition, the more able writers became 'tutors' for the less able. In the No Interaction condition, the more able writers acted as controls for the tutors and the less able as controls for the tutees. Over six weeks, the paired writers produced five pieces of personal writing collaboratively, while children in the No Interaction condition did so alone. RESULTS: On pre- and post-project analyses of the quality of individual writing, all groups showed statistically significant improvements in writing. However, the pre-post gains of the children who wrote interactively were significantly greater than those of the lone writers. There was some evidence that the paired writers also had more positive self-esteem as writers. CONCLUSION: The operation and durability of the Paired Writing system are discussed.

Child↗
PubMed2004

[The effect of aroma inhalation method on stress responses of nursing students].

PURPOSE: The purpose of this study is to identify the effect of aroma inhalation on stress responses (physical symptoms, levels of anxiety, perceived stresses)of nursing students. METHOD: This study was a quasi-experimental research using a non-equivalent pre-post design and was conducted from June 1 to June 5, 2002. The subjects consisted of 77 junior nursing students who were divided into 39 experimental group members and 38 control group members. A pretest and Post-test were conducted to measure body symptoms, the level of anxiety, and the level of perceived stress. In the experimental group, aromas were given using an aroma lamp, lavender, peppermint, rosemary and Clary-Sage. In the control group, the treatment was not administered. RESULT: As a result of administering aroma inhalation to nursing students, their physical symptoms decreased, their anxiety scores were low, and their perceived stress scores were low, showing that aroma inhalation could be a very effective stress management method. CONCLUSION: Nursing educators should play an important role in contributing to college students' physical and psychological health by helping enhance their recognition of stress management and effectively relieving their stress using essential oils.

Aromatherapy↗
PubMed2000

Outcomes monitoring and the testing of new psychiatric treatments: work therapy in the treatment of chronic post-traumatic stress disorder.

OBJECTIVE: To evaluate the effectiveness of a work therapy intervention, the Department of Veterans Affairs (VA) Compensated Work Therapy program (CWT), in the treatment of patients suffering from chronic war-related post-traumatic stress disorder (PTSD); and to demonstrate methods for using outcomes monitoring data to screen previously untested treatments. DATA SOURCES/STUDY SETTING: Baseline and four-month follow-up questionnaires administered to 3,076 veterans treated in 52 specialized VA inpatient programs for treatment of PTSD at facilities that also had CWT programs. Altogether 78 (2.5 percent) of these patients participated in CWT during the four months after discharge. STUDY DESIGN: The study used a pre-post nonequivalent control group design. DATA COLLECTION/EXTRACTION METHODS: Questionnaires documented PTSD symptoms, violent behavior, alcohol and drug use, employment status, and medical status at the time of program entry and four months after discharge from the hospital to the community. Administrative databases were used to identify participants in the CWT program. Propensity scores were used to match CWT participants and other patients, and hierarchical linear modeling was used to evaluate differences in outcomes between treatment groups on seven outcomes. PRINCIPAL FINDINGS: The propensity scaling method created groups that were not significantly different on any measure. No greater improvement was observed among CWT participants than among other patients on any of seven outcome measures. CONCLUSIONS: Substantively this study suggests that work therapy, as currently practiced in VA, is not an effective intervention, at least in the short term, for chronic, war-related PTSD. Methodologically it illustrates the use of outcomes monitoring data to screen previously untested treatments and the use of propensity scoring and hierarchical linear modeling to adjust for selection biases in observational studies.

Chronic Disease↗
PubMed1989

Influence of body hair removal on physiological responses during breaststroke swimming.

Nine male collegiate swimmers (EXP) were studied 8 d before (PRE) and 1 d after (POST) shaving the hair from their arms, legs, and exposed trunk. A control group (CON, N = 4) of their teammates was also tested at these times but did not remove body hair. In PRE and POST, distance per stroke (SL), VO2, heart rate (HR), and post-swim blood lactate concentration (BL) were measured during a 365.8 m breaststroke swim at approximately 90% effort. Subjects also performed a tethered breaststroke swim with retarding forces of 6.27, 7.75, and 9.26 kg. The EXP group experienced a significant (P less than 0.05) reduction in BL (mean +/- SE: 8.48 +/- 0.78 to 6.74 +/- 0.74 mmol.l-1), a decreased VO2 (3.60 +/- 0.15 to 3.27 +/- 0.14 l.min-1), an increase in SL (2.07 +/- 0.08 to 2.31 +/- 0.10 m.stroke-1), and an insignificant (P = 0.08) decline in HR (174 +/- 5 to 168 +/- 4 beats.min-1) during the free swim. The CON group showed no changes in BL, SL, or HR. During the tethered swim, there were no significant PRE-POST differences in VO2, HR, or BL for either group. In a separate group of swimmers (nine who shaved body hair and nine controls), removing body hair significantly reduced the rate of velocity decay during a prone glide after a maximal underwater leg push-off. It is concluded that removing body hair reduces active drag, thereby decreasing the physiological cost of swimming.

Adult↗
PubMedDate not supplied

Sustained effects of educating retailers to reduce cigarette sales to minors.

Despite state laws prohibiting the purchase of tobacco by minors, the ease with which underage youth can purchase cigarettes has been documented nationwide. The public health community as well as policy makers have called for a combination of retailer education and enforcement of laws prohibiting tobacco sales to minors. Enforcement activity may not be feasible in many communities, however, and an educational intervention may be the only option. This paper reports results of a 6-month followup assessment following a face-to-face education intervention with retailers to reduce cigarettes sales to minors in San Diego County, CA. A control-experimental group, pre-post design was employed to study the sustained effects of the program on the illegal sale of cigarettes to minors. A total of 236 stores were visited by minors, ages 14-17 years, with the intent of purchasing cigarettes. Information was collected three times: pre-test, immediately following the intervention, and 6 months after the intervention ended. The groups included a no-treatment control group of 108 stores and an intervention group of 128 that received three educational visits from project staff over a 1-year period. Community education via media and informational presentations was also conducted. As previously reported, a 68-percent pretest sales rate was found for stores overall. Immediately following the intervention, 32 percent of the intervention group and 59 percent of the control group sold cigarettes to minors. These results were maintained 6 months following the conclusion of the intervention. Results are discussed in terms of education versus use of enforcement.

Adolescent↗
PubMed1994

Suicide intervention training evaluation: a preliminary report.

To date, very little work has been done on evaluating training in suicide intervention. This study developed and piloted a comprehensive method for evaluating suicide intervention training by applying three studies of immediate training effects on (a) suicide intervention abilities, (b) attitudes to suicide and suicide intervention, and (c) knowledge about suicide. The focus of the evaluation was a broadly used 2-day suicide intervention training program. Changes in suicide intervention abilities were measured by the Suicide Intervention Response Inventory (SIRI) and by performance in simulated suicide intervention situations, scored with the Suicide Intervention Protocol (SIP). Subjects consisted of 19 workshop participants in a pre-post condition and 17 participants in a post-test only condition. Results indicated significant increases in skills in suicide intervention situations. No significant effects were noted on the SIRI. Results from the attitudes and knowledge studies were very preliminary. They are reported here so that others may become aware of the methodology being used and the status of evaluation of the target program. Implications for further research are discussed.

Adult↗