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At least 793 records · Page 44Linked to original sources
PubMed1998

Self-directed strength training: its effect on leg strength in men with mental retardation.

OBJECTIVE: To compare isokinetic measures of peak torque (newton-meters) and total work (joules) in men with mental retardation on a test of knee extension after 12 weeks of trainer-directed training and 1 year of self-directed training. DESIGN: Repeated measures of analysis of variance using a planned comparison approach involving an independent 2 x 3 (group x test) design. SETTING: Subjects were tested at a university athletic training facility on three separate days. SUBJECTS: Volunteer sample of 12 subjects with mental retardation: 6 in strength training group, 6 in control group. INTERVENTION: Subjects performed an isokinetic knee extension test at a velocity of 60 degrees/sec on three separate days. Test 1 was the pretest, test 2 was conducted after 12 weeks of trainer-directed hydraulic resistance training, and test 3 was conducted after 1 year of self-directed hydraulic resistance training. RESULTS: For both isokinetic parameters measured, the strength-trained subjects demonstrated significantly higher scores after 12 weeks of training and after 1 year of training than the scores achieved on the pretest. No significant differences in peak torque or total work scores were found between test 2 and test 3 scores for the strength-trained group. No significant changes in isokinetic scores between test sessions were found for the control subjects. CONCLUSION: Men with mental retardation can maintain strength following a self-directed hydraulic resistance strength training program.

Adult↗
PubMed1999

Muscle strengthening and physical conditioning to reduce impairment and disability in chronic stroke survivors.

OBJECTIVE: To evaluate the impact of a program of muscle strengthening and physical conditioning on impairment and disability in chronic stroke subjects. DESIGN: A randomized pretest and posttest control group, followed by a single-group pretest and posttest design. SUBJECTS: Thirteen community-dwelling stroke survivors of at least 9 months. INTERVENTION: A 10-week (3 days/week) program consisting of a warm-up, aerobic exercises, lower extremity muscle strengthening, and a cool-down. MAIN OUTCOME MEASURES: Peak isokinetic torque of the major muscle groups of the affected lower limb, quadriceps and ankle plantarflexor spasticity, gait speed, rate of stair climbing, the Human Activity Profile (HAP), and the Nottingham Health Profile (NHP) were recorded twice for the treatment group and three times for the control group. RESULTS: Significant improvements were found for all the selected outcome measures (HAP, NHP, and gait speed) for the treatment group (p < .001). In terms of overall training effects, the 13 subjects demonstrated increases in strength of the affected major muscle groups, in HAP and NHP profiles, and in gait speed and rate of stair climbing without concomitant increases in either quadriceps or ankle plantarflexor spasticity. CONCLUSIONS: The 10-week combined program of muscle strengthening and physical conditioning resulted in gains in all measures of impairment and disability. These gains were not associated with measurable changes of spasticity in either quadriceps or ankle plantarflexors.

Activities of Daily Living↗
PubMed1997

Cued UCS rehearsal and the impact of painful conditioned stimuli: UCS rehearsal increases SCRs but reduces experienced pain.

The effects of cued UCS rehearsal on responses to a mildly painful CS previously paired with a highly painful UCS were investigated. Following CS pretest and CS-UCS pairings, subjects either mentally rehearsed the UCS (condition 1), received the real UCS (condition 2), mentally rehearsed an unrelated painful experience (condition 3), or waited (condition 4). In a fifth condition, subjects received CS and UCS unpaired before engaging in UCS rehearsal. During a posttest, subjects received CS-alone presentations and rated experienced pain and anxiety, while electrodermal responses were assessed. These responses were compared to pretest and acquisition responses. UCS rehearsal led to pain reduction of the CS comparable to the habituation effect of real UCS confrontation. In line with an associative basis for this effect, UCS rehearsal did not influence the pain experience of an unpaired CS. Yet, rehearsal of a memory of an unrelated painful experience also reduced the pain experience of the CS. Electrodermal responses showed delayed extinction and incubation after UCS rehearsal, but there were no significant effects on subjective anxiety. Incubation of electrodermal responses was related to low self-consciousness and the combination of low self-consciousness and high trait anxiety. Trait anxiety and worry proneness per se did not relate to incubation. The findings suggest that worry-like processes can have functional values like reducing pain impact, and cast doubt upon the contention that UCS rehearsal leads to an overall incubation of fear.

Adult↗
PubMed1997

Brain corticotropin-releasing factor immunoreactivity and receptors in five inbred rat strains: relationship to forced swimming behaviour.

In the present work we studied the relationship between behaviour in the forced swimming test (FST), a test that presumably measures depressive-like behaviour in rodents, and central corticotropin-releasing factor (CRF) concentration and binding in five strains of rats. The strains were: Brown-Norway (BN), Fisher (FIS) 344, Lewis (LEW), spontaneously hypertensive rats (SHR) and Wistar-Kyoto rats (WKY). The FST data corresponding to the pretest showed significant inter-strain differences in both struggling and immobility: BN and WKY rats displayed lower levels of struggling and longer periods of immobility, LEW and SHR rats showed intermediate levels, and FIS rats were the most active. The results of the pretest were roughly similar to those observed in the test, the activity of WKY being extremely low. The CRF binding revealed significant inter-strain differences in prefrontal cortex and hippocampus, but not in cerebellum, pons-medulla or hypothalamus: in the prefrontal cortex, BN and FIS rats showed greater CRF binding than LEW, SHR and WKY rats; in the hippocampus BN rats showed higher levels of CRF binding than the other strains. The study of CRF content in various brain areas revealed inter-strain differences in prefrontal cortex and pons-medulla, but not in parietal-temporal cortex or in hypothalamus (CRF concentrations in the hippocampus were not detectable): CRF content in the prefrontal cortex was higher in BN than in the other strains, although the differences with FIS were not statistically significant; in the pons-medulla, FIS and LEW showed significantly higher CRF content than the other strains. From the present results it appears that BN and WKY rats were more prone to adopt passive strategies in the FST, but they did not show higher brain CRF immunoreactivity or down-regulation of CRF receptors. Hence, although there were inter-strains differences in all variables studied, no evidence for a relationship between the FST behaviour and central CRF activity was found.

Animals↗
PubMed1995

Enamel wear caused by three different restorative materials.

The ideal restorative material should cause minimal wear of opposing enamel. This study compared the effects of gold alloy, glazed porcelain, and a laboratory-processed composite on opposing enamel. Ten samples of a type III gold alloy, a porcelain, and a visible-light, heat, and vacuum-processed composite were abraded against cusps of extracted molars for 10,000 cycles on an abrading machine. Pretest and posttest profilometric measurements of the restorative materials demonstrated no statistical difference. Pretest and posttest tracings of the cusps were made on an optical comparator to determine loss of vertical height and surface area. The porcelain caused significantly more loss of vertical height and surface area than the gold alloy or the composite, which were similar.

Analysis of Variance↗
PubMed2003

Transthoracic needle biopsy in the diagnosis of solitary pulmonary nodules: a survey of Canadian physicians.

OBJECTIVE: To describe Canadian physicians' opinions relative to the choice of diagnostic procedures in patients presenting with a solitary pulmonary nodule and to identify the attributes that may influence their decision. METHODS: We conducted a mailed survey among Canadian physicians including pulmonologists, thoracic surgeons, radiologists, and internists. Five hypothetical clinical scenarios designed to illustrate a wide spectrum of clinical situations (including nodules associated to very low, indeterminate, and high probabilities of malignancy in patients medically fit or unfit to undergo surgical resection) were submitted to each physician who had to choose among options of diagnostic procedures and to estimate the pretest probability of malignancy. RESULTS: The survey response rate was 47%. Overall, the physicians tended to overestimate the probability of malignancy. Twenty-eight percent of the respondents would have ordered a transthoracic needle biopsy in a medically fit patient presenting with a very low probability (< 2%) of malignancy, whereas 53% would have done so in a medically fit patient presenting with a very high probability (75%) of malignancy. In a regression analysis, the significant predictors of the use of transthoracic needle biopsy were (1) the pretest probability of cancer, (2) the patient's operability, (3) specialty (pulmonologists and thoracic surgeons being less likely to order a transthoracic needle biopsy than radiologists), and (4) the respondent's gender. CONCLUSIONS: There are widespread variations in clinical opinions among Canadian physicians regarding the use of transthoracic needle biopsy in the investigation of solitary nodules. Hypothetical transthoracic needle biopsy was often preferred when the result was unlikely to affect patient management.

Biopsy, Needle↗
PubMed2002

[Deep venous thrombosis of lower extremities in an Emergency Department. Utility of a clinical diagnosis model].

BACKGROUND: Deep vein thrombosis (DVT) is a difficult to diagnostic disease. The aim of this study was to determine the utility and accuracy of a risk stratification questionnaire and a diagnostic strategy, which were applied to patients with suspected DVT on lower extremities in an emergency department. PATIENTS AND METHOD: A prospective cohort study was performed in 569 outpatients with clinical suspected DVT during 14 months. The applied questionnaire stratified patients into three pre-test probability categories. Items included signs, symptoms, risk factors and potential alternative diagnosis, which were based on a modified Wells clinical model. DVT was diagnosed by the combined use of clinical model, compression ultrasonography (CUS) and follow-up CUS one week later in those moderate-high risk patients with an initial normal test. These patients were followed over three months for the development of venous thromboembolic complications. RESULTS: Two hundred three (35.7%) patients were classified as having a low, 186 (32.7%) moderate and 180 (31.6%) high clinical probability. Overall, DVT was diagnosed in 153 patients (26%; CI95%, 23.2-30.7%): 144 (96%) at the initial CUS, 6 (3.5%) at the second testing and 3 over the 3-month follow-up period. 22 patients had a low pretest probability (11%; CI95%, 7-16%), 43 (23%; CI95%, 17-30%) moderate, and 88 (49%; CI95%, 41-56%) high pretest probability. The difference in the prevalence of DVP among risk categories was significant (p < 0.00001). When the high and moderate groups were joined, the model had a 86% sensitivity, a 90% negative predictive value and a 43% specificity for diagnosis of DVT. CONCLUSIONS: The clinical model used in this study is accurate and feasible, though it is not enough to take clinical decisions. The diagnostic strategic used is effective but not efficient.

Adolescent↗
PubMed1999

Formal teaching of surgical skills in an obstetric-gynecologic residency.

OBJECTIVE: To describe a formal teaching program of basic surgical skills in an obstetric-gynecologic residency program and evaluate its effectiveness. METHODS: A surgical skills program was developed for all residents. Using bench and animal laboratory sessions, residents were given instruction and performed both laparoscopic and open abdominal procedures. All were given a pretest and were tested again 6 months later. Residents also evaluated their experiences. RESULTS: To date, the formal teaching sessions have been given to 24 residents, all of whom believed their confidence and technical skills improved as a result of the sessions. On a scale of 1 to 5, the median rating of the bench laboratory experience was 5 (range 4-5), and the pig laboratory was 5 (range 4-5). All residents believed the surgery sessions should be continued and the number of sessions increased. Preliminary evaluation indicated that time to suture a 10-inch incision decreased by 28%, from an average of 225 (standard deviation [SD] 51) seconds to 171 (SD 43) seconds (P < .001), and evaluation of surgical technique significantly improved at the second pretest (P = .013). Laparoscopic placement of pegs on a board in 2 minutes increased from an average of 5 (SD 2.5) to 7.3 (SD 2.6; P = .001). The cost of the bench laboratory sessions was minimal. Each pig was approximately $100, and the facility charge for each 4-hour laboratory session was $1500. CONCLUSION: When formal surgical training was given to obstetric-gynecologic residents, their surgical skills improved subjectively and objectively.

Adult↗
PubMed1999

Multimedia to teach urology to medical students.

OBJECTIVES: To test the hypothesis that an interactive multimedia-based computer application may be used to teach urology to undergraduate medical students. METHODS: Third-year medical students rotating on their urology clerkship were studied. Student knowledge was measured with a multiple choice test administered in a pretest-post-test experimental design. The educational intervention was a multimedia-based application that presented a clinical module on hematuria, using natural language-like entries. Student attitudes toward the multimedia application were assessed by a survey. RESULTS: Twenty-three consecutive third-year medical students participated. Mean pretest and post-test scores +/- standard deviation were 35%+/-11% versus 74%+/-17%, respectively, P<0.0001. Student questionnaire responses indicated highly positive opinions that the multimedia-based module was easy to use, was fun, provided natural patient responses, had clear exercises, provided immediate feedback, was educational, and had a nonthreatening format, and that the multiple choice questions were clear and fair. CONCLUSIONS: Multimedia-based education may be used to teach urology to undergraduate medical students.

Computer-Assisted Instruction↗
PubMed2001

An automated analysis of rat behavior in the forced swim test.

The Porsolt forced swim test (FST) is a commonly used paradigm to evaluate antidepressant activity of drugs. This test is based on visual measurement of the rat's floating time (FT) in a tank filled with water. Here, we present an automated, accurate and faster method for estimating FT by the distance moved (DM) by the animal via the use of the Ethovision software in three separate experiments. Experiment 1 investigated the effect of varying delays (24-h and 7-day) between pretest and test on FT and DM. Experiment 2 aimed at examining the effects of a 2-day withdrawal period in rats sensitized to amphetamine and cocaine, on FT and DM. Finally, Experiment 3 looked at the effects of desipramine and fluoxetine on FT and DM. The results of these experiments show that increasing the delay between pretest and test reduced FT during subsequent exposure (test). In addition, rats sensitized to and then withdrawn from either amphetamine or cocaine did not differ in FT or DM compared with control rats. Finally, both desipramine and fluoxetine reduced FT and increased DM. Furthermore, DM was consistently significantly negatively correlated with FT. These results support the use of an automated method for the evaluation of rat behavior in FST.

Amphetamine↗
PubMed1995

Physician-targeted program on inhaled therapy for childhood asthma.

BACKGROUND: Inhaled medications are the mainstay of asthma therapy, but significant deficiencies exist in the knowledge and skills of physicians regarding use of metered-dose inhalers (MDI) and spacer devices. OBJECTIVE: We developed, implemented, and evaluated the effects of a physician-targeted educational program on inhaled therapy in a group of pediatric residents in our institution. METHODS: Patient-directed instruction sheets on aerosol therapy were developed on the basis of literature review and expert guidelines. These served to establish a consistent foundation for the educational curriculum. The program was delivered through one-on-two teaching sessions (45 minutes). Residents were provided with a summary of theoretical and practical information and with devices for practice (a placebo MDI, InspirEase and AeroChamber holding chambers, and the AeroChamber device with mask). Each session included review of an educational monograph, demonstration of proper technique, and practice with the different devices. The program was evaluated by a randomized-control design. Assessment of practical skills included number of correct steps for the use of MDI (maximum score, 7), InspirEase (maximum, 7) and AeroChamber (maximum, 6). Theoretical knowledge was assessed with 25 multiple-choice questions. RESULTS: Pretest scores in the experimental group (n = 24) were 3.7 of 7, 1.9 of 7, and 0.3 of 6 steps correct for MDI, InspirEase, and AeroChamber devices, respectively, and 13 of 25 for the theoretical knowledge assessment. The control group (n = 26) had similar pretest scores. After the program the experimental group significantly improved in all parameters: 6.3 of 7, 5.9 of 7, and 4.5 of 6 steps correct for MDI, InspirEase, and AeroChamber devices, respectively, and 18 of 25 questions correct (p < 0.01 for all parameters). CONCLUSIONS: Implementation of a simple educational program among pediatric residents can significantly increase their skills in the use of inhalational therapy.

Administration, Inhalation↗
PubMed1998

Measuring quality of life in children with rhinoconjunctivitis.

OBJECTIVE: The objective of this study was to develop, pretest, and validate a questionnaire to measure quality of life in children with seasonal allergic rhinoconjunctivitis (SAR). METHODS (DEVELOPMENT STUDY): Thirty-four children with SAR were enrolled from summer camps, notices in the media, and an allergy clinic (Southern Ontario). After generating a pool of 48 potentially important quality of life items, the children identified the ones that they experienced with their SAR and scored each for bother (1 = a little bothered to 4 = extremely bothered). Items identified most frequently and with the highest bother score were included in the Paediatric Rhinoconjunctivitis Quality of Life Questionnaire (PRQLQ). The PRQLQ was pretested for ease completion and accuracy of understanding. RESULTS (DEVELOPMENT STUDY): The PRQLQ has 23 items in five domains (nose symptoms, eye symptoms, practical problems, other symptoms, and activities). Responses are given on a seven-point scale, and children are asked to score their experiences during the previous 7 days. METHODS (VALIDATION STUDY): Seventy-five children with symptomatic SAR were enrolled from notices in the media and a pediatric allergy clinic (Austin, Tex.). A single cohort design was used, with children assessed at 0, 1, and 3 weeks. The PRQLQ was administered to the children by a trained interviewer at 1 and 3 weeks. A conventional nasal symptom daily diary was completed for 1 week before each of these clinic visits. Global ratings were completed at the final visit. RESULTS (VALIDATION STUDY): In patients who were stable between clinic visits, the PRQLQ demonstrated good reliability (intraclass correlation coefficient = 0.93). The questionnaire was very responsive to change (p < 0.001) and was able to differentiate between patients who were in a stable clinical state and those whose clinical state changed between visits (p = 0.005). Correlations between the PRQLQ and diary scores were close to predicted and supported both the cross-sectional and longitudinal validity of the PRQLQ. CONCLUSIONS: The PRQLQ measures the quality of life impairments important to children with SAR. Children provide reliable and accurate responses, the measurement properties are strong, and the questionnaire can be used with confidence in clinical trials, clinical practice, and surveys.

Child↗
PubMed1999

A preliminary evaluation of the Colorado RETHINK Parenting and Anger Management program.

OBJECTIVE: The purpose was to report preliminary behavioral, social, and emotional results, and to project some potential economic results of a parenting and anger management program in a mountain state. METHOD: Following local and state-wide needs assessments, child abuse prevention was identified as the number two critical issue. An effective, research-based, preventive educational workshop program--RETHINK Parenting and Anger Management--was selected for testing and program evaluation. Measurable outcome objectives were written and assessments were developed and tested. A one-group pretest-posttest design with a convenience sample of parents was used for the study. Seventy-five of 99 parents completed pretests before and posttests after participating in the 6-week series of skill-enhancing workshops. RESULTS: Using a repeated measures analysis of variance, participants' group mean anger control levels increased (p = .016). Their family conflict levels fell (p = .006). Their overall anger levels fell (p = .000). Their violence levels fell, verbal aggression levels fell (p = .002). Their partners' violence levels also fell, verbal aggression levels fell (p = .004), and physical aggression levels fell (p = .032). In addition, participants reported increased knowledge levels (100%), improved attitudes (97.3%), improved behaviors (94.7%), and decreased unrealistic expectations of their children (69.3%). CONCLUSION: The findings suggest that professional preventive education specialists may now have an effective program to assist parents in managing their anger. Further research is encouraged. When parents participate in 6 weeks of skill building with well-trained professionals, positive changes in parenting and anger management are possible.

Adult↗
PubMedDate not supplied

Humidification method that decreases condensate contamination in ventilator tubing.

OBJECTIVE: To demonstrate combining unheated bubble-through humidifier with a heat-moisture exchanger filter for the purpose of decreasing condensate contamination in mechanical ventilator tubing. DESIGN: Single-case, pretest and posttest. SETTING: University-affiliated and nonprofit hospital. PATIENT: A 32-year-old man with Pickwickian syndrome and pneumonia caused by Pseudomonas aeruginosa received mechanical ventilation for 14 days. METHODS: Ventilator tubing was cultured in two 24-hour trials, using a pretest and posttest design, to assess tubing bacterial contamination during use of 2 humidification methods. In the first trial, a traditional heated bubble-through humidifier (HBH) was used for 24 hours. Before the start of the second trial, the "wet" tubing and the heated bubble-through humidifier were removed and replaced with clean equipment through the use of aseptic technique. The bubble-through humidifier was placed on the "cold," or unheated mode, and a heat-moisture exchanger filter was attached to the Y-connector of the ventilator tubing. RESULTS: The heated bubble-through humidifier method revealed contamination of the ventilator tubing in 3 places with the patient's strain of P aeruginosa in addition to copious water condensate. The unheated bubble-through humidifier/heat moisture exchanger filter method demonstrated no bacterial contamination or condensate in the tubing. CONCLUSION: It can be inferred that the humidification method using the combination of an unheated bubble-through humidifier and a heat moisture exchanger filter has the potential benefit of preventing "reseeding" of the patient's airway with contaminated condensate.

Adult↗
PubMedDate not supplied

Coronary risk factor status after percutaneous transluminal coronary angioplasty.

OBJECTIVE: To determine whether patients modify their risk factors after undergoing percutaneous transluminal coronary angioplasty (PTCA). DESIGN: One-group, pretest-posttest. Pretest data were collected on the day before PTCA, and posttest data were collected at a mean follow-up of 11 months after PTCA. Data were collected from medical records and by patient self-report. SETTING: University-affiliated, metropolitan public and private hospitals. PATIENTS: Two hundred nine patients undergoing PTCA. OUTCOME MEASURES: Patients' smoking and exercise habits were assessed by self-report. Serum cholesterol level and body mass index were determined from entries in medical charts. RESULTS: All measured risk factors, with the exception of smoking, underwent favorable change (p < 0.001) after PTCA. The number of current smokers, however, increased significantly (p < 0.001), as did the number of cigarettes these patients smoked per day (p < 0.05). CONCLUSION: Evaluation of the effect of intervention strategies on reducing patients' smoking behavior after PTCA is required.

Adult↗
PubMedDate not supplied

Effectiveness of a music therapy intervention on relaxation and anxiety for patients receiving ventilatory assistance.

OBJECTIVE: To test the effects of music therapy on relaxation and anxiety reduction for patients receiving ventilatory assistance. DESIGN: Two-group, pretest-posttest experimental design with repeated measures. Subjects randomized to either a 30-minute music condition or a rest period. SETTING: Four urban midwestern intensive care units. SUBJECTS: Fifty-four alert, nonsedated patients receiving mechanical ventilation. OUTCOME MEASURES: State anxiety (pretest and posttest), heart rate, and respiratory rate obtained every 5 minutes for 30 minutes. RESULTS: Subjects who received music therapy reported significantly less anxiety posttest (10.1) than those subjects in the control group (16.2). Heart rate and respiratory rate decreased over time for those subjects in the music group as compared with the control group subjects. CONCLUSIONS: A single music therapy session was found to be effective for decreasing anxiety and promoting relaxation, as indicated by decreases in heart rate and respiratory rate over the intervention period with this sample of patients receiving ventilatory assistance.

Adolescent↗
PubMed1996

Sunny days, healthy ways: evaluation of a skin cancer prevention curriculum for elementary school-aged children.

BACKGROUND: Primary prevention of skin cancer must start early in life to reduce total life-time sun exposure and severe overexposure in childhood. Childhood is an excellent time to form life-long prevention habits. A school-based curriculum can be an effective prevention strategy. OBJECTIVE: Our purpose was to determine the effectiveness of a skin cancer prevention curriculum at increasing knowledge and attitudes supporting prevention and decreasing sun exposure by children in grades four, five, and six. METHODS: Twenty-four classes (N = 447 students) from four public elementary schools in southern Arizona participated. Half received a pretest, half were tested at the conclusion of the 5-week curriculum in early spring, and half were tested 8 weeks later in late spring. Objective measures of suntanning were obtained. RESULTS: The curriculum increased knowledge about skin cancer prevention and attitudes supporting prevention and decreased suntanning. Self-reported preventive behavior was inconsistent and only weakly associated with measures of suntanning. CONCLUSION: The curriculum was effective at increasing skin cancer prevention. Resulting reduction in sun exposure was superior to that achieved with previous prevention curricula. Change in attitude needed time to emerge, appearing after 8 weeks. Self-reported preventive behavior by children in elementary school may lack validity. Pretesting did not alter effectiveness. Sixth-graders may be ready for more advanced content, but the curriculum is probably too advanced for kindergarten through third grade.

Attitude to Health↗
PubMed1987

Reinforcing CPR skills without mannequin practice.

We studied the effectiveness of two refresher methods on skills that did not involve mannequin practice. Sixty-seven Seattle subjects trained one year earlier were pretested and randomly assigned to one of two treatments that covered the technique of one-rescuer CPR: reading a three-page review (n = 33); or viewing a 15-minute videotape (n = 34). Subjects were tested on a recording mannequin immediately after the refresher. Pretest scores were low on almost all skills. After treatment, both groups demonstrated significant improvement (P less than .01), especially on checking the carotid pulse, correct hand position, and ventilation volume. Although students who had watched the tape performed better on compression rate (P less than .05), there was virtually equivalent improvement on the other skills regardless of treatment. Both methods showed promise for reversing skills degradation without mannequin practice.

Evaluation Studies as Topic↗