Prediction of 10 repetition maximum for short-arc quadriceps exercise from hand-held dynamometer and anthropometric measurements

Short-arc quadriceps exercise are commonly prescribed in physical therapy for strengthening knee extensor musculature. Determining the appropriate starting resistance has traditionally been a trial-and-error procedure. Therefore, developing an expedient method of estimating the correct starting resistance may lead to a more accurate exercise prescription. The primary purpose of this study was to establish a technique for predicting an individual's 10 repetition maximum (10 RM) based on hand-held dynamometer (HHD) strength recording and additional anthropometric predictor variables. Fifty healthy subjects (31 males and 19 females), aged 22-53 years, participated in the study. A prediction equation for determining 10 RM using HHD strength recording, weight, gender, and age was developed. By implementing this equation, clinicians can predict a normal, healthy, young to middle-aged adult's 10 RM within +/- 4.17 kg with a 95% confidence level (SEE = 2.13 kg).

Continuing medical education in marital and family therapy: a survey of South Australian psychiatrists

OBJECTIVE

South Australian psychiatrists were surveyed to determine their impressions of the usefulness of marital and family therapy (MFT) in the management of serious psychiatric conditions and to ascertain their previous experience with Continuing Medical Education (CME) about family therapy. It was expected that psychiatrists' preferences regarding CME would be related to their clinical experience of the usefulness of MFT.

METHOD

One hundred and twenty psychiatrists returned a questionnaire about their training, clinical and research interests, with ratings of the usefulness of MFT and CME preferences. This represented 65% of those eligible for the CME programme.

RESULTS

Thirteen percent of the respondents found MFT to be extremely useful and a further 47% found it moderately useful in their current practice. There was evidence of a possible training effect: respondents who had previous CME rated MFT as more useful, especially for mood disorders. Furthermore, the treatment of mood disorders seemed to have a particular relevance in family psychiatry, making a statistically unique contribution to ratings of MFT usefulness in the respondents' total practice. Sixty-nine percent of the respondents requested further CME in family therapy. This represented 45% of all South Australian psychiatrists. Respondents who rated MFT as more useful in practice were significantly more likely to be interested in CME.

CONCLUSIONS

There seems to be sufficient interest and clinical experience among psychiatrists for MFT to be included in CME courses. It is recommended that further training focus on major mental disorders, especially mood disorders and schizophrenia.

Adolescent suicide, depression and family dysfunction

This study investigated associations between adolescents' perceptions of their family dynamics (McMaster Family Assessment Device, FAD) and depression, suicide thoughts and attempts. High school students (mean age 15.2 years) completed self-report questionnaires including the Beck Depression Inventory (BDI), the FAD, questions about suicidal thoughts, plans and attempts, deliberate self harm, and selected life experiences. Univariate analysis showed that family dysfunction measured on the FAD is associated with thinking and planning suicide, deliberate self harm, suicide attempts, as well as severe depression (BDI > or = 22). Despite this, stepwise regression indicated that family dysfunction influences suicide behaviors indirectly through other variables such as depression. The FAD is recommended as a useful addition to questionnaires seeking to identify vulnerability to both depression and adolescent attempted suicide in early detection studies.

Effects of surface texture on weight perception when lifting objects with a precision grip

In this paper, we show that, when lifting an object using a precision grip with the distal pads of the thumb and index finger at its sides, the perceived weight depends on the object's surface texture. The smoother the surface texture, the greater the perceived weight. We suggest that a smoother object is judged to be heavier because the grip force, normal to the surface, required to prevent it from slipping is greater. The possibility of there being an influence of surface texture per se is excluded by a second experiment that employed a variant of the precision grip in which the thumb supports the weight of the object from underneath. With the grip oriented in this way, there is no need to match grip force to surface texture and, under these conditions, there is no effect of surface texture on weight perception. In the first two experiments, the test and comparison weights were lifted successively by the same hand. In a third experiment, the effect of surface texture was replicated for sequential lifts made with separate hands. Thus, the effect is not restricted to comparisons made with the same hand.

Evaluation of a patient information booklet

Preoperative teaching is an integral component of the care surgical patients receive. The need for consistent preoperative information has resulted in growing use of printed health information. There are many printed materials for nurses to choose from; however, these materials serve no useful teaching purpose if patients are unable to understand them. This study evaluates how well surgical patients understand the content presented in an educational booklet used for preoperative teaching. A Cloze test was designed to assess comprehension of a booklet prepared at a grade five reading level. Scores revealed that 84% of subjects scored above 56% and were able to comprehend the material independently; 10% scored between 44% and 56%, indicating they would require some help; and 6% scored less than 44% and were not able to comprehend the information.

Influences on control in diabetes mellitus: patient, doctor, practice, or delivery of care?

OBJECTIVE

To assess patient, doctor, practice, and process of care variables for their effect on glycaemic control in diabetes mellitus, and to quantify their relative effects.

DESIGN

Search of general practice medical records, patient questionnaires and examination, doctor questionnaire, videotaping and analysis of consultations, and practice questionnaire.

SETTING

12 practices with 32 participating general practitioners in Nottinghamshire.

SUBJECTS

318 patients randomly selected from those with diabetes in each practice, 10 for each participating doctor.

MAIN OUTCOME MEASURE

Glycaemic control as measured by random glycated haemoglobin A1c estimation (random haemoglobin A1 measurement).

RESULTS

Glycaemic control was significantly related to the disease process as measured by years since diagnosis, treatment group, and number of diabetes related clinical events. Females had significantly worse control than males. Other patient factors, such as age, social class, lifestyle, attitudes, satisfaction, and knowledge, had no association with glycaemic control. Of all the doctor factors examined, only doctors who professed a special interest in diabetes achieved significantly better glycaemic control. Bigger and better equipped practices and those with a diabetic miniclinic had patients with significantly better glycaemic control, as did those with access to dietetic advice. Patients attending hospital clinics had worse glycaemic control, but this seemed to be attributable to the case mix and practice characteristics. Shared care did not contribute to the multiple linear regression model.

CONCLUSION

Glycaemic control among diabetic patients in the community is related to such factors as treatment group, sex, and years since diagnosis; it is also related to the organisation and process of care. The findings support concentrating diabetic care on partners with special interests in diabetes in well equipped practices with adequate dietetic support.

The pre-admission program: a proactive approach to management

Spiralling health care costs are forcing hospital administrators to find creative alternatives to traditional health care delivery systems. One of the most recent innovations rapidly gaining favour is the pre-admission program. The article describes how a well-developed pre-admission program can have a significantly positive impact on bed utilization, diagnostic services, patient satisfaction and overall quality of care, and provides examples from a successful pre-admission program implemented at the University of Alberta Hospitals.

Bovine dopamine beta-hydroxylase cDNA. Complete coding sequence and expression in mammalian cells with vaccinia virus vector

We have isolated cDNA clones for bovine dopamine beta-hydroxylase from an adrenal medulla cDNA library and have determined the complete coding sequence. The largest cDNA clone isolated from the library is 2.4 kilobase pairs (kb) and contains an open reading frame of 1788 bases, coding for a protein of 597 amino acids and Mr = 66,803. The predicted amino acid sequence of the bovine cDNA contains 85% identity with human dopamine beta-hydroxylase (Lamouroux, A., Vingny, A., Faucon Biquet, N., Darmon, M. C., Franck, R., Henry, J.P., and Mallet, J. (1987) EMBO J. 6, 3931-3937; Kobayashi, K., Kurosawa, Y., Fujita, K., and Nagatsu, T. (1989) Nucleic Acids Res. 17, 1089-1102). Northern blot analysis reveals that the cDNA hybridizes to an mRNA of 2.4 kb present in bovine adrenal medulla, but not in kidney, heart, or liver. In addition, the cDNA hybridizes to a second RNA species of 5.5 kb, which is 4-fold less abundant than the 2.4-kb RNA. In vitro translation of a synthetic RNA transcribed from the 2.4-kb cDNA produces a 68-kDa protein, which is specifically immunoprecipitated by antiserum to bovine dopamine beta-hydroxylase. The 2.4-kb cDNA was cloned into a vaccinia virus vector, and the recombinant virus was used to infect the rat pheochromocytoma PC12 and monkey BSC-40 fibroblast cell lines. In both cell lines, infection with recombinant virus produces a protein of Mr = 75,000, which reacts with antiserum to bovine dopamine beta-hydroxylase. These results indicate that the 2.4-kb cDNA contains the genetic information necessary to code for the bovine dopamine beta-hydroxylase subunit.

The detection of sleep onset: behavioral, physiological, and subjective convergence

In this report, a sleep deprivation/multiple arousal paradigm was used in which response time (RT) and respiratory and electroencephalographic (EEG) measures were combined with a continuous behavioral index of arousal (a deadman switch) and frequently repeated Stanford Sleepiness Scale ratings to examine the process of falling asleep. Sleep was defined behaviorally as failure to respond to the faint auditory RT cue. Although response rates decreased significantly as EEG stages passed from W through 1 to 2, responding continued in both light "sleep" stages. Respiratory, subjective, and DM changes were more pronounced between Stages W and 1 than between Stages 1 and 2. If the criterion for wakefulness is cognitive response to external stimulation, accurate distinctions between sleep and wakefulness can only be made in EEG Stages 3, 4, and rapid eye movement sleep. If EEG is the criterion, then the data suggest that cognitive response is possible during Stages 1 and 2 "sleep". The concept of a Sleep Onset Period, characterized by lengthening response times and intermittent response failure (thereby reflecting neither true sleep nor wakefulness), may provide a useful resolution to this definitional dilemma.

Age and simple reaction time: decade differences for 5,325 subjects

In a booth at a public exhibition entitled "Medicines for Man," 5,325 men, women, and children carried out a 1-minute test of simple reaction time (RT) with 1 to 10 second randomized variable preparatory interval (PI). They recorded their ages by decade. Average RT over the last eight (of ten) trials increased progressively from the 20s up to age 60 and over, and downward to the teens and under 10s. The single fastest RT in each test varied much less with age, only the 20s being clearly faster than the rest, with the under 10s slower. Within-subject variability of RT was increased only in the under 10s and over 60s. Ability to sustain attention during the longer PIs may underlie the gross average RT differences with age, and possibly some more basic neural property the superiority of the 20s in fastest RT.

Plasma concentrations and clinical effects after single oral doses of prazepam, clorazepate, and diazepam

In a double-blind parallel-group pharmacokinetic and pharmacodynamic study, 31 healthy volunteers received single oral doses of prazepam (10 mg), clorazepate (7.5 mg), or diazepam (5 mg). Appearance in plasma of diazepam and of desmethyldiazepam was rapid after administration of diazepam and clorazepate, respectively, with peak plasma concentrations reached within an average of 1 hour. After oral prazepam, however, desmethyldiazepam appeared in blood slowly, with the highest mean concentration at 6 hours postdosage. Clinical self-ratings of fatigue and of "feeling spacey" were significantly different among groups, with changes over baseline being more marked with clorazepate and diazepam than with prazepam. Thus, differences in absorption rate of orally administered benzodiazepines can lead to differences in the intensity of single-dose effects, despite administration of doses that are equivalent in terms of long-term anxiolytic efficacy.