Habit Formation Intervention to Improve Type 2 Diabetes Self-Management Behaviors: A Feasibility Study.

IMPORTANCE: Self-management of lifestyle behaviors is the recommended focus for interventions to address Type 2 diabetes. Habit formation is an effective approach to changing personal behaviors, but evidence of success for Type 2 diabetes is limited. OBJECTIVE: To examine the feasibility and preliminary effectiveness of occupation-based habit formation interventions for improving diabetes self-management behaviors. DESIGN: Single-subject design with multiple participants providing 4 wk of baseline data followed by 10 wk of intervention data. SETTING: Individual telehealth sessions. PARTICIPANTS: Eight adults (ages 29-75 yr) with Type 2 diabetes, who had access to a telephone and who were not involved in other diabetes-related education or interventions voluntarily, enrolled into the study. INTERVENTION: Participants engaged in 10 wk of habit formation intervention focused on four diabetes self-management domains: nutrition, blood glucose monitoring, medication management, and physical activity. OUTCOMES AND MEASURES: Data gathered included findings on measures of diabetes self-care behaviors and habit formation. RESULTS: There was a significant change in self-care behaviors for 6 of the 8 participants (p < .05 for 1 participant, and p < .01 for 5 participants). Group changes were statistically significant (p < .001). Habit strength significantly improved for all areas of diabetes self-management (p < .001 for nutrition, blood glucose monitoring, and medication management and p = .001 for physical activity). CONCLUSIONS AND RELEVANCE: Findings suggest that the occupation-based intervention was feasible and showed promise for developing self-management behaviors. What This Article Adds: Habits are considered foundational to occupations, yet application of the science of habit formation is often not well understood by occupational therapists. This study considered the theoretical components of habit formation that have been neglected by prior studies and demonstrates the feasibility and preliminary effect estimates of a habit formation intervention when used with people with Type 2 diabetes.

Attention-Deficit Hyperactivity Disorder Status Moderates Polysubstance Use Among Substance Using Populations: A Cross-Sectional Analysis.

INTRODUCTION: Attention-deficit hyperactivity disorder (ADHD) increases the risk for comorbid psychiatric and substance use disorders, which may increase the risk of adverse patient outcomes. This study examined the prevalence of ADHD in residential addiction treatment as well as the prevalence of mono-substance use, comorbid substance use, and polysubstance use disorders (PUD) as a function of ADHD status. METHODS: All participants were adults (18 years and older) admitted to a residential substance use disorder treatment center in Sioux Falls, SD. Participants were administered a Wender Utah ADHD rating scale to assess ADHD status using a cutoff score of 46. The participants were administered ADHD questionnaires developed to assess ADHD history, family history, and academic performance. RESULTS: Students showed a 17% increase in confidence in discussing substance use with patients and a 47% increase in confidence in applying MI techniques after the instructional session. At CC, 54.5% of patients reported substance use and 16.7% of those patients responded that they would consider quitting in the next month after the student interview. In the post-clinic survey, students rated an average of 4.21 out of 5 on comfort level in discussing excessive substance use. CONCLUSION: ADHD and substance use disorder have notable comorbidity. This study demonstrates a high prevalence of ADHD in populations with substance use disorder. The presence of ADHD may be a risk factor for PUD. Effective screening and treatment of ADHD may alleviate substance use burden among users.

Does Remote and/or Virtual Learning Prepare First-Year Physician Assistant Students for Clinical Rotations as Effectively as In-Person Learning?

PURPOSE: The coronavirus disease 2019 pandemic has profoundly affected many lives, and the aftermath is still uncertain. Many aspects of life have been affected, including physician assistant (PA) education. The collective efforts of students and faculty, perseverance, and optimism have allowed the uninterrupted preparation of the next generation of PAs. The objective of this study was to understand PA students' perceptions of the effectiveness of remote and/or virtual learning in preparing PA students for clinical rotations. METHODS: This pilot study was a mixed-methods survey with quantitative and qualitative data involving 3 accredited PA programs in the United States. Statistics were analyzed using SAS 9.4. RESULTS: Ninety-four individuals responded to the survey with a response rate of 46.8%. Response distributions, standard deviations, and means were calculated. Likert scale response means for each survey item were used to estimate the overall perspective of the participants. CONCLUSION: Most participants highlighted the advantages of flexibility and an opportunity to balance school and family life, but the participants did not favor remote and/or virtual learning platforms for effectively preparing students for their clinical phase. More research on a larger scale is warranted. Including students' hands-on skills performance measures in addition to perceptions could provide objective evidence for the efficacy of remote and/or virtual learning in preparing students for clinical rotations.

US physical therapist practice patterns evaluating concussion and clinical practice guideline adherence.

OBJECTIVES: To assess the influence of contemporary physical therapy clinical practice guidelines (CPG) on concussion evaluation practice patterns and barriers/facilitators for CPG adherence. DESIGN: Electronic cross-sectional survey. SETTING: Online survey platform. PARTICIPANTS: US licensed physical therapists that manage concussion. MAIN OUTCOME MEASURES: 1) practice patterns 2) knowledge/use of CPG 3) barriers/facilitations to CPG adherence. RESULTS: Knowledge/use of CPG categories significantly predicted the model (χ2(1) = 10.966, p < .001) of total vignette scores/practice patterns with a statistically significant effect. A Kruskal-Wallis test indicated significant differences in total vignette score means based on knowledge/use between "not aware of the concussion CPG" and "integrated concussion CPG into practice" groups (p < .001, ES = .21). Knowledge/use of the CPG predicted the perceived barriers/facilitators model for three questions: investment in specialized concussion training (χ2(1) = 39.52, p < .001), necessary equipment to complete concussion evaluation (χ2(1) = 16.01, p < .001), and confidence around concussion evaluation knowledge (χ2(1) = 27.46, p < .001) with a significant effect. CONCLUSION: The results of this study provide support for guiding documents like the CPG to positively influence concussion practice patterns and insight into facilitators for guideline adherence.

The Predictive Accuracy of the CareMOSAIC Risk Assessment for Discharge Disposition in Medicare Bundle Patients After Total Joint Arthroplasty.

BACKGROUND: This article evaluates the predictive accuracy of the CareMOSAIC Risk Assessment for discharge disposition in Medicare patients undergoing total joint arthroplasty. METHODS: Retrospectively collected data from a single institution on 499 consecutive Medicare patients who underwent primary total hip arthroplasty or total knee arthroplasty were reviewed. The CareMOSAIC Risk Assessment was completed by each patient during the preoperative period. The CareMOSAIC Risk Assessment scores were calculated via the CareMOSAIC software, and the scores indicate a risk category for each patient as it relates to post-acute care discharge needs. RESULTS: The CareMOSAIC Risk Assessment with a binary logistic regression area under the receiver operating characteristic curve of 0.798 appears to be a reliable tool for predicting discharge disposition. The assessment had a positive predictive value of 90.0% and negative predictive value of 76.3% for discharge disposition. CONCLUSIONS: The CareMOSAIC Risk Assessment effectively predicts the discharge disposition for Medicare patients undergoing total hip or total knee arthroplasty.

DUAL-TASK ASSESSMENT IMPLICATIONS FOR ANTERIOR CRUCIATE LIGAMENT INJURY: A SYSTEMATIC REVIEW.

BACKGROUND: Several systematic reviews have evaluated the role of dual-task assessment in individuals with concussion. However, no systematic reviews to date have investigated dual-task protocols with implications for individuals with anterior cruciate ligament (ACL) injury or ACL reconstruction (ACLR). PURPOSE: To systematically review the evidence on dual-task assessment practices applicable to those with ACL deficiency/ACLR, specifically with the aim to identify motor-cognitive performance costs. STUDY DESIGN: Systematic review. METHODS: A systematic literature review was undertaken on those with ACL-deficient or ACL-reconstructed knees performing dual-task activities. The following databases were searched from inception to June 8, 2018 including CINAHL, PsychInfo, PubMed, SPORTDiscus, Web of Science, and gray literature. Three primary search categories (knee, cognition, and motor task) were included. Only one reviewer independently performed the database search, data extraction, and scored each article for quality. All studies were assessed for quality and pertinent data were extracted, examined and synthesized. RESULTS: Ten studies were included for analysis, all of which were published within the prior ten years. Performance deficits were identified in those with either ACL deficiency or ACLR while dual-tasking, such as prioritization of postural control at the expense of cognitive performance, impaired postural control in single limb stance, greater number of cognitive errors, and increased step width coefficient of variation while walking. No studies examined those with prior ACL injury or ACLR during tasks that mimicked ACL injury mechanisms such as jump-landing or single-leg cutting. CONCLUSION: The results of the current systematic review suggests that postural control, gait, and/or cognitive deficits exist when evaluated under a dual-task paradigm in those with ACL deficiency or ACLR. This systematic review highlights the need for future research on dual-task assessment for individuals who have sustained an ACL injury or undergone ACLR, specifically utilizing more difficult athletic movements. LEVEL OF EVIDENCE: Level 3a.

THE INFLUENCE OF VISUAL FIXATION ON HOP TEST PERFORMANCE.

BACKGROUND: It has been recognized that anterior cruciate ligament (ACL) injuries typically occur when athletes are attending to a secondary task or object, including teammates, opponents, and/or a goal. Commonly applied tests after ACL injury include a series of hop tests to determine functional status, yet do not control for visual fixation. PURPOSE: To examine the influence of visual fixation during two functional hop tests in healthy individuals. STUDY DESIGN: Repeated measures. METHODS: Participants performed the crossover triple hop for distance (XHOP) on the left lower limb, and the medial triple hop for distance (MHOP) on the right. For the hop test only conditions, participants were not instructed where to fix their vision while performing the hop test. The visual fixation condition required participants to fix their vision on an alternating plus/minus sign at the center of a display monitor located in front of the participant while performing each hop test, respectively. A retest session occurred 48-72 hours after the initial test session in order to examine reliability. RESULTS: Thirty-four healthy adults (age: 24.0 ± 3.9 years) completed testing procedures, performing the XHOP and MHOP under standard and visual fixation conditions. Of those participants, twelve completed a retest session for reliability analysis. Hop distance was not altered by the addition of visual fixation (p = 0.27), with trivial effect sizes found across conditions (d = 0.02 - 0.07); however, the addition of visual fixation slightly improved within- and between-session intrarater reliability, standard error of measurement, and minimal detectable change of the MHOP. CONCLUSION: Hop distance during the XHOP and MHOP was not influenced by visual fixation. Measurement of both the XHOP and MHOP was reliable, but lacked precision. Measurement properties for the MHOP including within- and between-session reliability, standard error of measurement, and minimal detectable change improved slightly with the addition of visual fixation compared to normal MHOP procedures. LEVEL OF EVIDENCE: 2b.

HAND GRIP STRENGTH IN SENIOR ATHLETES: NORMATIVE DATA AND COMMUNITY-DWELLING COMPARISONS.

BACKGROUND: Hand grip strength is supported as a valid physical capacity measure in older adults. Normative values for community-dwelling older adult hand grip strength were recently updated. With the majority of community-dwelling older adults identified as sedentary, it is likely that current norms represent a group that is relatively inactive. A sub-population of senior athletes who actively engage in exercise and competitive sport have consistently demonstrated superior performance on measures of physical capacity when compared to the general population. Normative values for hand grip strength have not been established for this unique group of aging athletes. PURPOSE: To establish hand grip strength norms for senior athletes and to compare these outcomes to available normative data in community-dwelling older adults. STUDY DESIGN: Cross-Sectional Study. METHODS: Measures of hand grip strength were taken on 2,333 senior athletes registered to compete in the National Senior Games between 2011 and 2017. Findings were divided into age and gender categories consistent with community-dwelling norms. Student t tests were used to compare senior athlete means to community-dwelling norms. Cohen's d was calculated to estimate the effect size of each comparison. RESULTS: Normative values for senior athlete hand grip strength are reported in kilograms by age, gender and hand dominance. For each age and gender category tested, senior athletes demonstrate dominant hand grip strength that ranges from 8.6-11.1 kg higher for males and 5.5 to 8.9 kg higher for females (p values<.0001) than published community-dwelling norms. Non-dominant grip strengths were also significantly higher (p values<.0001). Effect sizes were medium to large (Cohen's ds = 0.44-1.5). CONCLUSION: Senior athletes demonstrate hand grip strength that is significantly higher than their community-dwelling peers and more similar to a younger community-dwelling population. The population--specific norms presented here will assist health care providers in more accurately assessing this high-functioning subset of aging adults. LEVELS OF EVIDENCE: 2b.

INCORPORATING A DUAL-TASK ASSESSMENT PROTOCOL WITH FUNCTIONAL HOP TESTING.

BACKGROUND: Hop tests are commonly used within a testing battery to assess readiness for return to sport after anterior cruciate ligament (ACL) injury, yet athletes still experience a high rate of re-injury. Simultaneous performance of a secondary task requiring cognitive processing or decision-making may test the athlete under more realistic contexts. PURPOSE: To examine a clinically feasible, dual-task assessment paradigm applied during functional hop tests in healthy individuals. STUDY DESIGN: Repeated measures. METHODS: Participants performed the crossover triple hop for distance (XHOP) and medial triple hop for distance test (MHOP) under three separate conditions: standard procedures and two dual-task protocols including the backward digit span memory task and a visuospatial recognition task. The visuospatial task involved briefly displaying an image consisting of 18 randomly placed red and blue circles on a screen, where the participant was asked to identify the number of red circles in each image. The backward digit span task was applied by introducing a sequence of random numbers to the participants, who were required to repeat the sequence in reverse order. Each motor and cognitive task was performed independently and simultaneously, in accordance with the dual-task paradigm. RESULTS: Thirty-four healthy participants (age: 24.0 ± 3.9 years) completed testing procedures. No differences in hop distance were observed with the simultaneous application of a cognitive task, with the exception of the backward digit span memory task resulting in decreased hop distance (p = 0.04, d = 0.14). There were no differences in cognitive accuracy according to hop test type, although the effect size was greater for the XHOP (p = 0.08, d = 0.49) compared to the MHOP (p = 1.0, d = 0.07). The dual-task protocol revealed good-excellent within- (ICC3,1 = 0.85 - 0.99) and between-session (ICC3,k = 0.94 - 0.99) intrarater reliability for hop distance across all dual-task conditions. The addition of a cognitive task to the XHOP and MHOP resulted in a lower standard error of measurement and decreased minimal detectable change, as compared to standard testing procedures. CONCLUSION: The simultaneous application of a cognitive task did not alter hop distance, with the exception of the backward digit span memory task resulting in decreased hop distance with a trivial effect size. There were no differences in cognitive accuracy according to task type (sitting, XHOP, MHOP). All combinations of dual-task assessment demonstrated good-excellent within- and between-session intrarater reliability among healthy individuals, but measurement precision was deficient. LEVEL OF EVIDENCE: 2b.

Nursing Students' Professional Value Development: Can We Do Better?

AIM: The purpose of this study was to identify whether differences exist in nursing professional values based on program type and/or geographic location. BACKGROUND: Deliberate inclusion of values formation is critical to nursing education and high-quality nursing care. There is limited research comparing professional values development among students in all types of prelicensure RN programs and no research comparing students' professional values between geographic regions. METHOD: A secondary analysis was completed of original data collected in three descriptive studies using the Nursing Professional Value Scale-Revised®. RESULTS: Findings indicate prelicensure nursing students are educated with the values integrated within the American Nurses Association Code of Ethics. Significant differences (p < .05) were found when comparing geographic locations, program types, and Nursing Professional Value Scale-Revised factor scores. CONCLUSION: Additional research is needed to identify best practices for overall values formation in all program types.

Carbamoylated erythropoietin induces a neurotrophic gene profile in neuronal cells.

Erythropoietin (EPO), a cytokine molecule, is best-known for its role in erythropoiesis. Preclinical studies have demonstrated that EPO has robust neuroprotective effects that appear to be independent of erythropoiesis. It is also being clinically tested for the treatment of neuropsychiatric illnesses due to its behavioral actions. A major limitation of EPO is that long-term administration results in excessive red blood cell production and increased blood viscosity. A chemical modification of EPO, carbamoylated erythropoietin (CEPO), reproduces the behavioral response of EPO in animal models but does not stimulate erythropoiesis. The molecular mechanisms involved in the behavioral effects of CEPO are not known. To obtain molecular insight we examined CEPO induced gene expression in neuronal cells. PC-12 cells were treated with CEPO followed by genome-wide microarray analysis. We investigated the functional significance of the gene profile by unbiased bioinformatics analysis. The Ingenuity pathway analysis (IPA) software was employed. The results revealed activation of functions such as neuronal number and long-term potentiation. Regulated signaling cascades included categories such as neurotrophin, CREB, NGF and synaptic long-term potentiation signaling. Some of the regulated genes from these pathways are CAMKII, EGR1, FOS, GRIN1, KIF1B, NOTCH1. We also comparatively examined EPO and CEPO-induced gene expression for a subset of genes in the rat dentate gyrus. The CEPO gene profile shows the induction of genes and signaling cascades that have roles in neurogenesis and memory formation, mechanisms that can produce antidepressant and cognitive function enhancing activity.

Work-Life Balance in Women Physicians in South Dakota: Results of a State-Wide Assessment Survey.

INTRODUCTION/BACKGROUND: There is currently a high prevalence of burnout among women physicians. This is associated with factors related to job satisfaction and work-life balance. Female physicians are more likely to experience burnout and related negative consequences. Preventing burnout among physicians improves wellness in both doctors and patients. The goal of this study is to determine burnout among physicians in South Dakota and identify possible burnout prevention strategies to improve work-life balance. METHODS: South Dakota State Medical Association (SDSMA) physician members were emailed a survey with anonymous responses in November 2017 and January 2018. Survey questions were based on a 5-point Likert scale with two open-ended questions which were evaluated by qualitative measures. RESULTS: A total of 1,989 surveys were administered with 433 responses (21.8 percent). Of the 433 survey responses, 133 individuals provided additional comments regarding work-life balance. A slender majority of male and female physicians are satisfied with their work-life balance (54.7 and 55.4 percent, respectively). Both men and women physicians would choose the same specialty again (78.2 and 74.8 percent, respectively) as well as choose to be a physician again (79.4 and 78.7 percent respectively). Overall, women suggested more time for administrative tasks, more flexible hours, offering daycare at the hospital. CONCLUSIONS: Possible workplace interventions to prevent physician burnout include hiring scribes, allocating time for administrative work, and allowing less work hours. Personal strategies aiding in work-life balance include utilizing daycares, having supportive families, and hiring individuals to assist in daily home tasks.

Promoting Student Interest in Family Medicine Through National Conference Attendance.

INTRODUCTION: The University of South Dakota Sanford School of Medicine (USDSSOM) had success in preparing students to enter family medicine. A sharp decline in students choosing the specialty became noticeable in 2004. In 2005, only 10.2% of the graduating class entered family medicine residency programs. To reverse this trend, the Department of Family Medicine partnered with the South Dakota Academy of Family Physicians (SDAFP) chapter that year to send students to the American Academy of Family Physicians (AAFP) National Conference of Family Medicine Residents and Medical Students. This report examines the influence of national conference attendance on career choice. While many factors influence student choice, conference attendance served as an additive method for recruitment. METHODS: Internal departmental records on national conference attendance and subsequent National Resident Matching Program (NRMP) data were reviewed retrospectively, to determine if a correlation existed between conference attendance and choice of family medicine as a specialty. Chi-squared analysis was utilized to further examine this relationship. RESULTS: The association between conference attendance and number of times attending is significant (χ2 =6.78, P<.05). The recent data show that this intervention has resurrected student interest in family medicine, with USDSSOM now exceeding the NRMP average for family medicine. CONCLUSIONS: A positive correlation exists between national conference attendance and medical student choice to enter family medicine residency programs. This intervention may be used by more medical schools wishing to promote family medicine in order to help meet our nation's primary care workforce needs.

Analysis of Gauntlet Test Performance and Injury Risk in Intercollegiate Division I Female Soccer (Football) Players: A Retrospective Study.

CONTEXT: Injury risk factors and relevant assessments have been identified in women's soccer athletes. Other tests assess fitness (eg, the Gauntlet Test [GT]). However, little empirical support exists for the utility of the GT to predict time loss injury. OBJECTIVES: To examine the GT as a predictor of injury in intercollegiate Division I female soccer athletes. DESIGN: Retrospective, nonexperimental descriptive cohort study. SETTING: College athletic facilities. PARTICIPANTS: 71 female Division I soccer athletes (age 19.6 ± 1.24 y, BMI 23.0 ± 2.19). MAIN OUTCOME MEASURES: GT, demographic, and injury data were collected over 3 consecutive seasons. GT trials were administered by coaching staff each preseason. Participation in team-based activities (practices, matches) was restricted until a successful GT trial. Soccer-related injuries that resulted in time loss from participation were recorded. RESULTS: 71 subjects met the inclusion criteria, with 12 lower body time loss injuries sustained. Logistic regression models indicated that with each unsuccessful GT attempt, the odds of sustaining an injury increased by a factor of 3.5 (P < .02). The Youden index was 2 GT trials for success, at which sensitivity = .92 and specificity = .46. For successive GT trials before success (1, 2, or 3), the predicted probabilities for injury were .063, .194, and .463, respectively. CONCLUSIONS: The GT appears to be a convenient and predictive screen for potential lowerbody injuries among female soccer athletes in this cohort. Further investigation into the appropriate application of the GT for injury prediction is warranted given the scope of this study.

CHANGES IN DYNAMIC BALANCE AND HIP STRENGTH AFTER AN EIGHT-WEEK CONDITIONING PROGRAM IN NCAA DIVISION I FEMALE SOCCER (FOOTBALL) ATHLETES.

BACKGROUND: Lower extremity injury commonly affects female soccer athletes. Decreased dynamic balance and hip strength are identified risk factors for lower extremity injury. Little is known about how these factors adapt to a training stimulus in this population. PURPOSE: To retrospectively investigate changes in lower extremity dynamic balance and isometric hip strength in Division I collegiate female soccer athletes after participating in an eight-week strength and conditioning program. STUDY DESIGN: Retrospective, non-experimental cohort study. METHODS: As part of a standard testing battery, soccer athletes completed athletic performance pre- and post-testing separated by an eight-week off-season conditioning program consisting of overall strength and technical skill development. Testing included lower extremity dynamic balance assessment through the Star Excursion Balance Test (SEBT) and isometric hip abduction and external rotation (ER) strength testing, normalized to limb length and percent body mass, respectively. Athletes rested for one week prior to post-testing. RESULTS: Seventeen healthy Division I female soccer athletes (age: 18.8 ± 0.9 years, height: 1.7 ± 0.06 m, mass: 68.0 ± 8.2 kg) completed the protocol. Significant improvements in SEBT composite reach distance were observed in the dominant (DOM) (3.6 ± 4.8%, 95% CI: 1.1 to 6.0) and nondominant (NDOM) (4.8 ± 6.1%, 95% CI: 1.7 to 7.9) limbs. Significant improvements in DOM hip ER strength (2.4 ± 2.3%, 95% CI: 1.3 to 3.6) and DOM SEBT anterior reach (2.1 ± 2.8%, 95% CI: 0.6 to 3.5) were observed. Large effect sizes were observed for DOM and NDOM hip ER strength gains (0.87 - 1.0), while small-moderate effect sizes were noted for the anterior reach direction (0.40 - 0.66). Further, DOM hip ER strength gains were significantly associated with DOM anterior reach performance improvements (r2 = 0.37, p<.01). CONCLUSION: DOM hip ER strength gains appear to be associated with improved lower extremity dynamic balance on the ipsilateral limb for the SEBT anterior reach direction in collegiate, Division I female soccer athletes after an eight-week conditioning program. Future investigations should prospectively investigate intervention strategies to modify lower extremity injury risk factors in this population. LEVEL OF EVIDENCE: 2b.

Demographic considerations in anticoagulation therapy for atrial fibrillation.

BACKGROUND: Prevalence of atrial fibrillation (AF) continues to rise in an aging population. New strategies in anticoagulation management for the prevention of stroke are expanding options for individualized, patient centered care. METHODS: Demographic information was collected on 477 AF patients undergoing international normalized ratio testing for anticoagulation therapy. Travel distances and times were calculated based on patient address and testing site. RESULTS: Of the 477 patients studied, 60 percent were male. The average age was 76 years with a median age of 77.5 years. The average one-way distance traveled was 11.8 miles and 16 minutes, 45 seconds. Half of the patients were traveling at least six miles and 11 minutes. Ten percent of patients traveled at least 30 miles and could be classified as rural. CONCLUSION: Rural patients should be recognized and considered for alternative anticoagulation medications or individualized approaches to INR monitoring. They often encounter socioeconomic barriers to care and other health risks associated with rural travel. Providers need to consider basic demographic information when formulating treatment plans in conjunction with their patients to achieve effective patient centered care.

Predictors of mental healthcare use among domestic violence survivors in shelters.

We examined sociodemographic and illness/need associations with mental health care use and service use intensity (i.e., number of visits) among domestic violence survivors. Data from 252 women recruited from 5 Midwestern domestic violence shelters were analyzed. Univariate analyses indicated a more positive treatment attitude was related to increased mental health service use and service use intensity. Second, being Caucasian and greater PTSD severity were associated with increased service use intensity. A sociodemographic and attitudinal multivariate predictor model explained 14% of variance in treatment use intensity, and a need/illness model significantly contributed an additional 10% variance. In contrast, the interaction of PTSD Symptom Severity × Perceived Need was significant. Results demonstrate illness has a significant effect above and beyond sociodemographic variables in accounting for mental health care use, and that PTSD severity moderated the relationship between perceived need and service use.

A comparison of the Sensory Profile scores of children with autism and an age- and gender-matched sample.

BACKGROUND: The Centers for Disease Control and Prevention (CDC) reports that autism spectrum disorder (ASD) affects one in 88 children in the United States. The American Psychiatric Association's Diagnostic and Statistical Manual, Text Revision (DSM-IV-TR) defines ASD as a pervasive neurodevelopmental disorder characterized by qualitative impairment in communication and social interaction, and restricted, repetitive and stereotyped behavior patterns. The purpose of this study was to determine whether children with autism differ in their response to sensory input relative to typically developing age- and gender-matched peers. METHOD: The Sensory Profile (SP) is a 125-item caregiver questionnaire designed to measure a child's ability to process sensory information and to profile the effect of sensory processing on daily life activity. The results of the SP of 21 participants with autism ages 3 to 9 years were compared with an age- and gender-matched sample of typically developing children. RESULTS: Significant differences were found across all four SP quadrants (Registration, Seeking, Sensitivity, and Avoiding) as well as eight of the nine SP factor scores. This study adds to the evidence indicating that children with autism process and respond to sensory input differently than typically-developing peers. CONCLUSION: The findings from this study support previous research findings that sensory processing differences exist between children with ASD and their typically-developing peers, as measured by the SP.

The five times sit to stand test in senior athletes.

BACKGROUND AND PURPOSE: The Five Times Sit to Stand Test (FTSST) has been established as a valid and reliable functional measure for older adults. Norms have been clearly defined for community-dwelling older adults and can be useful in the identification of mobility decline and prediction of future disability. However, because of the high rates of inactivity in the population of community-dwelling older adults, it seems inappropriate to compare high-functioning older adults, for example, senior athletes, to these norms. With trends showing increased senior athlete participation, new norms may be necessary to appropriately evaluate this population of older adults. The purpose of this study was to (1) compare results of the FTSST in senior athletes older than 60 years to norms for community-dwelling adults of the same age (2) determine the effects of age, gender, and sport intensity on FTSST performance in senior athletes, and (3) establish norms appropriate for this population of interest. METHODS: The FTSST was performed on 276 (104 men, 172 women) senior athletes age 50 to 91 years (mean age = 64.9, SD = 15) reporting an average of 4 hours of cardiovascular training and 1 hour of strength training each week. All were actively engaged in national or state senior game competitions. RESULTS: All participants were able to complete the test. One hundred ninety-four participants between 60 and 89 years of age showed significantly faster times than currently reported norms. Performance was negatively associated with age, but did not differ significantly between genders. Participants in more physically demanding sports did show the best FTSST times, although athletes engaged in more leisure sports still outperformed norms for community-dwelling seniors. CONCLUSION: Senior athletes show significantly greater FTSST speed than norms derived from community-dwelling older adults. New normative guidelines are presented to assist the screening of these athletes on this functional performance measure.