Development and outcomes of a therapeutic group for women with postnatal depression.

Postnatal depression is a significant problem affecting approximately 14.5% of mothers and has the potential for negative long-term consequences for mothers and their children. Previous research suggests that group interventions using cognitive behavioural techniques can be helpful, providing mothers with strategies to address their problems as well as professional and peer support. This paper describes how a therapeutic group was developed by Health Visitors for mothers with postnatal depression in Oxfordshire. It was hypothesised that women who attended the group would feel better able to manage their mood, that their mood would improve and that attending the group would be a positive and supportive experience for them. Formal outcome measures as well as feedback questionnaires were used to evaluate the group and test these hypotheses as well as provide information to improve the service. An overview of the effectiveness of the group is given here, with the majority of women who attended showing improvement in their mood as well as high satisfaction with the content and processes of the course. The findings are discussed and plans for the future are presented.

Reliability of the EasyAngle® for Assessing Hip Range of Motion in Healthy Children.

Background: The use of digital goniometry has emerged as a viable alternative to universal goniometry for assessing hip range of motion (ROM). However, few studies have assessed the use of digital goniometry in pediatric populations and there are a limited number of studies that investigate any one device. The EasyAngle® is a digital goniometer that may be beneficial for use in pediatric settings as it requires only one hand to operate the device. Purpose: The purposes of this study were 1) to establish the intrarater and interrater reliability of the EasyAngle® digital goniometer in measuring hip joint ROM in healthy elementary school-aged children, and 2) to establish preliminary normative reference values for each year of age using the EasyAngle® for hip joint ROM in healthy elementary school-aged children. Study Design: Descriptive Laboratory Study. Methods: Passive hip ROM (flexion, abduction, extension, internal rotation, external rotation) was measured on each leg of healthy participants using the EasyAngle®. A total of 40 hip joints were measured. Two blinded raters conducted three trials of each hip motion on both legs. Intrarater and interrater reliability of the recorded hip range of motion were calculated using intra-class correlation coefficients (ICC) (3,1). Results: Twenty healthy children were measured (age 5-10, mean = 7.40 years old, SD = 1.37, 9 males, 11 females). Mean hip ROM was reported by age. Intrarater and interrater reliability were good to excellent for all hip ROM measurements (0.81-0.97 intra rater; 0.77- 0.91 interrater). Hip flexion had the strongest intrarater (0.96, 0.97) and interrater reliability (0.91). Intrarater reliability was lowest for hip abduction for Rater 1 and hip extension for Rater 2. Interrater reliability was lowest for hip external rotation (0.78). Conclusion: The EasyAngle® is a reliable tool for assessing hip range of motion in healthy children ages 5-10. Normative hip ROM values using the EasyAngle® are available to clinicians. Level of Evidence: Level 3- Reliability study.

The Ocular Hypertension Treatment Study: reproducibility of cup/disk ratio measurements over time at an optic disc reading center.

PURPOSE: To determine the reproducibility over time of visual estimates of the horizontal cup/disk ratio by trained technicians from optic disk stereophotographs. METHODS: Baseline optic disk stereophotographs are graded at entry and regraded annually in a masked fashion. The 1,636 participants in the Ocular Hypertension Treatment Study (OHTS) undergo stereoscopic optic disk photography at study entry and annually thereafter. Stereophotographs are graded independently by two technicians at the Optic Disc Reading Center. If the readers' estimates of horizontal cup/disk ratio differ by more than 0.2 disk diameters (DD), they attempt to reach a consensus; if they cannot, the horizontal cup/disk ratio is adjudicated by a glaucoma specialist. RESULTS: The percent of regradings differing by 0.2 DD or more from the estimate of horizontal cup/disk ratio made at entry was 4%, 6%, and 7%, respectively at years 1, 2, and 3. The percent differing by more than 0.2 DD was 1% or less at all years. Intraclass correlation coefficients were 0.93, 0.92, and 0.92, respectively. Estimates of horizontal cup/disk ratio from sequential full-frame photographs and simultaneous split-frame photographs appeared comparable and equally reproducible. Gradings by technicians were comparable to gradings by glaucoma specialists. CONCLUSIONS: High reproducibility between repeated gradings of baseline horizontal cup/disk ratio was achieved by trained technicians adhering to a rigorous protocol. Horizontal cup/disk ratio measurements in OHTS are sufficiently reproducible to provide information about the relationship of cup/disk ratio to the prognosis of individuals with ocular hypertension.