Repeated Measures Multivariate Analyses Of Variance Research Articles

Change in Views of Aging, Physical Activity, and Physical Health Over 8 Weeks: Results From a Randomized Study.

The AgingPLUS program targets motivational barriers, including negative views of aging, as mechanisms to increase adult physical activity. A pilot study was conducted to test the efficacy of this new program against a generic successful aging program. Fifty-six participants were randomly assigned to the AgingPLUS group, and 60 participants were assigned to the active control group. Repeated-measures multivariate analyses of variance assessed changes in views of aging, physical activity, blood pressure, and hand-grip strength from pretest (Week 0) to delayed posttest (Week 8). The Condition × Occasion interactions were nonsignificant; however, significant main effects for condition and occasion were found. Follow-up tests showed that views of aging were more positive, and physical activity had significantly increased at Week 8 for all participants. In addition, in the treatment group, elevated blood pressure had significantly decreased and hand-grip strength had significantly increased at Week 8. Despite the nonsignificant multivariate findings, the main effect findings provided partial support for the efficacy of the AgingPLUS program.

Add-On Effect of 0.01% Atropine in Orthokeratology Wearers for Myopia Control in Children: A 2-Year Retrospective Study.

Orthokeratology (OK) and low-concentration atropine are recommended approaches for controlling myopia. However, children with younger age and lower myopia are more likely to experience rapid axial progression during OK or atropine monotreatment. This study aimed to assess the efficacy of OK combined with low-concentration atropine for myopia control in childrenover 24months and to determine whether the effect was sustainable. In this retrospective study, we reviewed medical records of baseline and follow-up visits from children (7-14years) applying OK for myopia control. Sixty-eight children receiving monoorthokeratology treatment (OK group) and 68 children who received 0.01% atropine in combination with orthokeratology simultaneously (AOK group) were included. A series of ophthalmic tests at baseline were conducted, and axial length (AL) was measured every 6months. The comparison of AL change at different visits between the two groups was performed by repeated measures multivariate analyses of variance (RM-MANOVA). There were no significant differences in baseline characters between the two groups (p > 0.05). The AL significantly increased over time in both groups (all p < 0.05), and the 2-year change in AOK was 0.16mm (36%) lower than in OK (0.28 ± 0.22mm versus 0.44 ± 0.34mm, p = 0.001). Compared with OK group, the significant suppression of AL elongation in the AOK group was observed in 0-6, 6-12, and 12-18month periods (suppression rate: 62.5%, 33.3%, 38.5%, respectively, p < 0.05), while there was no significant difference in the 18-24month period (p = 0.105). The multiple regression analysis showed an interaction between age and treatment effect (interaction coefficient = 0.06, p = 0.040), indicating one year age decrease approximately associated with 0.06mm increased retardation in AL elongation in the AOK group. The add-on effect of 0.01% atropine in OK wearers only occurred within 1.5years, and younger children benefited more from the combination treatment.

Varying Demands and Quality of Play Between In-Conference and Out-of-Conference Games in Division I Collegiate Women's Soccer.

Bozzini, BN, McFadden, BA, Walker, AJ, and Arent, SM. Varying demands and quality of play between in-conference and out-of-conference games in Division I collegiate women's soccer. J Strength Cond Res 34(12): 3364-3368, 2020-The purpose of this study was to assess differences in physical workloads, physiological responses, and performance variables between in-conference (IC) and out-of-conference (OC) games during a collegiate women's soccer season. Female field players (N = 11), who played a minimum of 45 minutes for >50% of games, were evaluated using an integrative GPS and HR monitoring system to determine training load (TL), exercise energy expenditure (EEE), total distance covered (DIS), sprints, time spent in HR zones 4 and 5 (HRZ4 = 80-89% HRmax; HRZ5 = 90-100% HRmax), and distance covered in speed zones 4 and 5 (DISZ4 = 15.0-19.9 km·h; DISZ5 = ≥20 km·h). In addition, percent passing accuracy (PA%), dribbling success (DS%), tackling success (TS%), and challenges won (CW%) were generated for all games. Workload data were analyzed as a rate per minute playing time (PT) per game to account for differences in game duration and PT between OC (n = 7) and IC games (n = 11). Repeated-measures multivariate analyses of variance with univariate follow-ups and effect sizes (Hedges' g) were conducted to compare conditions (OC vs. CON) (p < 0.05). There were significantly greater TL, DIS, EEE, and HRZ5 per minute PT in OC versus IC games (Hedges' g: TL = 0.48; DIS = 0.20, EEE = 0.55; HRZ5 = 0.83; p < 0.05). Further analysis found significant differences in first half play favoring OC games (p < 0.05), but not second half play (p > 0.05). Based on these findings, OC games seem to be more demanding compared to IC, particularly during first half play. Emphasis should be placed on tailoring TL to the accumulating in-season demands through athlete-monitoring technology to prevent declines in performance in the latter half of the season.

Prospective Changes in Vestibular and Ocular Motor Impairment After Concussion.

The utility of prospective changes on the Vestibular/Ocular Motor Screening (VOMS) assessment are unknown, and 2 methods of scoring are published in the literature. Total scores are the total symptom scores for each VOMS component, and change scores are the difference between the pretest total symptom score and component total symptom scores. This study documented prospective changes in vestibular and ocular motor impairments and symptoms in high school athletes with concussion using the total and change scoring methods and compared the percentage of scores over clinical cutoffs using the total and change scoring methods for the VOMS. Sixty-three athletes (15.53 ± 1.06 years) completed the VOMS at baseline (ie, preinjury), 1 to 7 days, and 8 to 14 days after concussion. A series of repeated-measures multivariate analyses of variance were conducted on total and change scores. A 2-way repeated-measures analysis of variance was performed on the near-point convergence distance. A series of χ analyses compared scores exceeding clinical cutoffs between the total and change scoring methods. Total scoring revealed impairments (Wilks λ = 0.39, F16,47 = 4.54, P < 0.001, η = 0.61) on all VOMS components at 1 to 7 and 8 to 14 days compared to baseline. Change scoring revealed postinjury impairments compared with baseline (Wilks λ = 0.58, F14,49 = 2.52, P = 0.009, η = 0.42) on all components at 1 to 7 days; however, impairments at 8 to 14 days were revealed only for the vertical vestibular oculomotor reflex and vestibular motor sensitivity components. Total scoring identified significantly more scores over cutoffs at 1 to 7 days (χ1,63 = 5.97, P = 0.02) compared with change scores. Both total and change scoring methods on the VOMS are useful for identifying impairments following concussion.Video Abstract available for more insights from the authors (see Supplemental Digital Content 1, http://links.lww.com/JNPT/A230).

Changes in Health and Fitness in Firefighter Recruits: An Observational Cohort Study.

To observe longitudinal changes in health and fitness among firefighter recruits. Body composition, aerobic capacity, muscular power, muscular strength, and muscular endurance measures were longitudinally collected among 27 male firefighter recruits (mean ± SD, age = 29.9 ± 4.1 yr; height, 179.8 ± 4.6 cm; body mass, 87.2 ± 9.7 kg) at the beginning (W1) and end (W14) of their firefighter training academy, as well as at the end of their probationary period (W38). Repeated-measures multivariate analyses of variance (RM MANOVA) identified significant changes across time among measures of body composition (F10,17 = 30.390, Λ = 0.053, P < 0.001), aerobic capacity (F6,21 = 55.111, Λ = 0.060, P < 0.001), muscular power (F8,17 = 2.785, Λ = 0.433, P = 0.036), muscular strength (F6,20 = 34.908, Λ = 0.087, P < 0.001), and muscular endurance (F4,23 = 25.983, Λ = 0.181, P < 0.001). Follow-up post hoc analyses indicated that all measures, except muscular power, significantly improved from W1 to W14 (P < 0.05). However, significant decrements in many of these measures were also observed from W14 to W38 (P < 0.05). The results of the current study suggest that measures of health and fitness among firefighter recruits significantly improved throughout the firefighter training academy (W1 to W14). However, many of these positive physiological adaptations are lost before these recruits finish their probationary period as active-duty firefighters (W14 to W38). These results highlight the importance of developing exercise programming that is designed for the active-duty firefighter cohort population to maintain the beneficial adaptations in health and fitness previously created during the firefighter training academy.

Multi-step treatment for acquired alexia and agraphia (part II): a dual-route error scoring system

ABSTRACTDual-route neuropsychological models posit two distinct but interrelated pathways for reading and writing: the lexical and the sublexical. Individuals with reading/writing deficits often rely on the combined power of the integrated system to perform print-processing tasks. The resultant errors reflect varying degrees of lexical and sublexical accuracy in a single production; however, no system presently exists to analyze errors robustly in both routes. The goal of this project was to develop a system that simultaneously, quantitatively, and qualitatively captures changes in lexical and sublexical errors following treatment. Errors are evaluated hierarchically in both routes according to proximity to a target. This dual-route error scoring (DRES) system was developed using data from a novel treatment study for eight patients with acquired alexia/agraphia; a computerised version of the system was also developed (ADRES). Repeated-measures multivariate analyses of variance and post hoc analyses revealed significant dual-route treatment effects. Qualitative analyses revealed unique patterns of change across participants, reflecting the benefits of error evaluation beyond a binary correct/incorrect judgment. Finally, categorical error shifts were observed via group-level analysis. The results of this study indicate that treatment-induced evolution of reading/writing can be meaningfully and comprehensively represented by this novel scoring system.

Feasibility and Efficacy of the AgingPlus Program: Changing Views on Aging to Increase Physical Activity.

This study evaluated the feasibility and efficacy of the AgingPlus intervention program. AgingPlus is an 8-week multi-component motivational program which promotes increased physical activity by targeting adults' negative views on aging (NVOA) and perceptions of control, two known psychological barriers to physical exercise. A total of 62 adults, ages 50-82years, participated in this feasibility study. We assessed NVOA, perceptions of control, and physical activity level at baseline (Week 0), immediate posttest (Week 4), and delayed posttest (Week 12). High attendance rates, low attrition, and positive participant feedback indicated that the program had high acceptability. Repeated measures multivariate analyses of variance (RM-MANOVA) showed statistically significant and substantively meaningful improvements in NVOA, control beliefs, and physical activity from pretest to immediate and delayed posttest. The program effects did not differ between those younger or older than age 65. These findings provide promising support for the feasibility and efficacy of the AgingPlus program.

Treatment Outcomes for At-Risk Young Children With Behavior Problems: Toward a New Definition of Success

ABSTRACT. This study examined the outcomes of Early Pathways (EP), an in-home parent–child therapy program with 447 at-risk children younger than 5 years of age who were referred for severe behavior and emotional problems, such as aggression, oppositional behavior, and separation anxiety. EP emphasized parent-directed training of child behavior strategies including psychoeducation regarding child development, child-led play, and cognitive-behavioral techniques. Outcomes were assessed using a unique 2-dimensional definition of treatment completion, which consisted of treatment duration and an assessment of reliable change for the primary outcome measure of child behavior problems. Results showed that the majority of children (63.4%) met or exceeded treatment completion. In addition, repeated-measures multivariate analyses of variance at pretest, posttest, and follow-up revealed increased child prosocial behaviors, reduced child behavior problems, improved caregiver nurturing, an increase in parents’ developmentally appropriate expectations of children, improved parent–child relationships, and a decrease in clinical diagnoses following treatment. This study offers guidance for developing effective early-intervention services for families in poverty to enhance outcomes for their young children. Along with its existing large-scale, community-based effectiveness studies, future research should establish additional statistical support including a randomized, waitlist control design of EP.

Preservation of enucleated porcine eyes for use in a wet laboratory

To design a method to preserve enucleated porcine eyes for use in a wet laboratory. Laboratory of Experimental Ophthalmology, University Medical Center Groningen, the Netherlands. Experimental study. Porcine eyes were preserved using 15 methods including salt solutions, anterior chamber infusion fluids, tap water, mineral water, air, and topical glycerol on the cornea. The central corneal thickness (CCT) was measured by A-scan ultrasound over 3 days. Differences between increases in CCT were compared using repeated-measures multivariate analyses of variance. Also, lenses from eyes preserved in tap water were extracted and the lens epithelial cell morphology was studied. There was a significant interaction between the preservation method and CCT over 3 days (P<.001). Post hoc tests showed that the CCT in the sodium chloride (NaCl) 10.0% and tap-water groups increased significantly less than with 4 other preservation methods. However, preservation in NaCl 10.0% resulted in unusable shrunken coriaceous lenses. Addition of glycerol did not decrease the CCT. Lens epithelial cells from eyes preserved in tap water for 48 hours appeared to be intact but lost cell organization. Of the 15 tested methods to preserve porcine eyes, tap water (mineral content 1.79 mmol/L) resulted in the least corneal swelling. It is not necessary to use more expensive anterior chamber infusion fluids or other salt solutions. Neither author has a financial or proprietary interest in any material or method mentioned.

Blunted stress cortisol reactivity and failure to acclimate to familiar stress in depressed and sub-syndromal children

Depressed adults have shown blunted or elevated cortisol reactivity in response to various forms of psychosocial stress. However, there have been few studies of cortisol reactivity in children who had early onset depression or a history of depression during the preschool–school period. The present study utilized a laboratory stress paradigm and collected salivary cortisol from preschoolers at baseline (ages 3–5 years) and 24-month follow-up (ages 5–7 years). Repeated-measures multivariate analyses of variance (MANOVAs) were used to compare cortisol reactivity to mild stress between children with Major Depressive Disorder (MDD), elevated symptoms of depression (sub-syndromal MDD), and healthy controls. For healthy children, a quadratic cortisol reactivity curve was found at baseline (n=73), which appeared flatter under similar stressful situations at follow-up (n=14), which may reflect acclimation to the paradigm. In contrast, children with MDD (n=46) and sub-syndromal MDD (n=76) showed a peak cortisol response to the novelty of lab arrival and then reduced and blunted responses to stressors at baseline. These cortisol responses persisted at follow-up in children with a history of MDD (n=41) or sub-syndromal MDD (n=73). These results suggest that the hypothalamic–pituitary–adrenal (HPA) axis shows a blunted response to stress and failed to acclimate to familiar stressful situations in depressed and sub-syndromal depressed children.

D-serine adjuvant treatment alleviates behavioural and motor symptoms in Parkinson's disease

Parkinson's disease (PD) manifestations include motor symptoms and behavioural deficits that resemble schizophrenia negative symptoms. The N-methyl-D-aspartate subtype of glutamate receptor (NMDAR) represents a novel pharmacological target in PD. D-serine (DSR) allosterically modulates in-vivo NMDAR-mediated neurotransmission and has been shown to improve negative and antipsychotic drug-induced parkinsonian symptoms in schizophrenia patients. This pilot study assessed DSR effects in ten PD patients who completed a 6-wk double-blind, placebo-controlled, crossover adjuvant treatment trial with 30 mg/kg.d DSR. Primary outcome analyses consisted of separate repeated-measures multivariate analyses of variance for Unified Parkinson's Disease Rating Scale (UPDRS), Simpson-Angus Scale for Extrapyramidal Symptoms (SAS), Abnormal Involuntary Movement Scale (AIMS), and Positive and Negative Syndrome Scale (PANSS) scores. DSR treatment was well tolerated and resulted in increased DSR serum levels (p=0.001) and significantly reduced UPDRS (p=0.02), SAS (p=0.009) and PANSS (0.05) total scores. These preliminary findings suggest that DSR treatment may be beneficial in PD. Larger-sized studies with optimized DSR dosages are warranted.

Lung Volumes Used during Speech Breathing in Tracheoesophageal Speakers

The purpose of this study was to determine how tracheoesophageal (TE) speakers manipulate lung volumes to meet speech demands and how respiratory compromise (chronic obstructive pulmonary disease [COPD]) and task variables influence these behaviors. The lung volumes of 9 male TE speakers (4 with COPD, 5 without) during tidal breathing, spontaneous speech, and reading were investigated. Repeated-measures multivariate analyses of variance were used to compare lung volumes and utterance length across speech tasks and by respiratory health. A one-way analysis of variance was used to compare aerodynamic measures and intelligibility by COPD diagnosis. There was a significant main effect of task and a significant interaction effect of COPD and task on lung volumes at initiation and termination of speech. The TE speakers terminated speech exclusively below the resting expiratory level (REL) in both speech tasks because of elevated RELs, which are often present after laryngectomy. There were no main effects of COPD on any lung volume measures and no significant group differences in utterance length, aerodynamic measures, or intelligibility. Intelligibility and aerodynamic measures were not influenced by lung volumes and were comparable to findings of previous research. Speaking past the REL might be a compensation to optimize expiratory control for speech in a compromised system and a marker for the increased effort often anecdotally described by TE speakers.

The influences of professional development on teachers' self-efficacy toward educational change

Background: Many children and adolescents are physically inactive and become even less active as they age. USA high school students' rates of attendance in physical education (PE) classes sharply decline by grade with 73% of ninth graders attending PE, while only 31% of seniors attend. Non-Caucasian youth report the lowest levels of physical activity participation. Thus, helping teachers to learn how to increase their students' PA during PE is important. Purpose: The purpose of this study was to examine the influences of professional development on teachers' self-efficacy towards teaching physically active fitness and health promoting lessons. Participants and setting: Fifty elementary physical education teachers from a large urban school district in the Midwest USA participated. Thirty teachers volunteered to be in one of the two professional development groups (n = 15 each) with a control group of 20 teachers. Teachers' students were some of the heaviest in the USA with 37% regarded as overweight and 64% reporting spending less than 10 minutes being active in physical education. Intervention: All teachers (n = 30) in the two professional development groups learned how to teach a physical activity oriented curriculum titled the Exemplary Physical Education Curriculum (EPEC) during an eight-hour workshop. Group 1 teachers (n = 15) also participated in two more eight-hour workshops and received two school site visits by teachers experienced in teaching EPEC. Thus, the Group 1 professional development intervention was an extended version of the one-day workshop experienced by Group 2 teachers. Data collection: All teachers (n = 50) in all three groups completed EPEC efficacy and general educational efficacy scales at the beginning (Time 1) and end of the academic year (Time 4). In addition the two professional development groups completed all scales at the start of the first workshop (Time 2) and immediately after the workshop ended (Time 3). Data analysis: Two sets of Repeated Measures Multivariate Analyses of Variance (RM-MANOVA) were conducted. The first RM-MANOVA used scores at Times 1 and 4 for all three groups whereas the second RM-MANOVA was conducted using Group 1 and Group 2 data from Times 1, 2, 3 and 4. Findings: Both intervention groups had increases in their efficacy to teach motor skill objectives (F(1, 28)=7.26, p < 0.01, η = 0.21), physical activity and fitness knowledge objectives (F(1, 28)=8.50, p < 0.01, η = 0.23), personal and social objectives (F(1, 28)=3.29, p < 0.08, η = 0.11) and community efficacy (F(1, 28)=3.08, p < 0.09, η = 0.10). Teachers in both groups maintained disciplinary efficacy (F(2, 47)=4.29, p = 0.02, η = 0.35), whereas the control group suffered a loss of disciplinary efficacy. Associated effect sizes were moderate to large. Conclusions: In general we found support for the value of professional development training in a physical activity curriculum on teachers' self-efficacy perceptions for teaching the curriculum.

Rang de naissance, difficultés de comportement et relation mère-enfant chez des jeunes de 4 à 11 ans de fratries composées de deux enfants

Birth Order, Behavioural Problems, and the Mother-Child Relationship in Siblings Aged 4 to 11 Years From a 2-Child Family This study was designed to define the relation between some sibling characteristics (birth order, sex, and interval between successive births) and some behavioral problems in children, on the one hand, and certain dimensions of the mother-child relationship, on the other hand. The sample, from National Longitudinal Survey of Children and Youth, included 1,196 families with 2 biological children aged 4 to 11 years. Behavioural problems and dimensions of the mother-child relationship were assessed by mothers. Repeated-measures multivariate analyses of variance were conducted. Analyses showed that first-born children have more internalized symptoms than second-born children. Second-born children also have more positive interactions with their mothers than first-born children. The interval between successive births does not affect these results. Several differences emerged between siblings. Health professionals should take these findings into account in their clinical assessments.

Bigger is better: size-selective mortality throughout the life history of a fast-growing clupeid, Spratelloides gracilis

MEPS Marine Ecology Progress Series Contact the journal Facebook Twitter RSS Mailing List Subscribe to our mailing list via Mailchimp HomeLatest VolumeAbout the JournalEditorsTheme Sections MEPS 317:237-244 (2006) - doi:10.3354/meps317237 Bigger is better: size-selective mortality throughout the life history of a fast-growing clupeid, Spratelloides gracilis M. G. Meekan1,*, L. Vigliola2, A. Hansen3, P. J. Doherty2, A. Halford4, J. H. Carleton2 1Australian Institute of Marine Science, PO Box 40197, Casuarina MC, Darwin, Northern Territory 0811, Australia 2Australian Institute of Marine Science, P.M.B. 3, Townsville MC, Queensland 4810, Australia 3The Institute of Biological Sciences, Department of Marine Ecology, University of Aarhus, Finlandsgade 14, Aarhus 8200, Denmark 4Sultan Qaboos University, Dept. of Fisheries and Marine Science, PO Box 34, Al-Khod 123, Sultanate of Oman *Email: m.meekan@aims.gov.au ABSTRACT: A cohort of the fast-growing sprat Spratelloides gracilis was sampled during late-larval, juvenile and adult life-history phases using light traps on the North West Shelf of Western Australia. Otoliths from 154 larvae, juveniles and adults that hatched during a 20 d window were analysed to produce back-calculated daily records of size-at-age and growth rate. These traits were compared among sequential samples using repeated-measures MANOVAs (multivariate analyses of variance) to determine whether selective mortality occurred in the cohort. Late-stage larvae in our catches averaged 23 ± 3 d of age and were 22 ± 2 mm standard length (SL), while juveniles averaged 47 ± 6d of age and 36 ± 6 mm SL. We found that individuals that survived the larval stage to become juveniles underwent strong selective mortality. This selective mortality acted to preferentially remove fish that were slow-growing and/or relatively small members of the cohort. The size variation on which this selection acted was present at hatching and propagated by growth during the larval stage. Size at hatching is principally determined by egg size, implying that maternal contributions had an important influence on the outcome of selective events. We found no evidence of selective mortality operating during the transition of juvenile sprats to adulthood. Adults averaged 78 ± 6 d of age and 44 ± 5 mm SL. Log-linear analyses indicated that the cohort underwent 8.6% mortality mm–1 SL and had a daily mortality rate of 3.7% between larval and adult stages. Given an average linear growth rate of 0.96 mm d–1 during the larval phase, this suggests that selective mortality based on size (bigger-is-better) was approximately twice as important as mortality due to age differences (stage duration) among members of the cohort. KEY WORDS: Larval fish · Otoliths · Size selection · Growth rate · Selective mortality · Predation · Bigger-is-better · Stage duration Full text in pdf format PreviousNextExport citation RSS - Facebook - Tweet - linkedIn Cited by Published in MEPS Vol. 317. Online publication date: July 18, 2006 Print ISSN: 0171-8630; Online ISSN: 1616-1599 Copyright © 2006 Inter-Research.

Relation of Game Location and Experience on Mood States

The study investigated relationships between game location, performers' experience, and mood states. 31 experienced collegiate soccer players completed the Brunel Mood Scale to assess anger, calmness, confusion, depression, fatigue, happiness, tension, and vigor before eight competitive games (four home and four away). Participants were categorized into Experienced and Less Experienced groups, based on the level of performance at which they played. Repeated-measures multivariate analyses of variance compared mean mood scores across location and experience, and follow-up univariate analyses suggested the increase in mood scores on Tension and decrease in scores on Calmness, Happiness, and Vigor between playing away and at home were significantly greater for Less experienced soccer players than Experienced players. Implications of these findings for the applied practitioner are discussed.

Motor performance with a simulated artificial limb.

The present study was conducted to examine performance differences on a reaching and grasping task related to an activity of daily living. This involved either the anatomical limb or a simulated artificial limb. College-aged volunteers (2 men and 4 women), one of whom was left-handed, performed the reaching and grasping task. The apparatus, placed on a table before the seated participant, was a square wooden board which contained a starting key and holes for the insertion and removal of a small Fiberglas dowel. At the beginning of the trial the participant depressed the start key, reached forward and grasped the dowel, and then returned the dowel to a finishing hole located directly in front of the start key. The results of 2 (side) x 2 (type of limb) repeated-measures multivariate analyses of variance on the mean and standard deviation of the movement times showed a significant main effect for type of limb (Wilks lambda 3,3 = .047 and .079, respectively, p < .05). Analyses of variance on mean total transport time, extension time, flexion time, and their standard deviations showed that times were slower and less consistent with the prosthesis for all measures. These results and those of later research should be focused on the development of training principles for both therapists and individuals with an amputation. In addition, the simulated prosthesis is an excellent experimental model for basic and clinical research in the control and acquisition of coordinated movement.

Pediatric AIDS: Are Physicians Ready?

This study assessed medical residents' perceptions of their overall competence to provide primary care to pediatric AIDS patients. On a 7-point Likert scale, residents in pediatric (n=260) and family practice (n=161) training programs across the United States rated their educational preparedness and training experiences in AIDS care in 9 areas. Respondents were predominantly White (74%) and female (53%). completing their 3rd year of training (94%) at a university-affiliated program (87%), with a mean age of 31. Overall, 98% of the residents had treated HIV-infected and AIDS-infected patients. Repeated-measures multivariate analyses of variance were used to identify significant differences between the two specialties on 9 areas of curricular training and two patient age groups (pediatric and adolescent). Perceptions of the residents concerning their preparedness to diagnose HIV and AIDS treat AIDS-related illnesses, treat AIDS patients and their overall level of competence to provide AIDS primary care for ...

Efficacy of behavioral management and patient education on vascular access cleansing compliance in hemodialysis patients.

Compared four treatment conditions to test their ability to enhance compliance with vascular access cleansing (VAC) procedures in a group of 56 hemodialysis patients. The conditions were patient education, behavioral management with monetary incentive, patient education/behavioral management, and attention control. Behavioral observers rated VAC behavior at pretreatment, posttreatment 1-month follow-up, and 1-year follow-up. Knowledge of VAC procedures was also assessed via a questionnaire at pretreatment and posttreatment. Data were analyzed using repeated-measures multivariate analyses of variance. Results indicated that the patients in the education/behavioral, behavioral, and education groups gave significantly more correct answers on our VAC knowledge questionnaires at posttreatment than did patients in the attention control group. Further, patients in the education/behavioral and behavioral groups completed significantly more VAC steps at posttreatment and 1-month follow-up than did patients in the education group and in the attention control group. Differences were not maintained at 1-year follow-up, although more than 50% of the patients were lost to follow-up. Implications of the present findings for behavioral and educational interventions are discussed.