Effect of skinfold levels on lipids and blood pressure in younger and older adults

As shown in 5507 white participants in a total population sample, the level of fatness is systematically related to lipid levels and to blood pressure levels in older adolescents, younger adults, and older adults of both sexes. At all three age levels, the fatter subjects were highest in serum cholesterol, serum triglycerides, and systolic and diastolic blood pressure and more often hypertensive. The effect of fatness level on the four risk factors was similar for all four skinfolds regardless of location. Fatness level is thus related to lipid levels and blood pressure levels in both younger and older subjects, and there is no evidence that "central" or "peripheral" or upper body and truncal skinfolds are more directly related to these risk factors even after the sixth decade.     

Group therapy for chronic medical illness: a multidiagnosis group

Chronic medical illness, and the resulting feelings of alienation, dependency, and distress, represent significant psychiatric issues in the general hospital setting. This article presents the results of the first 3 years of a pilot psychotherapy group at UCLA. This group differed from the typical didactic or support groups offered within the hospital in that membership was not limited to any particular diagnostic group. It was hypothesized that such a multidiagnosis group would facilitate exploration of dynamic and interpersonal issues. Both the group process and the response of the membership supported this hypothesis. However, an interesting distinction emerged within the group between members who saw themselves as chronically medically ill and those who defined themselves as disabled. "Disabled" members were generally less satisfied with the group and tended to benefit less than other members. In light of the above findings, we offer recommendations for establishment of similar groups in other hospital settings.     

The validity and reliability of hand-held dynamometry in assessing isometric external rotator performance

The validity and reliability of hand-held dynamometry and Cybex dynamometry were investigated using maximal isometric contractions of the external rotators of the shoulder in 14 healthy male subjects. Three maximum voluntary contractions were recorded from each subject by a hand-held dynamometer and a Cybex isokinetic dynamometer at two testing sessions approximately 1 week apart. Analysis of variance did not reveal any significant differences between the mean peak torques obtained with either instrument or between days. The intrarater reliability was clearly established for both the hand-held dynamometer (r = 0.986) and Cybex dynamometer (r = 0.993). Within-day correlations between the two instruments accounted for 27% (day 1) and 60% (day 2) of the explainable variance. This suggests that although both techniques produced identical peak torque values and measured the same element of performance-strength, they did so in a slightly different manner. The possible nature of these differences is discussed.J Orthop Sports Phys Ther 1988;10(6):213-217.     

Runners' diarrhea. Different patterns and associated factors.

One hundred and nine distance runners participated in a questionnaire survey of bowel function related to running. Thirteen (12%) had had fecal incontinence while running. Sixty-eight (62%) had stopped to have a bowel movement while training. Forty-seven (43%) had "nervous" diarrhea before competition and 13 (12%) had stopped during competition for a bowel movement. Fifty-one (47%) had experienced diarrhea after racing or hard runs and 17 (16%) had seen blood in their stool in the same situations. Runners who had nervous diarrhea before competition were more likely to have symptoms of milk intolerance and irregular bowel function when not exercising, and runners who had symptoms of the irritable bowel syndrome often had to stop for a bowel movement during training. Runners with diarrhea after racing or hard runs frequently experienced severe abdominal cramps, nausea and vomiting, and occasionally, rectal bleeding at the same time. Any form of "runners' diarrhea" was unrelated to age, previous intestinal infection or food poisoning, food allergies, or dietary fiber.     

Good sleep, bad sleep: a meta-analysis of polysomnographic measures in insomnia, depression, and narcolepsy.

Primary insomnia, major depression, and narcolepsy are usually considered to be separate disorders, distinguished by different polysomnographic profiles. But do polysomnographic data provide adequate evidence to segregate the three disorders, or might they display fundamentally the same sleep disturbance, differing only in degree? To test the viability of these two alternate hypotheses, the authors performed a meta-analysis of controlled polysomnographic studies of these disorders. A summary measure of degree of sleep disturbance was constructed from five variables: wakefulness after sleep onset, percentage of stage 1 sleep, percentage of stage 3 + 4 sleep, rapid eye movement (REM) latency, and REM density. The results of available studies for each variable were combined using a weighted average of effect sizes. An overall "sleep disturbance index" was then calculated by combining the estimates for the five above listed variables. On both the individual measures and especially on the summary index, insomnia, depression, and narcolepsy were arrayed on a simple continuum of progressively more severe sleep disturbance--congruent with the clinical observation that these disorders display progressively more disturbed sleep. These findings suggest that sleep can be disturbed in only a limited number of ways: in evaluating sleep architecture, it may not be possible to elaborate much beyond a single axis of good-to-bad sleep. Thus, polysomnographic measures may not provide adequate evidence to classify insomnia, depression, and narcolepsy as separate entities.     

Back support mechanisms during manual lifting

The ability of individuals to lift heavy loads without injury to the vertebral elements has led to the formulation of several explanations of this phenomenon. In this article, the existing literature on lifting is reviewed and mechanisms of back support during lifting are described. These mechanisms include the intra-abdominal pressure mechanism, the thoracolumbar fascia mechanism, and combinations of these mechanisms with the use of the erector spinae, multifidus, and psoas muscles. Physical therapists are often responsible for teaching patients and workers "proper" lifting techniques; however, controversy exists concerning the proper lift. Although lifting with the lower back in flexion and lifting in extension have been proposed, there are indications for each depending on individual circumstances. Lifting instructions for workers without low back injuries should be distinguished from instructions for patients with low back pain. General rules for lifting include: plan the lift, avoid twisting, keep the load close to the body, and bend at the knees.