Evelyn L. Lewis

Efficacy of strength training in prepubescent to early postpubescent males and females: Effects of gender and maturity

There has been considerable debate concerning the benefits of children participating in weight training programs. With the potential benefits of such training in specific rehabilitation regimens, the safety/efficacy of weight training is a topic in need of scientific study. Fifty-two experimental and 39 control subjects participated in this study. A 2 x 2 x 2 (gender by treatment by Tanner stage) ANOVA was used to examine pre- to post-test differences in six strength measures, eight anthropometric measures, five motor performance measures, and one flexibility measure associated with participation in a 12-week progressive resistance programme. In addition, safety of the weight training programme was examined. For strength differences, there were two significant main effects favouring strength gains in males and four favouring the experimental group. For anthropometric changes, 3-way interactions occurred that were not easily explained. However, the predominant main effect was treatment; the experimental group generally experienced gains in body segment girths with decreases in skinfold thickness. For motor performance, the experimental group had greater improvements in three of five parameters. The experimental group also had significantly greater gains in flexibility. The weight training programme was associated with only one injury. These findings support the general observation that physical benefits can be gained safely by children who participate in a weight training programme.

Factor structure of the Anxiety Sensitivity Index among African American college students

This study examined the factor structure of the Anxiety Sensitivity Index (ASI) among African American college students. Confirmatory factor analysis indicated the 3-factor solution commonly found among other populations did not fit the data for African Americans. Although an exploratory factor analysis indicated the presence of a Mental Incapacitation factor, the Physical Concerns factor was divided into unsteady and cardiovascular concerns. Items typically comprising the Social factor were reflective of emotional controllability among African Americans. The ASI was also moderately correlated with measures of anxiety and depression providing only weak evidence of convergent and discriminate validity of the ASI for African Americans. Although support for the multidimensional nature of AS was found, the factor composition differs for African Americans.

Cognitive–Behavioral Group Therapy Versus a Wait-List Control in the Treatment of African American Women with Panic Disorder

This study examined the efficacy of group Panic Control Therapy (PCT; D. H. Barlow & M. G. Craske, 1994) for African Americans. Twenty-five African American women were assigned to either a treatment or wait-list control (WLC). Treatment was 11 group sessions, and wait-list participants did not receive any treatment for the same duration. At pretreatment, both groups were moderately anxious and depressed. At posttreatment, the PCT group experienced a significant reduction in panic frequency, avoidance behavior, state and trait anxiety, and anxiety sensitivity. There was no significant change on these variables for the WLC. There was a trend for change in depression among the PCT group only. On average, 54% of the treated group was classified as recovered, 17% as improved but not recovered, and 27% as unimproved. As many as 95% of the WLC were unimproved. The overall effect size of the study was comparable to that reported in previous studies of cognitive treatments incorporating interoceptive exposure with White Americans. These preliminary results suggest that CBT for panic is effective with African American women with panic disorder.

Parental bonding and anxiety: differences between African American and European American college students.

Empirical evidence suggests that early home environments characterized by low care and high overprotection are positively associated with the adult expression of anxiety. While available evidence supports this position for European Americans, there has been no examination of the relationship between perceived parental rearing practices and anxiety among African Americans despite the theoretical assertion that African American parenting environments may be characterized as somewhat more overprotective than European Americans. This study investigated the relationship between maternal rearing patterns and trait and state measures of anxiety and depression among a sample of 59 African American and 55 European American college students. Results indicated that both groups reported similar levels of anxiety, depression, perceived care, and perceived overprotection. European Americans exhibited the typical pattern of a negative relationship between anxiety, depression, and care and a positive relationship between anxiety and overprotection. African Americans evidenced a similar negative relationship between anxiety, depression, and care, but no relationship between anxiety, depression, and overprotection. Furthermore, specific aspects of ethnic identity (i.e., ethnic achievement, ethnic behaviors) were found to be negatively associated with measures of trait anxiety among African Americans but not European Americans.

The Effects of False Physiological Feedback on Tumescence and Cognitive Domains in Sexually Functional and Dysfunctional Men

A false feedback paradigm was used to produce a discrepancy between expected and “actual” tumescence among 57 sexually dysfunctional and 58 sexually functional men randomly assigned to one of four false tumescence feedback conditions: negative (NEG), neutral (NEU), positive (POS), or no (NO) feedback. Participants predicted an erection score before viewing an erotic film and then received false tumescence feedback based on this score. Tumescence and cognitive ratings were obtained before and after the feedback. It was predicted that discrepancies would differ between dysfunctional and functional participants such that functional participants would have the ability to overcome discrepancies, whereas dysfunctional participants would not. As expected, POS decreased tumescence for dysfunctional participants and NO did not influence tumescence for either group. Unexpectedly, NEU decreased tumescence for dysfunctional participants and NEG decreased tumescence for functional participants. Despite tumescence changes, cognitive ratings generally followed the feedback that was given. These results only partially support current models of sexual dysfunction and behavioral regulation. Anxiety, self-focused attention, cognitive interference, and unexpectedness of the feedback could not account for the partial support. However, most feedback that was outside of the realm of the status quo for both functional and dysfunctional participants did decrease tumescence, despite outcome expectancies. These results suggest that both functional and dysfunctional men may be at risk for erectile failure should feedback about their performance be discrepant from what they expect. Prevention and treatment should focus on preparing men for occasional erectile failure and on helping them overcome discrepant feedback.

Making a business case for small medical practices to maintain quality while addressing racial healthcare disparities.

Various reports have documented variations in quality of care that occur among racial and ethnic populations, even after accounting for socioeconomic factors and health insurance status. Although quality improvement initiatives are often touted as the answer to healthcare disparities, researchers have questioned whether a business case exists that supports this notion. We assess various barriers and incentives for using quality improvement to address racial and ethnic healthcare disparities in small-to-medium-sized practices. We believe that although both indirect and direct cost incentives may exist, a favorable business case for small private practices cannot be made unless there are additional financial incentives. The business community can work with health plans to provide these incentives.