Wheelchair coasting downhill is a reliable work task

OBJECTIVE: To measure test-retest reliability of physiological responses during submaximal wheelchair downhill and horizontal treadmill ergometry. DESIGN: A test-retest design was used on a convenience sample. Four male and three female non-wheelchair users, (22-43 years of age) propelled or coasted in a wheelchair under steady-state conditions. Four minute work bouts were performed at 1, 2, 3, and 4 km/hr. (0.62, 1.24, 1.86 and 2.5 mph, respectively) at 0 degrees, -2 degrees, and -4 degrees. Subjects were studied twice under each of the 12 conditions. Six tests were performed daily, with testing occurring over four days. Dependent variables included oxygen consumption, minute ventilation and heart. Intraclass correlation coefficients were determined for each set of paired tests. RESULTS: Intraclass correlation coefficients were high for absolute VO_{2}(R=0.84-0.99), V_{E} (R=0.86-0.98) and HR (R=0.95-1.0) over the range of 4 speeds and 3 inclinations studied. On average, % differences from test 1 to test 2 were less than 3%. CONCLUSION: At the treadmill speeds and inclinations (positive and negative) studied in this investigation, untrained wheelchair users responded in a physiologically reliable manner.     

Examining the impact of gender, race/ethnicity, and family factors on mental health issues in a sample of court-involved youth

Faced with anywhere between one half and two thirds of its youth having a diagnosable mental illness, the identification and treatment of mental health concerns is a critically important endeavor for professionals working with youth who have contact with the juvenile justice system. In addition, the literature suggests that factors related to both the family and to the gender of the adolescent must be incorporated into any approach to assessment and intervention within this special population. Further, prior work that has documented the interaction of gender and family issues with adolescent race/ethnicity warrants further empirical attention, as does the intermediary role that the family may play in the development of both internalizing and externalizing behaviors. The present study extends this literature by examining factors related to gender, race/ethnicity, family factors, and mental health issues in a sample of 2,549 Caucasian and African American youth coming to the attention of juvenile courts. Multivariate analysis of variance results indicated significant main effects for gender and race/ethnicity, as well as a significant gender x race/ethnicity interaction for the family and externalizing variables. A multiple group structural equation modeling procedure was employed in order to test the hypothesis that family environment mediates the relationship between gender and mental health problems, as well as to test for potential differences in these relationships as a function of race/ethnicity. Results indicated support for the mediation model in the sample of African American youth but not in the sample of Caucasian youth.     

Conceptualising Social Value for the Third Sector and Developing Methods for Its Assessment

Recent legislation in the UK has placed an expectation on social purpose organisations (SPOs) to consider, monitor and evaluate the societal value they generate. However, meaningful engagement with the Social Value Act by the third sector is relatively low, which reflects both conceptual and methodological shortcomings. This paper describes a programme of action research which has developed a user-friendly tool to assist smaller SPOs to explore, evidence and value the benefits that they produce for society. Conceptualising social value through the lens of the localism, personalisation, deliberative democracy and social innovation agendas, the paper describes the process and experience of applying a Social Return Assessment tool and the lessons learnt for the three SPOs involved, the third sector, and for commissioning bodies. Recommendations reflect the need for a standardised monitoring and evaluation framework tailored to specific third sector interest groups and networks.     

Promoting Health and Wellness in African American Males through Rites of Passage Training

The current work presents exploratory research findings related to the effectiveness of Let the Circle Be Unbroken, an African-centered “rites of passage” training program, to promote health and well-being in a sample of high-risk, African American males. An abbreviated version of the ADPRC-TADPOLE questionnaire was administered to 39 African American boys, between the ages of 8 and 16 years, who were participating in a community-based “rites of passage” training program. Findings suggest that the Let the Circle Be Unbroken training program is a viable program for improving self-esteem among young African American males. The implications of this research are relevant to the reduction of some health disparities observed among underrepresented populations, especially African American males.     

The health effects of caregiving by grandparents in Taiwan: an instrumental variable estimation

Previous research on the health effects of caring for grandchildren has had variable findings, including both positive and negative effects on the health of grandparents. The estimated effects of caregiving may be affected by selection, with the health of grandparent affecting the likelihood of undertaking caregiving. The health effects of caregiving also likely differ according to the cultural motivations for caregiving by grandparents. This paper assesses whether selection into caring for grandchildren affects the estimated effects of caregiving on the health of Taiwanese grandparents. We used four waves (1993?C2003) of the Survey of Health and Living Status of the Elderly in Taiwan to estimate the effect of grandparent caregiving on self-rated health, mobility, and depression. To control for unobserved selection into caregiving, we employed time-varying instrumental variables (the number of grandchildren and marital status of adult children) in addition to person fixed effects. After adjusting for baseline differences, caregivers had better self-rated health, fewer mobility limitations, and fewer depressive symptoms compared to the non-caregivers, which suggest evidence of health improvement for grandparents. Instrumental variable analysis showed that caring for grandchildren was endogenously determined with grandparents?? mobility limitations, and grandparent caregivers benefited from a significant reduction in the number of mobility limitations. Our finding suggests that caring for grandchildren can be beneficial for the health of Taiwanese grandparents and supports our hypothesis that a culturally expected role of caregiving results in role enhancement.     

To tell or not to tell: the impact of disclosure on sexual assault survivors' recovery

There is a growing body of research examining the disclosure of sexual assault. But the focus on time to first disclosure does not capture the whole picture. Survivors also differ in how long they continue to disclose, to whom they disclose, and the types of reactions received during disclosure. To provide a more comprehensive view of disclosure, this study sought to identify patterns of disclosure among a sample of 103 female sexual assault survivors recruited from the community. This study also sought to identify characteristics of each disclosure pattern, differences in how each disclosure pattern tends to unfold (e.g., who is told and how they react), and differences in how these disclosure patterns are related to physical and mental health outcomes. Results revealed four distinct disclosure patterns: nondisclosers, slow starters, crisis disclosers, and ongoing disclosers. Assault characteristics and rape acknowledgment distinguished nondisclosers and slow starters from the other two disclosure groups. Slow starters were also less likely to disclose to police and medical personnel and received negative reactions less frequently while nondisclosers experienced more symptoms of depression and posttraumatic stress than other groups. Implications of these findings for future research and practice are discussed.     

Estimating Evacuation Shelter Deficits in the Houston–Galveston Metropolitan Area

Evacuation is frequently used by emergency managers and other officials as part of an overall approach to reducing the morbidity and mortality associated with hurricane landfall. In this study, the evacuation shelter capacity of the Houston–Galveston Metropolitan Statistical Area (MSA) was spatially assessed and shelter deficits in the region were estimated. These data provide essential information needed to eliminate shelter deficits and ensure a successful evacuation from a future storm. Spatial statistical methods—Global Moran's I, Anselin Local Moran's I (Local Indicators of Spatial Association [LISA]), and Hot Spot Analysis (Getis-Ord Gi*) were used to assess for regional spatial autocorrelation and clustering of evacuation shelters in the Houston–Galveston MSA. Shelter deficits were estimated in four ways—the aggregate deficit for the Houston–Galveston MSA, by evacuation Zip-Zone, by county, and by distance or radii of evacuation Zip-Zone. Evacuation shelters were disproportionately distributed in the region, with lower capacity shelters clustered closer to evacuation Zip-Zones (50 miles from the Coastal Zip-Zone), and higher capacity shelters clustered farther away from the zones (120 miles from the Coastal Zip-Zone). The aggregate shelter deficit for the Houston–Galveston MSA was 353,713 persons. To reduce morbidity and mortality associated with future hurricanes in the Houston–Galveston MSA, authorities should consider the development and implementation of policies that would improve the evacuation shelter capacity of the region. Eliminating shelter deficits, which has been done successfully in the state of Florida, is an essential element of protecting the public from hurricane impacts.