Effects of manual resistance training on fitness in adolescents.

Manual resistance training (MRT), an alternative to traditional resistance training, requires minimal equipment and may be effective when applied in school-based physical education (PE) classes. The purpose of this study was to document the physical changes in adolescents (n = 222) using MRT in school-based PE settings. Six fitness tests from the Fitnessgram assessment tool were selected to assess students' cardiovascular and muscular fitness, and skinfold tests were used to assess body composition. One control and 2 experimental groups were defined. The control group of students (n = 129) attended regular PE classes. One experimental group (n = 63) attended PE that was complemented by the MRT system. A second experimental group (n = 30) attended PE complemented by MRT and cardiovascular endurance training. With use of the selected Fitnessgram tests, post-test measurements were performed after 9 and 18 weeks of PE. At baseline, there were no significant differences among the 3 groups for most measures. Compared with baseline, the experimental groups improved significantly in all 6 fitness measures and showed more improvements than the control group in most fitness measures both at 9 and 18 weeks. None of the groups showed significant improvement in body composition. The results documented that an MRT-complemented PE program was effective in improving adolescents' muscular fitness. An 18-week combined MRT and cardiovascular endurance training program effectively improved cardiovascular and muscular fitness but was ineffective in improving adolescent body composition. An MRT-based exercise session requires minimal equipment and set-up and can be performed in a short period of time, and therefore it is suitable for application in regular PE settings.

Timing of Hospice Referral: Assessing Satisfaction While the Patient Receives Hospice Services.

Generally, satisfaction with timing of hospice referral was measured in mortality follow back surveys of patients who died in hospice. In contrast in this study, investigators assessed timing of the hospice referral in patients/families enrolled in hospice for a minimum of two weeks. About 1/3 of patients/families identified it would have been easier if they started hospice earlier. Barriers to early hospice access were associated primarily with access to the healthcare system.

Hispanics' experiences in the health system prior to hospice admission.

National data document that Hispanics are under-represented in hospice. Policy makers often attribute the under-representation to Hispanics' cultural values and preferences, however, another reason may be healthcare system barriers encountered by Hispanics. We explored Hispanics' versus Whites' experiences in the healthcare system prior to hospice admission to help account for Hispanics under-representation in hospice. The conceptual model was the Agency for Healthcare Research and Quality Model on Healthcare Access. Whites' experiences were used as benchmarks to identify healthcare disparities for Hispanics. In four hospice agencies, Hispanic (n = 60) and White (n = 60) Medicare patients were interviewed. The results showed that prior to hospice admission, Hispanics had less access to health services known to be associated with hospice access.

Hispanic access to hospice services in a predominantly Hispanic community.

Although the largest minority population in the United States, Hispanics are under-represented in hospice at the national level. The study purpose was to document Hispanic access to hospice services in an environment where Hispanics are a majority population. The framework for the study was Aday and Anderson's model for access to medical care. In this framework, access is not defined as availability of services and resources, but whether services are actually used by the people who need them. We completed retrospective chart reviews of 500 Medicare beneficiaries who died in four hospices. Study variables were decedent characteristics and access to hospice and hospice disciplines. Results showed that Hispanics and whites differed on characteristics known to influence access to health services, e.g., preferred language and type of caregiver Although the proportion of Hispanic elders dying in hospice was less than the proportion living in the community, the proportions of Hispanic elders who died in the community or died in their homes were not differentfrom the proportion that died in hospice. When access to hospice disciplines was compared between Hispanic and white decendents, the results showed one difference-more whites than Hispanics had access to volunteer services. Overall, the study showed that Hispanics were not underrepresented in hospice, and they had equal access to hospice disciplines. These findings differ from national data and may be associated with Hispanics being the majority population in the community. To learn how population dominance influences minority access to services, Hispanic access to hospice could be studied in locales with varying proportions of Hispanics in the population.