ABSTRACT
The potential for high performance in many sports can be assessed by quantifying whole-body explosiveness. The backwards overhead medicine ball (BOMB) throw is commonly-used to tests this ability, but the effect of varied loading on test execution is unknown. The purpose of this study was to determine the effect of different medicine ball (MB) loads on force, velocity, and power output during the BOMB throw. Female collegiate softball and rugby players (n=31) performed the BOMB throw on a force plate using 2.7, 3.6, 4.5, and 5.5 kg MBs, with three throws per load in a randomised order, and 30 seconds rest between throws. A series of Repeated Measures ANOVAs noted no differences (p>0.05) in peak power, peak force, peak velocity, force at the moment of peak power, or velocity at the moment of peak power, across MB loads. The lack of differences among these loads indicates that coaches can likely compare kinetic characteristics of the BOMB throw within this range (2.7-5.5 kg). Therefore, coaches can use the BOMB throw with 2.7-5.5 kg MBs for training or measurement among female athletes to obtain reference data for programming or evaluation.
Subject(s)
Baseball , Sports , Humans , Female , Biomechanical Phenomena , Muscle, Skeletal , Athletes , Muscle StrengthABSTRACT
PURPOSE: Adherence to and persistence with antidepressants are often suboptimal. However, little is known about how patient knowledge and outcome expectations may influence antidepressant adherence and persistence. METHOD: Individuals who had been prescribed their first antidepressant to treat depression in the preceding 6 months were recruited to an online survey via Facebook. Knowledge, education received, and initial outcome expectations were analyzed for associations with persistence and adherence. RESULTS: Two hundred and twenty surveys were analyzed. A total of 117 participants had taken their antidepressant for at least 3 months; another 25 had never started or stopped after <3 months without consulting their doctor. Differences in expectations and various educational messages among persistent and nonpersistent participants were identified. Having received the instruction "don't stop it without checking with your doctor" was a significant independent predictor of persistence (odds ratio [OR] =5.9, 95% confidence interval [CI] =1.4-24.5). At the time of the survey, 82.7% of participants were taking an antidepressant and 77.9% were adherent. Significant independent predictors of adherence were a greater age (OR =1.1, 95% CI =1.0-1.2), knowledge (OR =1.6, 95% CI =1.1-2.3), being informed of common side effects (OR =5.5, 95% CI =1.1-29.0), and having discussed ways to solve problems (OR =3.9, 95% CI =1.1-14.5). CONCLUSION: Improving outcome expectations and particular educational messages may increase adherence and persistence. Greater knowledge may enhance adherence. Further investigation is warranted to determine whether a focus on these simple educational messages will improve outcomes in patients who commence an antidepressant.
ABSTRACT
BACKGROUND: Point-of-care international normalized ratio (INR) monitoring devices simplify warfarin management by allowing selected patients to monitor their own therapy in their homes. Patient self-testing (PST) has been shown to improve the clinical outcomes of warfarin therapy compared to usual care. OBJECTIVE: To compare management of warfarin therapy using PST combined with online supervision by physicians via a custom system with usual warfarin management, which involved laboratory testing and physician dosing. METHODS: Interested patients were recruited via community pharmacies to participate in a warfarin PST training program. Participants were required to have a long-term indication for warfarin, have been taking warfarin for at least 6 months, and have Internet access in their home. The training involved two sessions covering theoretical aspects of warfarin therapy, use of the CoaguChek XS, and the study website. Following training, patients monitored their INR once weekly for up to 3 months. Patients and physicians utilized a secure website to communicate INR values, dosage recommendations, and clinical incidents. Physicians provided a 6-12 month history of INR results for comparison with study results. The percentage of time spent within the therapeutic INR range (TTR) was the primary outcome, with participants acting as their own historical controls. The percentage of INR tests in range and participant satisfaction were secondary outcomes. RESULTS: Sixteen patients completed training requirements. The mean age of participants was 69.8 (SD 10.1) years. TTR improved significantly from 66.4% to 78.4% during PST (P=.01), and the number of tests within the target range also improved significantly (from 66.0% at prior to the study to 75.9% during PST; P=.04). Patients and physicians expressed a high degree of satisfaction with the monitoring strategy and online system. CONCLUSIONS: PST supported by an online system for supervision was associated with improved INR control compared to usual care in a small group of elderly patients. Further research is warranted to investigate the clinical outcomes and cost-effectiveness of online systems to support patients monitoring medications and chronic conditions in the home.
