Reliability of the sitting hand press-up test for identifying and quantifying the level of scapular medial border posterior displacement in overhead athletes.

BACKGROUND: The lack of proper scapular kinematics can limit the function of the entire shoulder complex.(1,3) Many forms of scapular dyskinesis have been proposed along with tests to measure for the position and motion associated with those positional and movement faults (2,4-6). While scapular internal rotation has been listed among the forms of scapular dyskinesis there has not been a reliable test documented in the literature that examines this motion. The purpose of this study was to determine whether an innovative scapular medial border posterior displacement measurement device has adequate inter-rater and intra-rater reliability when used at rest and during the sitting hand press up test. METHODS: 16 male Division III baseball players free of upper limb injury for the previous 12 months participated in the study. Posterior scapular displacement measures were taken on each subject in a resting static posture and while performing a sitting hand press up test. Subjects were tested twice within 24 hours by two separate examiners. Intraclass correlation coefficients (ICC) were calculated to determine intra-rater and inter-rater reliability. RESULTS: The intra-rater reliability for rater 1 was .97 (95% confidence interval [CI]= .91-.98), for the rest position and .95 (95% CI= .86-.98) for the sitting hand press-up position. Intra-rater reliability for rater 2 was .99 (95% CI= .97-.99) for the rest position and .98 (95% CI=. 95-.99) for the sitting hand press-up position. The ICCs for inter-rater reliability of the scapular medial border posterior displacement measurement in at the rest position and the sitting hand press-up position were .89 (95% CI= .81-.96) and .89 (95% CI= .80-.96) respectively. CONCLUSIONS: The findings of this study indicate that the measurement of medial border posterior displacement using this device demonstrates good to excellent inter-rater and intra-rater reliability.

Externalities in the Workplace: A Response to a Rejoinder to a Response to a Response to a Paper.

Professor Henderson has simply repeated the same two points he made in his earlier critique (Henderson 2007) of our article "Smoke-free Ordinances Increase Restaurant Profit and Value" (Alamar and Glantz 2004). He argues 1.) that secondhand smoke is not an externality, therefore no government intervention is required to protect workers and customers in restaurants and bars, and 2.) the empirical results in the paper are not conclusive because the data are cross-sectional. Henderson also issues a challenge for us to advocate for the repeal of the California law on smoke-free restaurants. While we enjoy a good debate and do not mind adding another publication to our CVs, we do hope that Prof. Henderson will not find the burning desire to restate his position again, after we respond this last time.

Effect of smoke-free laws on bar value and profits.

The tobacco industry has claimed that smoke-free bar laws caused bar revenues to decline by 30%. After we controlled for economic variables, we found that bars located in areas with smoke-free laws sold for prices that were comparable to prices for similar bars in areas with no smoking restrictions. Other studies have reported that sales did not decline, and we also found that neither price nor sales declined. Therefore, bar owners' concerns that smoke-free laws will reduce the value of their bars are unfounded.

Effect of increased social unacceptability of cigarette smoking on reduction in cigarette consumption.

Taxes on cigarettes have long been used to help reduce cigarette consumption. Social factors also affect cigarette consumption, but this impact has not been quantified. We computed a social unacceptability index based on individuals' responses to questions regarding locations where smoking should be allowed. A regression analysis showed that the social unacceptability index and price had similar elasticities and that their effects were independent of each other. If, through an active tobacco control campaign, the average individual's views on the social unacceptability of smoking changed to more closely resemble the views of California residents, there would be a 15% drop in cigarette consumption, equivalent to a 1.17 dollars increase in the excise tax on cigarettes.

Modeling Addictive Consumption as an Infectious Disease.

The dominant model of addictive consumption in economics is the theory of rational addiction. The addict in this model chooses how much they are going to consume based upon their level of addiction (past consumption), the current benefits and all future costs. Several empirical studies of cigarette sales and price data have found a correlation between future prices and consumption and current consumption. These studies have argued that the correlation validates the rational addiction model and invalidates any model in which future consumption is not considered. An alternative to the rational addiction model is one in which addiction spreads through a population as if it were an infectious disease, as supported by the large body of empirical research of addictive behaviors. In this model an individual's probability of becoming addicted to a substance is linked to the behavior of their parents, friends and society. In the infectious disease model current consumption is based only on the level of addiction and current costs. Price and consumption data from a simulation of the infectious disease model showed a qualitative match to the results of the rational addiction model. The infectious disease model can explain all of the theoretical results of the rational addiction model with the addition of explaining initial consumption of the addictive good.

SMOKE-FREE ORDINANCES INCREASE RESTAURANT PROFIT AND VALUE.

This study estimates the economic value added to a restaurant by a smoke-free policy using regression analysis of the purchase price of restaurants, as a function of the presence of a smoke-free law and other control variables. There was a median increase of 16% (interquartile range 11% to 25%) in the sale price of a restaurant in a jurisdiction with a smoke-free law compared to a comparable restaurant in a community without such a law. This result indicates that, contrary to claims made by the tobacco industry and other opponents of smoke-free laws, these laws are associated with an increase in restaurant profitability.