To understand the similarities, differences, and relationships between three tools for performance and capacity assessment currently available for Maternal and Child Health (MCH) programs and for state and local health agencies. Three tools for performance and capacity assessment currently available for Maternal and Child Health (MCH) programs and for state and local health agencies, the Title V MCH Block Grant Performance and Outcome Measures (Title V "24"), CAST-5, and the National Public Health Performance Standards Program (NPHPSP) were compared using two metrics, a conceptual model of the public health system, and a set of attributes related to the use of the instruments. Both CAST-5 and the NPHPSP are focused on the capacity and key processes (10 Essential Public Health Services) of the public health system, although CAST-5 is intended for capacity assessment and the NPHPSP is intended for performance measurement. The Title V "24" tool is also intended for ...

The experiences of sexual minority women (i.e., women who do not
identify as ‘heterosexual’) in India have largely been absent in scientific
literature. In partnership with India’s oldest and largest sexual and
gender minority-advocacy organisation, the Humsafar Trust, our
study used community-based participatory research principles to
explore the lived experiences and health concerns of sexual minority
women in Mumbai. Study methodologies included interviews with
key informants, a focus group comprised of six women, and an
additional 12 in-person interviews with sexual minority women to
identify important physical, mental, social and other health priorities
from these women’s perspectives. Thematic data are organised within
the framework offered by the social ecological model, including
individual, interpersonal, micro and macro levels. Findings from
this study are important in providing the groundwork for future
research and intervention involving sexual minority women in India,
a dramatically underserved population.

Factors that may confound comparisons between electromyographic (EMG) biofeedback training and its control conditions include feedback quality and experience of success. We investigated the usefulness of a control procedure designed to overcome these potential sources of confounding. The procedure consisted of training muscle tension stability. We used it as a control for frontal EMG relaxation training in children with asthma. To equate the groups for feedback quality and experience of success, we gave each child in the control condition audio feedback decreasing in pitch when muscle tension was at or near baseline levels, and feedback increasing in pitch when muscle tension was either substantially above or below baseline levels. Children in both groups were instructed to decrease the pitch of the tone. In comparison to children in the relaxation condition, the children in the control condition exhibited stable levels of muscle tension throughout eight training sessions. We concluded that feedback for stable muscle tension may be a useful control procedure for EMG biofeedback training whenever experimental and control procedures differ in either feedback quality of degree to which they permit subjects to experience success. Descriptor Key Words: electromyographic (EMG) control; EMG stability training; biofeedback control. 1This research was supported by NIH-Grant HL 27402. We are grateful to Paul Schnitter who constructed the EMG stability feedback device. 2Address all correspondence to

We studied the effects of electromyographic biofeedback on measures of asthma severity in children. Fifteen children received biofeedback training to reduce facial tension, and 14 children, who served as controls, received biofeedback training to maintain facial tension at a stable level. Assignment to experimental condition was random. As a result of training, electromyographic

Abstracts of 15th Annual Meeting 377 differences for age in the normal children. Further, ANOVA demonstrated that the verbal fluency measure was clinically useful in differentiating the Language Disorder/Dysphonetic Dyslexic subgroup from the Visual-Spatial/Dyseidetic dyslexic subgroup and the ADHD group, both of which tended to perform within the average range.

Agreement has not emerged either on the sensory attributes that underlie psychophysical decisions in respiratory magnitude scaling tasks or on the physical stimuli giving rise to human judgments. Accordingly, sensory attributes of respiratory sensations were explored in the present study by adopting scaling techniques designed to help uncover the organization of sensory experiences elicited by various breathing maneuvers. Physical stimulus characteristics underlying human judgments were also considered. Subjects rated the dissimilarity between 45 pairs of breathing maneuvers on a scale ranging from 0 ("no difference at all") to 10 ("very much difference"). Cluster analysis and multidimensional scaling were employed to uncover the perceived grouping among different types of maneuvers and the relative organization of maneuvers in a Euclidean space. Dissimilarity judgments varied primarily as a function of a single attribute, degree or magnitude of external loading, ranging from an infinite respiratory load to no load at all. This continuum may depend on interactions among pressure or tension, airflow, and lung volume displacement. A secondary attribute may relate to airflow direction (inspiration or expiration).

Respiratory sensations were measured by magnitude production in 15 young (23-33 years) and 15 old (61-85 years) healthy males to compare exponents for static respiratory muscle forces in the two age groups. Perceptions of static inspiratory and expiratory forces were scaled both at the end of normal expiration and at lung volume extremes. Exponents for young and old groups did not differ, and were independent of lung volume. The average exponent for perceived respiratory force was 1.7.

Event-related potentials were recorded to brief presentations of four levels of inspiratory flow-resistive loads in young adults. We labeled the loads according to the level of resistance they provided subjectively: sub-threshold (0.34 cmH 2 O/l per s), near-threshold (4.01 cmH 2 O/l per s), intermediate (10.4 cmH 2 O/l per s), and near-occlusion (57.5 cmH 2 O/l per s). No discernible ERPs were elicited by the undetected, sub-threshold stimulus but late components of the ERP (P2, N2, and P3) were observed to each of the three larger stimuli. They were related, in part, to behavioral judgments obtained during the stimulus periods. Both the latency and amplitude of the ERP components varied systematically as a function of stimulus magnitude, in a manner comparable to that observed in ERP paradigms using auditory and visual stimuli. Thus, the data show that event-related potentials to breathing are sensitive to physiologic effects of resistive loads present at the onset of inspiration. Respiratory ERPs may be used to infer sensory and perceptual responses to increases in airflow resistance and, accordingly, may relate to the perception of airflow obstruction in patient populations.

Earlier research suggested that the effects of facial muscle tension changes on other responses are not widespread but limited to a rather narrow set of pulmonary events. Further evidence in support of the specificity of the facial muscle-pulmonary relationship was provided in the present study by monitoring changes in several responses as a function of muscle tension training. Feedback training for increases and decreases in muscle tension at both facial and limb muscle sites was given to adult males. The effects of these manipulations on PEFR, RR, and HR were examined. Increases in facial muscle tension resulted in PEFR decreases whereas increases in limb muscle tension did not. Decreases in facial muscle tension were not observed as a function of training and no PEFR changes resulted from these conditions. Neither RR nor HR were related to the facial EMG changes observed during feedback training. These observations demonstrated the specificity inherent in the relationship between facial muscle tension and PEFR. and lent support to the hypothesis that these two responses are linked reflexively.

services can be found online on the World Wide Web at: The online version of this article, along with updated information and ISSN:0012-3692 ) http://chestjournal.chestpubs.org/site/misc/reprints.xhtml Downloaded from 832 CHEST Original Research ASTHMA Original Research

The University of North Carolina at Charlotte, a doctoral/research-intensive university, is the largest institution of higher education in the Charlotte region. The university currently offers 18 doctoral, 62 master's and 90 baccalaureate programmes. Fall 2008 enrolment exceeded 23 300 students, including more than 4900 graduate students.

Evaluation for Atopic Disease M. Emberger; Allergy and Asthma Specialists, P.C., Blue Bell, PA. RATIONALE: To survey which supplements are being used by patients prior to their evaluation in an allergists's office. METHODS: For one month, as part of the RN's intake process for new patients, surveys of supplement use, and in particular, for treatment of atopic diseases, were obtained. All dietary supplements not initially listed by patients were queried, and then added to their chart. RESULTS: Out of 55 new patients surveyed, 32[57%] were on supplements, 20 for atopic diseases and 12 for other reasons. Only 14 out of the 32 new patients initially listed all of the supplements they were taking, the other 18 revealed their supplements only upon further questioning. 23[42%] were not on any supplements. CONCLUSIONS: With the amount of new patients taking supplements, there is a need to specifically ask patients at their initial visit which supplements they are using. Accurate knowledge of these supplements should be reviewed for side effects, interactions with other medications, and possible allergic reactions. Team members of all allergy offices need to know this information for each new patient so the best care plan for their situation can be created and carried out. Further exploration is necessary on how these supplements should fit into a care plan for new patients, and, if after their allergist's visit and a new care plan has been in place, do changes occur in the patient's use of supplements.

Male and female subjects were compared on heartbeat, respiratory resistance, and light-tone signal-detection tasks. Subjects judged whether a series of 10 tones was coincident with their heartbeats; whether an external load added to the airway was either present or absent during targeted inspiratory cycles; and whether a series of 10 light flashes was matched with auditory tones presented following a fixed delay of either 50 or 100 ms. Nonparametric indices of perceptual sensitivity and response bias indicated that tnen were more sensitive than women on the resistive load task (p < .05) atid on the heartbeat task (p = .07). Performance on the light-tone task was virtually identical. All subjects used a stricter criterion on the respiratory resistance task than on either the heartbeat or the lighttone task; women employed a stricter criterion than men on the heartbeat task. The gender differences may be understood in terms of lateralization of central processing of somesthetic sensory information.