Identifying subgroups that succeed or fail with three levels of physical activity intervention: the Activity Counseling Trial.

The authors used recursive partitioning methods to identify combinations of baseline characteristics that predict 2-year physical activity success in each of 3 physical activity interventions delivered in the multisite Activity Counseling Trial. The sample consisted of 874 initially sedentary primary care patients, ages 35-75 years, who were at risk for cardiovascular disease. Predictors of 2-year success were specific to each intervention and represented a range of domains, including physiological, demographic, psychosocial, health-related, and environmental variables. The results indicate how specific patient subgroups (e.g., obese, unfit individuals; high-income individuals in stable health) may respond differently to varying levels and amounts of professional assistance and support. The methods used provide a practical first step toward identifying clinically meaningful patient subgroups for further systematic investigation.     

Perceived racism and cardiovascular reactivity and recovery to personally relevant stress.

This study evaluated cardiovascular responses (CVR) to an active speech task with blatantly discriminatory (BRC) versus neutral (NRC) stimuli and an anger recall task in a sample of Black men (N = 73; age 18 to 47). Diastolic blood pressure scores were higher for NRC versus BRC stimuli during anger recall (p = .05). Moreover, persons in the NRC group who perceived high levels of racism (vs. no racism or BRC group) during active speech showed larger increases in blood pressure across postspeech rest, anger recall, and subsequent rest (p = .03). The notable elevation in CVR in response to an ambiguous event extends current models of racism suggesting that subtle racism is a psychosocial stressor that erodes health through chronically elevated CVR.     

Effects of Stimulus Number and Target-to-Distractor Ratio on the Performance of Random Array Letter Cancellation Tasks

Cancellation tests are commonly used in the clinical assessment of visuospatial function, but there has been little study of task characteristics influencing performance. This study was designed to assess factors which affect cancellation performance. Sixteen healthy subjects sequentially performed four random-array letter cancellation tasks. The forms contained 50 and 100 stimuli and target:distractor (T/D) ratios of 1:4 and 1:9 with target letter “A” and randomly selected letter distractors. The primary performance measure was calculated as the number of correctly cancelled targets divided by the time to complete the task, corrected for accuracy. This measure revealed a strong effect of T/D ratio (p< .0001), with performance adversely affected by higher proportion of distractors. There was no effect of stimulus number. This suggests that T/D ratio should be considered in cancellation test design and interpretation.     

Developing an efficient clinical information system for a comprehensive psychiatric institute: I. Principles,design, and organization

The principles, design considerations, and components of a clinical information system intended to support and enhance the patient care, educational, and research missions of a comprehensive psychiatric institute are presented. Major characteristics of the system are its emphases on efficiency, simplicity, and intensive user involvement throughout the development of the system.