The effects of tai chi (TC) and low impact exercise (LIE) interventions on physical functioning and psychological well-being of sedentary older people were contrasted. Participants were randomized to TC, LIE, or non-exercise control groups with interventions running for 12 weeks. Postintervention assessments with 72 participants who completed the study revealed that participants in both exercise groups improved with respect to upper body strength, balance, cardiovascular endurance, lower body strength, sleep disturbances, and anxiety. Participants in the LIE group reported better functional ability while those in the TC group reported better subjective health. Findings suggest that tai chi and low impact exercise are safe, cost-effective ways to improve both physical and psychological functioning of older people.
To ascertain how effective the seven-item Beck Depression Inventory-FastScreen for medical patients (BDI-FS) was in screening geriatric (> 55 years old) patients for depression, the BDI-FS and the 15-item Geriatric Depression Scale (GDS-S) were administered to 33 (44%) male and 42 (56%) female outpatients who were scheduled for routine office visits by physicians specializing in geriatric medicine. The internal consistency of the BDI-FS was high (coefficient alpha = 0.83), and it was positively correlated with the GDS-S, r = 0.81, p < 0.001. The BDI-FS scores were not related to sex, age, ethnicity, or type of medical diagnosis, but were positively correlated with a diagnosis of depression (r = 0.49, p < 0.001) and being prescribed an antidepressant (r = 0.55, p < 0.001). A BDI-FS cut-off score of four and above had 100% sensitivity and 84% specificity rates, respectively, for identifying patients who were and were not diagnosed with depression.
Over the past 10 to 15 years, there has been marked progress in clinical research on depression in nursing home residents. There have also been significant changes in federal regulations designed to improve the quality of care. In 1987, only 10% of nursing home residents diagnosed with depression were receiving treatment, but by 1999,25% of all residents were receiving antidepressants. We report on two studies: one demonstrating that treatment for depression has a substantial, ecologically relevant impact in the nursing home and another demonstrating that profound changes have occurred in the clinical epidemiology of depression and its treatment in the nursing home. Although the numbers of nursing home residents receiving antidepressants have increased dramatically, there are now second-generation problems that must be addressed to ensure the delivery of effective treatment. Developing models to ensure quality of care will require focused mental health services research.
The launch of Osteopathic Continuous Certification (OCC) signifes the next stage of the osteopathic board certification process. The OCC process replaces the old recertification system for all osteopathic physicians who earned time-limited certificates from American Osteopathic Association (AOA) certifying boards. All 18 AOA certifying boards are now engaged in the continuous certification process. With the advent of any new system, many questions and concerns will arise. The AOA Bureau of Osteopathic Specialists continues to evaluate its new certification system and prepare for modifcations in response to this feedback.
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