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To evaluate a theory-based educational program to prevent Lyme disease and other tick-borne illnesses (TBI), a randomized controlled trial of an educational program was delivered to ferry passengers traveling to an endemic area in southeastern Massachusetts. Rates of TBI and precautionary and tick check behaviors were measured over three summers in 30,164 passengers. There were lower rates of TBI among participants receiving TBI education compared with control participants receiving bicycle safety education (relative risk [RR] = 0.79) and a 60% reduction in risk among those receiving TBI education who visited Nantucket Island for more than 2 weeks compared to control participants (RR = 0.41, 95% confidence intervals = 0.18 to 0.95, p less than 0.038). TBI-educated participants were also significantly more likely to take precautions (use repellent, protective clothing, limit time in tick areas) and check themselves for ticks. The study demonstrates that a theory-based Lyme disease prevention program can increase precautionary behavior and result in a significant reduction in TBI. (Contains 3 tables and 1 figure.)

Examines patients (N=257) with lumbar spinal stenosis preoperatively and at six months to relate patient expectation to baseline function and pain and to determine how patient expectations and preoperative function interact to predict postoperative outcomes. Results show that patients with many preoperative expectations, particularly those with low baseline function, reported more improvement in postoperative function than patients with few expectations. (Author/MKA)

A survey of 120 postal worker participants in a back safety course and 89 controls found (1) there was increased knowledge among experimentals but no significant behavior change; and (2) experimentals were less likely to report reinforcement for healthy behaviors. The complexities of worker social support show that it cannot be relied upon to reinforce educational program goals. (SK)

A variety of programs have produced changes in knowledge, behavior, and health for arthritis patients. National dissemination of patient education programs is in progress. Research needs center on new populations, delivery methods, and arthritis-specific applications of theory. (SK)

Healthy function is controlled by a complex set of variables. A study investigated whether aged people with chronic illnesses or healthy aged show less flexibility when responding to various stressors as compared to healthy adults. People in this study used a card game to assess self-reported coping behavior. Healthy adults showed greater variability than those in illness groups or the elderly., The authors tested the hypothesis that individuals with a variety of severe chronic illnesses and the healthy elderly exhibit a loss of flexibility in their response to a variety of [...]

An educational program that teaches workers ways to avoid back injury does not appear to be beneficial. Physical therapists taught 2,534 postal workers and 134 supervisors the principles of back safety, including proper ways of lifting and handling, posture, exercise and pain management. Although the program increased workers' knowledge of back safety, it did not reduce the number of back injuries, time lost from work, or costs associated with back injuries when their outcome was compared to a group that did not receive the training.

Continuous passive motion (CPM) may be more effective and less expensive than traditional physical therapy for rehabilitation of patients who have undergone total knee arthroplasty, or knee replacement surgery. This method involves the use of a CPM machine set for a certain rate and arc of motion to exercise the patient's knee. Among 93 patients with arthritis who underwent total knee arthroplasty, 48 were treated with CPM plus conventional physical therapy and 45 were treated with conventional physical therapy alone. Patients in the CPM group had increased active range of motion, less swelling and less need for manipulations, compared with those in the conventional physical therapy group. Patients treated with CPM did not experience significantly less pain or fewer complications than those who were not treated with CPM. Costs associated with treatment were less for patients in the CPM group than for those in the conventional physical therapy group., Objective.--To evaluate the efficacy of continuous passive motion (CPM) in the postoperative management of patients undergoing total knee arthroplasty. Design.--A randomized controlled single-blind trial of CPM plus standardized rehabilitation vs standard rehabilitation alone. Setting.--A referral hospital for arthritis and musculoskeletal care. Patients.--Consecutive patients with end-stage osteoarthritis or rheumatoid arthritis undergoing primary total knee arthroplasty who had at least 90[degree] of passive knee f exion. One hundred fifty-four patients were eligible and 102 patients agreed to participate and were randomized. Ninety-three patients completed the study protocol. Intervention.--Continuous passive motion machines programmed for rate and specified arc of motion within 24 hours of surgery with range increased daily as tolerated with standardized rehabilitation program compared with standardized rehabilitation program alone. Main Outcome Measures.--Primary outcomes were pain, active and passive knee range of motion, swelling (or circumference), quadriceps strength at postoperative day 7, as well as complications, length of stay, and active and passive range of mot on and function at 6 weeks. Results.--Use of CPM increased active flexion and decreased swelling and the need for manipulations but did not significantly affect pain, active and passive extens on, quadriceps strength or length of hospital stay. At 6 weeks there were no differences between the two groups in either range of motion or function. In this series, use of CPM resulted in a net savings of $6764 over conventional rehabilitation in achieving these results. Conclusion.--For the average patient undergoing total knee arthroplasty, CPM is more effective in improving range of motion, decreasing swelling, and reducing the need for manipulation than is conventional therapy and lowers cost. (JAMA. 1992;268:1423-1428)

The Society for Public Health Education's (SOPHE) three midyear scientific symposia were evaluated by all SOPHE members who attended and 10 percent of those who did not. Ninety percent learned something relevant to their work; 33-50 percent made business contacts; 20 percent increased their participation in association activities because of the meetings. (JOW)