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Journal of Shoulder and Elbow Surgery Sep 2012An increase in elbow pathology in adolescents has paralleled an increase in sports participation. Evaluation and classification of these injuries is challenging because...
BACKGROUND
An increase in elbow pathology in adolescents has paralleled an increase in sports participation. Evaluation and classification of these injuries is challenging because of limited information regarding normal anatomy. The purpose of this study was to evaluate normal radiographic anatomy in adolescents to establish parameters for diagnosing abnormal development. Established and new measurements were evaluated for reliability and variance based on age and sex.
METHODS
Three orthopaedic surgeons independently, and in a standardized fashion, evaluated the normal anteroposterior and lateral elbow radiographs of 178 adolescent and young adult subjects. Fourteen measurements were performed including radial neck-shaft angle, articular surface angle, articular surface morphologic assessment (subjective and objective evaluation of the patterns of ridges and sulci), among others. We performed a statistical analysis by age and sex for each measure and assessed for inter- and intraobserver reliability.
RESULTS
The distal humerus articular surface was relatively flat in adolescence and became more contoured with age, as objectively demonstrated by increasing depth of the trochlear and trochleocapitellar sulci, and decreasing trochlear notch angle. Overall measurements were similar between males and females, with an increased carrying angle in females. There were several statistically significant differences based on age and sex; but these were small and unlikely to be clinically significant. Inter and intraobserver reliability were variable; some commonly utilized tools had poor reliability.
CONCLUSION
Most commonly utilized radiographic measures were consistent between sexes, across the adolescent age group, and between adolescents and young adults. Several commonly used assessment tools show poor reliability.
Topics: Adolescent; Body Weights and Measures; Elbow; Female; Humans; Male; Observer Variation; Radiography; Reference Values; Young Adult
PubMed: 22329911
DOI: 10.1016/j.jse.2011.10.026 -
PLoS Computational Biology Aug 2018Workshops are used to explore a specific topic, to transfer knowledge, to solve identified problems, or to create something new. In funded research projects and other...
Workshops are used to explore a specific topic, to transfer knowledge, to solve identified problems, or to create something new. In funded research projects and other research endeavours, workshops are the mechanism used to gather the wider project, community, or interested people together around a particular topic. However, natural questions arise: how do we measure the impact of these workshops? Do we know whether they are meeting the goals and objectives we set for them? What indicators should we use? In response to these questions, this paper will outline rules that will improve the measurement of the impact of workshops.
Topics: Education; Humans; Knowledge; Learning; Research; Weights and Measures
PubMed: 30161124
DOI: 10.1371/journal.pcbi.1006191 -
Australian Journal of General Practice Oct 2018Continuity of care is a fundamental element of traditional general practice linked, via an expanding evidence base, with important patient and system outcomes. It is of...
BACKGROUND
Continuity of care is a fundamental element of traditional general practice linked, via an expanding evidence base, with important patient and system outcomes. It is of particular importance as populations age and live increasingly with significant, ongoing lifestyle and chronic disease challenges.
OBJECTIVES
The aim of this article is to examine the challenges in measuring and promoting continuity of care in Australia.
DISCUSSION
Appropriate measurement is challenging and the choice of tool requires careful consideration. This should include scope, length, validation testing, accessibility of the tool, alignment with the initiative requiring evaluation, and application to local and system-level analysis. As our healthcare system looks to major reform in the near future, we must ensure that it supports and incentivises continuity of care in its policy development, care models, payment method, training, data analytics, and community consultation and messaging.
Topics: Australia; Continuity of Patient Care; Family Practice; Humans; Weights and Measures
PubMed: 31195766
DOI: 10.31128/AJGP-05-18-4568 -
Nursing Research 2020Extended hospitalization in neonatal intensive care units subjects preterm infants to multiple stress exposures that affect long-term cognitive functioning, motor...
BACKGROUND
Extended hospitalization in neonatal intensive care units subjects preterm infants to multiple stress exposures that affect long-term cognitive functioning, motor development, and stress reactivity. Measurement of stress exposure is challenging with multiple measures of stress exposure in use, including counts of skin-breaking or invasive procedures or counts of noxious sensory exposures.
OBJECTIVES
The purpose of this analysis was to compare measures of stress exposure commonly used by researchers and to determine the predictive validity of these measures for early neurobehavior. We accomplished this objective through the following specific aims: (a) describe the stress exposures of preterm infants in the first 2 weeks of life, (b) determine the correlations among measures of stress exposure, and (c) compare the predictive validity of measures of stress exposure for early neurobehavior.
METHODS
Very preterm infants born between 28 and 31 weeks postmenstrual age were enrolled from four neonatal intensive care units in a large Midwest city. We measured stress exposure over the first 14 days of life for each infant as a count of skin-breaking procedures, a count of invasive procedures, and cumulative scores derived from the Neonatal Infant Stressor Scale. Neurobehavior was assessed at 35 weeks postmenstrual age using the motor development and vigor and alertness/orientation subscales from the Neurobehavioral Assessment of the Preterm Infant. We used Spearman's rho to determine correlations among the measures of stress exposure and multiple linear regression to determine the predictive validity of each stress exposure measure for neurobehavioral outcomes.
RESULTS
Seventy-one preterm infants were included in the analysis. We found marked variance across individuals in all measures of stress exposure. There were moderate-high correlations among the measures of stress exposure. No measure of stress exposure was associated with early neurobehavior.
DISCUSSION
The stress experiences of hospitalized preterm infants vary. This variance is reflected in all measures of stress exposure. Because measures of stress exposure are highly correlated, the most objective measure requiring the least interpretation should be used. However, the currently available measures of stress exposure used in this analysis may not reflect the infant's physiological stress responses and fail to associate with early neurobehavior.
Topics: Female; Humans; Infant; Infant, Newborn; Infant, Premature; Intensive Care Units, Neonatal; Male; Midwestern United States; Neurobiology; Stress, Psychological; Weights and Measures
PubMed: 32604153
DOI: 10.1097/NNR.0000000000000444 -
Medicina (Kaunas, Lithuania) May 2019To identify the relationship between neck circumference (NC) and cardiometabolic risk factors in children. Children and adolescents 6-18 years old (n = 548) from five...
To identify the relationship between neck circumference (NC) and cardiometabolic risk factors in children. Children and adolescents 6-18 years old (n = 548) from five counties of San Luis Potosí, México were included. Data was collected for biological markers (glucose and lipid profile) and anthropometric and clinical measurements-weight, height, NC, waist circumference (WC), and blood pressure (BP). Body mass index (BMI) was calculated using Quetelet formula (kg/m). Descriptive analysis, correlation tests, and receiver operating characteristic (ROC) analysis were performed. : NC was highly correlated with BMI and WC in both genders ( <0.0001). The most frequent risk factor was high BMI (38.7%). Sensitivity and specificity analysis of NC and high BMI showed an area under the ROC curve of 0.887. : According to our findings, NC is a simple, low-cost, and non-invasive measurement, which has a high association with high BMI and increased WC.
Topics: Adolescent; Anthropometry; Body Mass Index; Child; Cross-Sectional Studies; Female; Humans; Male; Metabolic Diseases; Mexico; Neck; Pediatrics; Risk Assessment; Risk Factors; Weights and Measures
PubMed: 31117308
DOI: 10.3390/medicina55050183 -
CMAJ : Canadian Medical Association... Mar 2004
Topics: Evidence-Based Medicine; Publishing; Quality Control; Reproducibility of Results; Statistics as Topic; Weights and Measures
PubMed: 15023904
DOI: 10.1503/cmaj.1031694 -
The American Journal of Clinical... Jan 2017The American Academy of Pediatrics (AAP) has recommended that nutritional management of the preterm infant should aim to achieve body composition that replicates the in...
BACKGROUND
The American Academy of Pediatrics (AAP) has recommended that nutritional management of the preterm infant should aim to achieve body composition that replicates the in utero fetus, but intrauterine body composition reference charts for preterm infants are lacking.
OBJECTIVE
Our objective was to create body composition reference curves for preterm infants that approximate the body composition of the in utero fetus from 30 to 36 wk of gestation.
DESIGN
A total of 223 ethnically diverse infants born at 30 + 0 to 36 + 6 wk of gestation were enrolled. Inclusion and exclusion criteria were specified so that the sample would represent healthy appropriately growing fetuses (e.g., singleton, birth weight appropriate for their gestational age, and medically stable). Cross-sectional reference values were generated for fat mass (FM), fat-free mass (FFM), and percentage body fat (PBF) by gestational age (GA), with the use of air-displacement plethysmography (ADP) and the lambda-mu-sigma method for percentile estimation.
RESULTS
GA-specific percentile values and a percentile and z score calculator for FFM, FM, and PBF are presented. These values aligned closely with ADP centile values published for term infants from 36 to 38 wk of gestation. The medians were also similar to the mean values for the reference fetus derived from chemical analysis previously.
CONCLUSIONS
To our knowledge, these are the first body composition reference charts for total FM and FFM at birth in preterm infants to assist in following AAP guidelines. Future work will test the clinical utility of body composition monitoring for improving nutritional management in this population. This trial was registered at clinicaltrials.gov as NCT02855814.
Topics: Adipose Tissue; Anthropometry; Birth Weight; Body Composition; Body Fluid Compartments; Body Weights and Measures; Cross-Sectional Studies; Female; Fetus; Gestational Age; Humans; Infant, Newborn; Infant, Premature; Male; Plethysmography; Premature Birth; Reference Values
PubMed: 27806978
DOI: 10.3945/ajcn.116.138248 -
The AAPS Journal Sep 2006Analytical ultracentrifugation (AUC) and field flow fractionation (FFF) are 2 important biophysical methods for measuring protein aggregates. Both methods can separate... (Review)
Review
Analytical ultracentrifugation (AUC) and field flow fractionation (FFF) are 2 important biophysical methods for measuring protein aggregates. Both methods can separate protein monomer from its aggregate forms under a broad range of solution conditions. Recent advances in instrumentation and data analysis, particularly in the field of analytical ultracentrifugation technology, have significantly improved the capability and sensitivity of these biophysical methods for detecting protein aggregates. These advances have resulted in an increased use of these methods in the biopharmaceutical industry for characterization of therapeutic proteins. However, despite their many advantages over conventional methods, the difficulty in the use of the instrumentation and the complexity of data analysis process, have often hampered the widespread use and proper interpretation of data. This article reviews the recent progress in both technologies, and a few case studies are also presented to discuss their advantages and limitations.
Topics: Biological Products; Fractionation, Field Flow; Immunoglobulin G; Macromolecular Substances; Ultracentrifugation; Weights and Measures
PubMed: 17025276
DOI: 10.1208/aapsj080367 -
Disability and Rehabilitation Mar 2019We aimed to evaluate the construct validity of the Eating Assessment Tool (EAT-10) by determining its dimensionality, rating scale integrity, item-person match,...
PURPOSE
We aimed to evaluate the construct validity of the Eating Assessment Tool (EAT-10) by determining its dimensionality, rating scale integrity, item-person match, precision and relationship with the degree of airway invasion and functional oral intake.
METHODS
We conducted a retrospective analysis of patients' EAT-10 scores. We used the Rasch rating scale model. We investigated correlations between the EAT-10 and scores on the Penetration-Aspiration Scale (PAS) and Functional Oral Intake Scale (FOIS).
RESULTS
The median score of the EAT-10 from 127 patients was 16 of 40 (range 0-40). Confirmatory factor analysis supported unidimensionality. The 5-point rating scale categories met published criteria. Two items misfit the Rasch model and two other items displayed differential item functioning. Rasch person reliability was 0.79. Our patient cohort was divided into three person-strata. Correlations between the EAT-10 and the PAS and FOIS were weak to moderate in strength (respectively: r = 0.26, p = 0.0036; r = -0.27, p = 0.0027).
CONCLUSIONS
Our analyses identified deficits in the construct validity of the EAT-10 suggestive of a need to improve the EAT-10 to support its frequent use in clinical practice and research. Implications for Rehabilitation Swallowing disorders are associated with severe complications, such as pneumonia and malnutrition, and impose both social and psychological burdens on patients. The Eating Assessment Tool is a self-report instrument developed to estimate initial dysphagia severity and monitor change in patient-reported dysphagia symptoms as a response to treatment. This study shows that the Eating Assessment Tool has deficits in its construct validity and a need to improve the instrument to support its frequent use in clinical practice and research.
Topics: Adult; Deglutition Disorders; Disability Evaluation; Feeding and Eating Disorders; Female; Humans; Male; Middle Aged; Outcome Assessment, Health Care; Reproducibility of Results; Retrospective Studies; Self Report; Surveys and Questionnaires; Weights and Measures
PubMed: 29117726
DOI: 10.1080/09638288.2017.1398787 -
Bone & Joint Open May 2023Reimers migration percentage (MP) is a key measure to inform decision-making around the management of hip displacement in cerebral palsy (CP). The aim of this study is...
AIMS
Reimers migration percentage (MP) is a key measure to inform decision-making around the management of hip displacement in cerebral palsy (CP). The aim of this study is to assess validity and inter- and intra-rater reliability of a novel method of measuring MP using a smart phone app (HipScreen (HS) app).
METHODS
A total of 20 pelvis radiographs (40 hips) were used to measure MP by using the HS app. Measurements were performed by five different members of the multidisciplinary team, with varying levels of expertise in MP measurement. The same measurements were repeated two weeks later. A senior orthopaedic surgeon measured the MP on picture archiving and communication system (PACS) as the gold standard and repeated the measurements using HS app. Pearson's correlation coefficient (r) was used to compare PACS measurements and all HS app measurements and assess validity. Intraclass correlation coefficient (ICC) was used to assess intra- and inter-rater reliability.
RESULTS
All HS app measurements (from 5 raters at week 0 and week 2 and PACS rater) showed highly significant correlation with the PACS measurements (p < 0.001). Pearson's correlation coefficient (r) was constantly over 0.9, suggesting high validity. Correlation of all HS app measures from different raters to each other was significant with > 0.874 and p < 0.001, which also confirms high validity. Both inter- and intra-rater reliability were excellent with ICC > 0.9. In a 95% confidence interval for repeated measurements, the deviation of each specific measurement was less than 4% MP for single measurer and 5% for different measurers.
CONCLUSION
The HS app provides a valid method to measure hip MP in CP, with excellent inter- and intra-rater reliability across different medical and allied health specialties. This can be used in hip surveillance programmes by interdisciplinary measurers.
PubMed: 37212198
DOI: 10.1302/2633-1462.45.BJO-2023-0031.R1