Language Assessment in a Snap: Monitoring Progress Up to 36 Months

This article describes the development and validation of the Developmental Snapshot, a 52-item parent questionnaire on child language and vocal communication development that can be administered monthly and scored automatically. The Snapshot was created to provide an easily administered monthly progress monitoring tool that enables parents to better recognize language milestones and offers professionals prompt information to fine-tune intervention strategies. Initial items were piloted by 15 families; refinement and further development of the instrument was conducted with parents of 308 typically developing children. Reliability and criterion validity metrics were examined on subsets of approximately 60 children who completed the Snapshot on a monthly basis and who were evaluated on standard assessments administered by speech language pathologists (SLPs). Divergent validity was also examined for samples of children diagnosed with language delays related to autism spectrum disorder (ASD) (n = 77) or not (n = 49). Results supported the criterion validity (r = .67–.97) and test–retest reliability claims of the Snapshot (r = .95). Sensitivity and specificity for language delay detection also were good at 87%. Potential applications for progress monitoring, fidelity of intervention, and enhancing parents’ awareness of their child’s language and vocal communication changes are discussed

Orthopaedic provider perceptions of virtual care : which providers prefer virtual care?

AIMS: The purpose of our study was to determine which groups of orthopaedic providers favour virtual care, and analyze overall orthopaedic provider perceptions of virtual care. We hypothesize that providers with less clinical experience will favour virtual care, and that orthopaedic providers overall will show increased preference for virtual care during the COVID-19 pandemic and decreased preference during non-pandemic circumstances. METHODS: An orthopaedic research consortium at an academic medical system developed a survey examining provider perspectives regarding orthopaedic virtual care. Survey items were scored on a 1 to 5 Likert scale (1 = strongly disagree , 5 = strongly agree ) and compared using nonparametric Mann-Whitney U test. RESULTS: Providers with less experience were more likely to recommend virtual care for follow-up visits (3.61 on the Likert scale (SD 0.95) vs 2.90 (SD 1.23); p = 0.006) and feel that virtual care was essential to patient wellbeing (3.98 (SD 0.95) vs 3.00 (SD 1.16); p \u3c 0.001) during the pandemic. Less experienced providers also viewed virtual visits as providing a similar level of care as in-person visits (2.41 (SD 1.02) vs 1.76 (SD 0.87); p = 0.006) and more time-efficient than in-person visits (3.07 (SD 1.19) vs 2.34 (SD 1.14); p = 0.012) in non-pandemic circumstances. During the pandemic, most providers viewed virtual care as effective in providing essential care (83.6%, n = 51) and wanted to schedule patients for virtual care follow-up (82.2%, n = 50); only 10.9% (n = 8) of providers preferred virtual visits in non-pandemic circumstances. CONCLUSION: Orthopaedic providers with less clinical experience seem to favourably view virtual care both during the pandemic and under non-pandemic circumstances. Providers in general appear to view virtual care positively during the pandemic but are less accommodating towards it in non-pandemic circumstances

Manufacturing Workers Have a Higher Incidence of Carpal Tunnel Syndrome

OBJECTIVE: It is unclear whether clerical or labor-type work is more associated with risk for developing work-related carpal tunnel syndrome (WrCTS). METHODS: National employment, demographic, and injury data were examined from the Bureau of Labor Statistics databases for the years 2003 to 2018. Injuries for clerical and labor industries were compared using linear regression, two-group t test, and one-way analysis of variance (ANOVA) analysis. RESULTS: WrCTS injuries are decreasing over time (B = -1002.62, P \u3c 0.001). The labor industry demonstrated a significantly higher incidence of WrCTS when compared with the clerical industries (P \u3c 0.001). Within labor industries, the manufacturing industry had the highest incidence of WrCTS over time (P \u3c 0.001). CONCLUSIONS: Our study showed WrCTS injuries have declined over time. Additionally, our findings may suggest that the labor industry has a stronger association with WrCTS than the clerical industry

Are orthopaedic providers willing to work overtime to address COVID-19-related patient backlogs and financial deficits?

AIMS: COVID-19-related patient care delays have resulted in an unprecedented patient care backlog in the field of orthopaedics. The objective of this study is to examine orthopaedic provider preferences regarding the patient care backlog and financial recovery initiatives in response to the COVID-19 pandemic. METHODS: An orthopaedic research consortium at a multi-hospital tertiary care academic medical system developed a three-part survey examining provider perspectives on strategies to expand orthopaedic patient care and financial recovery. Section 1 asked for preferences regarding extending clinic hours, section 2 assessed surgeon opinions on expanding surgical opportunities, and section 3 questioned preferred strategies for departmental financial recovery. The survey was sent to the institution\u27s surgical and nonoperative orthopaedic providers. RESULTS: In all, 73 of 75 operative (n = 55) and nonoperative (n = 18) providers responded to the survey. A total of 92% of orthopaedic providers (n = 67) were willing to extend clinic hours. Most providers preferred extending clinic schedule until 6pm on weekdays. When asked about extending surgical block hours, 96% of the surgeons (n = 53) were willing to extend operating room (OR) block times. Most surgeons preferred block times to be extended until 7pm (63.6%, n = 35). A majority of surgeons (53%, n = 29) believe that over 50% of their surgical cases could be performed at an ambulatory surgery centre (ASC). Of the strategies to address departmental financial deficits, 85% of providers (n = 72) were willing to work extra hours without a pay cut. CONCLUSION: Most orthopaedic providers are willing to help with patient care backlogs and revenue recovery by working extended hours instead of having their pay reduced. These findings provide insights that can be incorporated into COVID-19 recovery strategies. Level of Evidence: II

Upper-Extremity Injuries are the 2nd Most Common Workplace Injuries from 1992 to 2018

Musculoskeletal injuries occur frequently in the workplace, yet it is unclear whether upper-extremity, lower-extremity, or trunk injuries are the most prevalent. We hypothesize that: (1) trunk injuries are the most common in the overall workplace, and (2) upper-extremity injuries are more common in labor-based industries than non-labor industries. Workplace related injury data from 1992 to 2018 was collected from the Bureau of Labor Statistics “Workplace Injuries & Illnesses” database. Occurrence of trunk, upper-extremity, and lower-extremity injuries in major industries (agriculture, construction, manufacturing, and healthcare) were aggregated during this time period and compared. Overall workplace related injury occurrence in major industries from 1992 to 2018 for the following body regions were tabulated as follows: upper-extremity (4,471,340 cases), lower-extremity (3,296,547 cases), and trunk (5,889,940 cases) (p\u3c.05). Upper-extremity injury incidence was observed to be significantly higher than lower-extremity injury incidence in the manufacturing industry (p\u3c.001) and significantly lower than trunk injury incidence in the healthcare industry (p\u3c.001). However, differences between upper-extremity injury incidence and both lower-extremity and trunk injury incidence were not significant for the other industries. When comparing the occurrence of upper-extremity injuries across industries from 1992 to 2018, significant differences were determined between all industries except for healthcare (p\u3c.001). When identifying changes in injury occurrence in each respective industry across this time span, manufacturing was shown to have the largest decrease (x=-5,432, r=-.91) followed by construction (x=-966, r=-.87) and then agriculture (x=-270, r=-.79). Weak correlation was observed for healthcare (x=118, r=.15)