Limitations Of Administrative Databases In Orthopaedic Surgery Research: A Study In Obesity And Anemia

The use of national inpatient databases for orthopaedic surgery research has been increasing. However, large databases that rely on administrative data, such as International Classification of Diseases Ninth Revision (ICD-9) codes, may misrepresent patient information, thus affecting the results of studies using this data. The present study uses easily quantified and objective variables of obesity and anemia as example comorbidities to assess the accuracy of ICD-9 codes in the setting of their continued use in orthopaedic surgery database studies. For each study arm, a large inpatient population was obtained from the Yale-New Haven hospital. Each patient\u27s medical record was reviewed, and the presence of ICD-9 discharge codes for obesity and anemia was directly compared to documented body mass index (BMI) and preoperative hematocrit, respectively. ICD-9 discharge codes for both non-morbid obesity and anemia had a sensitivity of just 0.19. The sensitivity of the ICD-9 code for morbid obesity was 0.48. Using obesity and anemia as examples, this study highlights the potential errors inherent to ICD-9 codes. This calls into serious question the utility of administrative databases for research purposes. Moreover, it is likely that these inaccuracies apply to additional variables as well. As database research continues to increase within orthopaedic surgery, it is important to realize that study outcomes can be skewed by data accuracy, and thus should not be blindly accepted simply by virtue of large sample sizes

Pediatric Burn Management: Examining Efficacy and Affordability

Our research was led by Kelly Culhane, OTR/L, at California Children Services (CCS), in searching for efficacious and cost-effective occupational therapy treatments, or sequences of treatments, in chronic pediatric (ages 3-21) burn scar management. The primary outcomes following burn scar treatment are to increase functionality, mobility, well-being, and to improve the physical appearance of the scars. Research suggests that exercise, massage, silicon gel, and silicon patches can all be used as occupational therapy treatment for burn scars. Unstructured massages and silicon patches were found to be the most cost-effective solutions, resulting in less itch and scar vascularity, and increased range of motion of the burn scar sites. Additionally, completion of exercise programs were found to lead to fewer surgeries to improve functionality of burn scars. Because burn scars are infrequently seen by pediatric occupational therapists, a website page was created on burn scarring information and treatment for practitioners who may not have much exposure to burn scar treatment. The impact of the website page was measured by counting visits to the site in its two week launch period; the site acquired a total of 107 views in March and April of 2023, with 71 views in March and 36 views in April. Although treatment recommendations were based upon the most current published research, a limitation to this review was the scant number of studies on burn scar treatments, specifically in the pediatric population. Future studies focused on the pediatric population and how they best respond to various burn scar treatments would be beneficial for enhancing evidenced-based interventions

Étude sur les puissances opératives dans la doctrine de St Thomas

Thèse de doctorat -- Université catholique de Louvain, 191

The selection of children\u27s literature for teaching values and ethics through use of art forms

Values and ethics taught through children\u27s literature can be effective in helping develop good character in students. Actively involving children in learning through art forms helps increase meaning and understanding. Art forms such as creative dramatization, pantomime, creative interpretation, role playing, and reader\u27s theater are concrete learning strategies that extend children\u27s literature. With these hands-on strategies, the outcome is that children will remember the values learned through children\u27s literature and apply them in their own life. This study is designed to select children\u27s literature for teaching ethics and values through use of art forms. The purpose is to answer the following questions: 1. Which children\u27s literature can be used to teach ethics and values? 2. Of that literature (selected for #1), which children\u27s literature can be used to teach ethics and values through use of art forms? The methodologies used are a literature review of relevant research articles and an analysis of children\u27s literature for elementary grade levels (k-6) related to this topic. In the studies reviewed, researchers examine ethics and values in children\u27s literature and the use of art forms. First, books are selected that meet criteria for quality children\u27s literature; then, criteria for ethics and values; finally, criteria for art forms. From the data and children\u27s literature reviewed, specific examples of children\u27s literature, with listed values and suggested art forms, are categorized by genre and presented as a selection of children\u27s literature for teaching values and ethics through use of art forms

Are dates processed like words rather than like numbers? A study of transposition priming effects

Neuropsychological case-studies suggested that dates and encyclopedic numbers may be processed differently than unknown numbers. However, this issue was not yet investigated in reading in healthy participants, so that it is unclear if dates are read like words and processed as lexical items, or like numbers where each position strictly defines the digit value in a base-10 system. Here, we compared processing of known dates to unknown numbers in a group of 26 experts (students and teachers in History). Participants performed an explicit recognition task on dates (e.g., 1789, 1945, …) and on acronyms (e.g., FNRS, HDMI, …), half known and half unknown. They were preceded by an identical prime (e.g., 1945-1945), a transposed-character prime (e.g., 1495-1945) or a substituted-character prime (e.g., 1635-1945). Results show that for dates, there is a significant transposition gain (-57ms), while for unknown numbers as well as for acronyms (known and unknown), the transposed-character prime induced a cost (from +17 to +257ms) rather than a gain. The facilitation due to transposed characters found here on dates is similar to what is observed in studies of lexical decision on words. Therefore, it suggests that dates may be processed with similar types of orthographical mechanisms than words