The Functional Movement Screen Is Not A Valid Measure of Movement Competency

Movement assessments are used to determine injury risk, physical competency, and return-to-activity. The Functional Movement Screen (FMS) was developed to identify movement competency and susceptibility to injury. Although this tool is frequently used, its efficacy and validity have not been conclusively determined. The three studies presented in this thesis explored the validity of the FMS through comparison to existing validated tests and statistical measures of internal validity. The purpose of Study 1 was to determine if performance in the FMS and the Y-Balance Test (YBT) were related. The YBT is a measure of dynamic stability, a component of functional movement. This study showed partial correspondence between the tests, though the correlation was not strong enough to consider them interchangeable nor that dynamic stability was a large component of the FMS score The purpose of Study 2 was to investigate the factorial validity of the FMS. This is particularly important as the aggregate score of the FMS test is used to determine injury risk. Exploratory factor analysis of a sample of healthy adults revealed that the FMS has a multidimensional factor structure, and therefore using the aggregate score of the FMS is not appropriate. The purpose of Study 3 was to assess whether the factor structure of the FMS is consistent across different populations. We compared exploratory factor analyses and factor congruence of the FMS in a general population sample, varsity athletes, and firefighters. We observed a two-factor structure that varied in composition between groups, suggesting that the factor structure of the FMS may differ, according to population. Overall, this thesis determined that the aggregate score of the FMS is not a valid tool for evaluating functional movement. Although the FMS does appear to partially quantify dynamic stability, it is also characterized by a lack of consistency between populations, and a multidimensional factor structure. This suggests that the aggregate score should not be used to interpret an individual’s movement proficiency or susceptibility to injury

Resource allocation and health technology assessment in Australia: Views from the local level

Objectives: Several studies have shown that a key determinant of successful health technology assessment (HTA) uptake is a clear, fair, and consistent decision-making process for the approval and introduction of health technologies. The aim of this study was to gauge healthcare providers' and managers' perceptions of local level decision making and determine whether these processes offer a conducive environment for HTA. An Area Health Service (AHS) aimed to use the results of this study to help design a new process of technology assessment and decision making. Methods: An online survey was sent to all health service managers and healthcare providers working in one AHS in Sydney, Australia. Questions related to perceptions of current health technology decisions in participants' own institution/facility and opinions on key criteria for successful decision-making processes. Results: Less than a third of participants agreed with the statements that local decision-making processes were appropriate, easy to understand, evidence-based, fair, or consistently applied. Decisions were reportedly largely influenced by total cost considerations as well as by the central state health departments and the Area executive. Conclusions: Although there are renewed initiatives in HTA in Australia, there is a risk that such investments will not be productive unless policy makers also examine the decision-making contexts within which HTA can successfully be implemented. The results of this survey show that this is especially true at the local level and that any HTA initiative should be accompanied by efforts to improve decision-making processes. Copyright © 2009 Cambridge University Press

Assessing the Correlation of Microscopy-based and Volumetry-based Measurements for Resin Swelling in a Range of Potential Greener Solvents for SPPS

The degree of resin swelling in a particular solvent system is one of the critical parameters for SPPS, and for solid phase synthesis, in general. Methods used for measuring the degree of resin swelling include microscopy-based and volumetry-based methods. This study describes, and compares, the use of both methods for a number of commercially available resins commonly used in SPPS, with a range of solvents which have been identified in the literature as “greener” than DCM, DMF and NMP. The results were analysed by statistical methods and a significant correlation between the two distinct methods has been demonstrated for the first time. The results will likely be used, in conjunction with other literature methods, to help in choosing both the resin and solvent system for greener SPPS (GSPPS), as well as for continuous flow SPPS, which is of growing importance

Differential effects of insulin signaling on individual carbon fluxes for fatty acid synthesis in brown adipocytes

Considering the major role of insulin signaling on fatty acid synthesis via stimulation of lipogenic enzymes, differential effects of insulin signaling on individual carbon fluxes for fatty acid synthesis have been investigated by comparing the individual lipogenic fluxes in WT and IRS-1 knockout (IRS-1 KO) brown adipocytes. Results from experiments on WT and IRS-1 KO cells incubated with [5-¹³C] glutamine were consistent with the existence of reductive carboxylation pathway. Analysis of isotopomer distribution of nine metabolites related to the lipogenic routes from glucose and glutamine in IRS-1 KO cells using [U-¹³C] glutamine as compared to that in WT cells indicated that flux through reductive carboxylation pathway was diminished while flux through conventional TCA cycle was stimulated due to absence of insulin signaling in IRS-1 KO cells. This observation was confirmed by quantitative estimation of individual lipogenic fluxes in IRS-1 KO cells and their comparison with fluxes in WT cells. Thus, these results suggest that glutamine’s substantial contribution to fatty acid synthesis can be directly manipulated by controlling the flux through reductive carboxylation of alpha-ketoglutarate to citrate using hormone (insulin).Singapore-MIT Alliance (SMA

Disparate responses of tumour vessels to angiotensin II: tumour volume-dependent effects on perfusion and oxygenation

Perfusion and oxygenation of experimental tumours were studied during angiotensin II (AT II) administration whereby the rate of the continuous AT II infusion was chosen to increase the mean arterial blood pressure (MABP) by 50–70 mmHg. In subcutaneous DS- sarcomas the red blood cell (RBC) flux was assessed using the laser Doppler technique and the mean tumour oxygen partial pressure (p O 2) was measured polarographically using O 2-sensitive catheter and needle electrodes. Changes in RBC flux with increasing MABP depended mainly on tumour size. In small tumours, RBC flux decreased with rising MABP whereas in larger tumours RBC flux increased parallel to the MABP. As a result of these volume-dependent effects on tumour blood flow, the impact of AT II on tumour p O 2 was also mainly tumour volume-related. In small tumours oxygenation decreased with increasing MABP during AT II infusion, whereas in large tumours a positive relationship between blood pressure and O 2 status was found. This disparate behaviour might be the result of the co-existence of two functionally distinct populations of tumour vessels. In small tumours, perfusion decreases presumably due to vasoconstriction of pre-existing host vessels feeding the tumour. In larger malignancies, newly formed tumour vessels predominate and seem not to have this vasoresponsive capability (lack of smooth muscle cells and/or AT receptors), resulting in an improvement of perfusion which is not tumour-related per se, but is due to the increased perfusion pressure. © 2000 Cancer Research Campaig

The score is not the music: integrating experience-based and practice-based perspectives on value co-creation in collective consumption contexts

In response to recent calls for deeper understanding of value co-creation between multiple actors, this article explores co-creation in collective consumption contexts. These are defined as settings within which multiple consumers, and optionally multiple other actors such as service personnel, are co-present (physically and/or virtually) and coordinate with one another during product/service consumption. To understand co-creation in such contexts, the article argues for an integration of practice-based and experience-based perspectives, because while collective coordination occurs via social practices, the value that results is by definition an individual experience. By studying an orchestral music context in which multiple consumers and service providers participate, the authors develop a framework dialectically relating co-creation practices to value. Four variables emerge influencing the relationship between co-creation practices and value: role rigidity, consumer heterogeneity conflict, participation access, and signposting. Value can be constrained by role rigidity and by consumer heterogeneity conflict between consumers of differing competence; mitigating this requires that service providers pay attention to participation access and signposting (guiding consumers to select and combine practices in line with their skills and competences). Overall, the findings show how practices shape not just coordination among consumers, but also social learning. Implications for service organizations include how to facilitate social learning between novices and experts so as to optimize value for all