Patient-Reported Outcomes in Male and Female Collegiate Soccer Players During an Athletic Season

Context: Clinicians are urged to document patient-based outcomes during rehabilitation to measure health-related quality of life (HRQOL) from the patient\u27s perspective. It is unclear how scores on patient-reported outcome instruments (PROs) vary over the course of an athletic season because of normal athletic participation. Objective: Our primary purpose was to evaluate the effect of administration time point on HRQOL during an athletic season. Secondary purposes were to determine test-retest reliability and minimal detectable change scores of 3 PROs commonly used in clinical practice and if a relationship exists between generic and region-specific outcome instruments. Design: Cross-sectional study. Setting: Athletic facility. Patients or Other Participants: Twenty-three collegiate soccer athletes (11 men, 12 women). Main Outcome Measure(s): At 5 time points over a spring season, we administered the Disablement in the Physically Active Scale (DPA), Foot and Ankle Ability Measure-Sport, and Knee Injury and Osteoarthritis Outcome Score (KOOS). Results: Time effects were observed for the DPA (P = .011) and KOOS Quality of Life subscale (P = .027). However, the differences between individual time points did not surpass the minimal detectable change for the DPA, and no post hoc analyses were significant for the KOOS-Quality of Life subscale. Test-retest reliability was moderate for the KOOS-Pain subscale (intraclass correlation coefficient = 0.71) and good for the remaining KOOS subscales, DPA, and Foot and Ankle Ability Measure-Sport (intraclass correlation coefficients \u3e 0.79). The DPA and KOOS-Sport subscale demonstrated a significant moderate relationship (P = .018). Conclusions: Athletic participation during a nontraditional, spring soccer season did not affect HRQOL. All 3 PROs were reliable and could be used clinically to monitor changes in health status throughout an athletic season. Our results demonstrate that significant deviations in scores were related to factors other than participation, such as injury. Finally, both generic and region-specific instruments should be used in clinical practice

Athletic Training Student Core Competency Implementation During Patient Encounters

Context: Health care research evidence suggests that early patient encounters (PEs), as well as the purposeful implementation of professional core competencies (CCs), for athletic training students (ATSs) may be beneficial to their ability to provide care. However, no investigators have related facets of the clinical education experience with CC implementation as a form of summative assessment of the clinical experience. Objective: To determine the relationship between the frequency and length of PEs, as well as the student\u27s role and clinical site during PEs, and the students\u27 perceived CC implementation during these encounters. Design: Cross-sectional study. Setting: Professional athletic training program, National Collegiate Athletic Association Division I institution. Patients or Other Participants: We purposefully recruited 1 athletic training program that used E*Value software; 40 participants (31 females, 9 males) enrolled in the professional phase (12 first year, 14 second year, 14 third year) participated. Intervention(s): Participants viewed a 20-minute recorded CC educational module followed by educational handouts, which were also posted online for reference throughout the semester. The E*Value software was used to track PEs, including the type of encounter (ie, actual patient, practice encounter, didactic practice scenario), the type of site where the encounter occurred (university, high school), and the participant\u27s role (observed, assisted, performed), as well as responses to an added block of questions indicating which, if any, of the CCs were implemented during the PE. Main Outcome Measure(s): Variables per patient were PE length (minutes), participant role, site at which the encounter occurred, and whether any of the 6 CCs were implemented (yes/no). Variables per participant were average encounter length (minutes), encounter frequency, modal role, clinical site assignment, and the number of times each CC was implemented. Separate 1-way analyses of variance were used to examine the relationships between role or clinical site and implementation of total number of CCs. Multiple linear regressions were used to determine how the average length and frequency of PEs were related to the average and total number of implemented CCs. Binary logistic regression models indicated how the length of each encounter, role of the participant, and type of clinical site related to the implementation of each CC. Results:  The roles of participants during PEs were related to their ability to implement the total number of CCs (F = 103.48, P \u3c .001). Those who observed were likely to implement fewer total CCs than those who assisted (M diff = −0.29, P \u3c .001); those who assisted were likely to implement more total CCs than those who performed (M diff = 0.32, P \u3c .001). Frequency of encounters was the only significant variable in the model examining all independent variables with CC implementation (b4,32= 3.34, t = 9.46, P \u3c .001). Conclusions:  The role of the student, namely assisting during PEs, and the volume of PEs should be considered priorities for students to promote greater CC implementation

Two-week joint mobilization intervention improves self-reported function, range of motion, and dynamic balance in those with chronic ankle instability

We examined the effect of a 2-week anterior-to-posterior ankle joint mobilization intervention on weight-bearing dorsiflexion range of motion (ROM), dynamic balance, and self-reported function in subjects with chronic ankle instability (CAI). In this prospective cohort study, subjects received six Maitland Grade III anterior-to-posterior joint mobilization treatments over 2 weeks. Weightbearing dorsiflexion ROM, the anterior, posteromedial, and posterolateral reach directions of the Star Excursion Balance Test (SEBT), and self-reported function on the Foot and Ankle Ability Measure (FAAM) were assessed 1 week before the intervention (baseline), prior to the first treatment (pre-intervention), 24–48 h following the final treatment (post-intervention), and 1 week later (1-week follow-up) in 12 adults (6 males and 6 females) with CAI. The results indicate that dorsiflexion ROM, reach distance in all directions of the SEBT, and the FAAM improved (p < 0.05 for all) in all measures following the intervention compared to those prior to the intervention. No differences were observed in any assessments between the baseline and pre-intervention measures or between the postintervention and 1-week follow-up measures (p > 0.05). These results indicate that the joint mobilization intervention that targeted posterior talar glide was able to improve measures of function in adults with CAI for at least 1 week

Neonatal Hypoglycemia in Diabetic Mothers: a Systematic Review

Hypoglycemia occurs in approximately 8-30% of neonates born to mothers with diabetes. The full extent of the individual and contextual risk factors of hypoglycemia remains unclear and no systematic review of the available studies exists to date. We identified published studies using PubMed and EBSCO host search engines. A modified STROBE statement was used to assess studies\u27 strengths, weaknesses, and generalizability. A total of 16 articles were eligible for full text review. The clinical risk factors in these studies were broadly classified into two: infant-related and mother-related risk factors. The identified infant-related risk factors were SGA, macrosomia, prematurity, lower cord blood glucose, ponderal index and male sex. On the other hand, mother-related risk factors includes maternal hyperglycemia, ethnic origin, diabetes diagnosed prior to 28 weeks of gestation, pre-pregnancy BMI of ≥ 25 kg/m², blood glucose, maternal diabetes type and maternal HbA1c. Irrespective of diabetes type, infants born to diabetic mothers appear to have a higher risk of developing hypoglycemia compare to those born to normal mothers. The overall evidence suggested that these studies mainly focus on the clinical characteristics of infants and mothers. Future research should focus on the identification of risk factors at the individual and contextual levels that can independently predict neonatal hypoglycemia. Appropriate emphasis should also be given to better define neonatal hypoglycemia

Opioid and Non-Opioid Prescribing Rates for Ankle Fractures in Emergency Departments across the United States between 2006 and 2015

This presentation describes the percentage of patients prescribed a controlled and non-controlled medication in an United States Emergency Department for a diagnosed ankle fracture

A Nation-Wide Survey of High School Baseball Coaches’ Perceptions Indicates Their Arm Care Programs Play a Role in Injury Prevention

Background Arm care programs consisting of upper extremity strengthening and stretching have been recommended for injury prevention for pitchers of all ages. There has been no investigation into high school baseball coaches’ usage and perceptions of arm care programs to mitigate physical impairments associated with injuries in baseball players. Hypothesis/Purpose The purpose of this study was to investigate the current usage of arm care programs by high school baseball coaches. The primary objective was to determine if coaches use group-based or individualized arm care programs. The secondary objective sought to determine if the use of arm care programs is influenced by coaches’ age, education, and experience level. Finally, this study explored the potential barriers to arm care implementation and high school baseball coaches’ current awareness and beliefs of injury prevention. Study Design Descriptive cross-sectional survey Methods A 29-item online survey was emailed to 18,500 high school baseball coaches throughout the United States. Data were collected for three months, and the response rate was 3.7%. Results A total of 87.3% (n=571/654) of responding coaches use arm care programs with their players. Of coaches performing arm care, only 18.5% of 571 individualize their arm care exercises based on specific player needs. However, older and more experienced coaches are more likely to individualize their programs. Among the 12.7% (n=83/654) of coaches who do not use arm care programs, the two most commonly cited reasons for not implementing arm care were lack of observed benefit (41%) and insufficient staff (31%). Although 42% of 654 coaches recognized reduced shoulder mobility as a major contributor to injury, risk factors such as throwing with a fatigued arm, previous injury history, and throwing \u3e 8 months per year were not consistently identified as primary risk factors. Conclusion The results of this study suggest that the majority high school baseball coaches implement group-based arm care exercise programs to prevent injury. Lack of confidence in the effectiveness and staffing limitations were major barriers to implementation of arm care programming. However, the responding coaches exhibited inconsistent risk factor awareness and dated injury prevention beliefs. Therefore, better educational collaboration between rehabilitation professionals and high school coaches regarding injury risk factors and preventative strategies is warranted. Level of Evidence Level

Erratum: Oral salt and water versus intravenous saline for the prevention of acute kidney injury following contrast-enhanced computed tomography: study protocol for a pilot randomized trial Salmonella blood stream infections in a tertiary care setting in Ghana.

[This corrects the article DOI: 10.1186/s40697-015-0048-7.]

NUScon: a community-driven platform for quantitative evaluation of nonuniform sampling in NMR

Although the concepts of nonuniform sampling (NUS) and non-Fourier spectral reconstruction in multidimensional NMR began to emerge 4 decades ago (Bodenhausen and Ernst, 1981; Barna and Laue, 1987), it is only relatively recently that NUS has become more commonplace. Advantages of NUS include the ability to tailor experiments to reduce data collection time and to improve spectral quality, whether through detection of closely spaced peaks (i.e., “resolution”) or peaks of weak intensity (i.e., “sensitivity”). Wider adoption of these methods is the result of improvements in computational performance, a growing abundance and flexibility of software, support from NMR spectrometer vendors, and the increased data sampling demands imposed by higher magnetic fields. However, the identification of best practices still remains a significant and unmet challenge. Unlike the discrete Fourier transform, non-Fourier methods used to reconstruct spectra from NUS data are nonlinear, depend on the complexity and nature of the signals, and lack quantitative or formal theory describing their performance. Seemingly subtle algorithmic differences may lead to significant variabilities in spectral qualities and artifacts. A community-based critical assessment of NUS challenge problems has been initiated, called the “Nonuniform Sampling Contest” (NUScon), with the objective of determining best practices for processing and analyzing NUS experiments. We address this objective by constructing challenges from NMR experiments that we inject with synthetic signals, and we process these challenges using workflows submitted by the community. In the initial rounds of NUScon our aim is to establish objective criteria for evaluating the quality of spectral reconstructions. We present here a software package for performing the quantitative analyses, and we present the results from the first two rounds of NUScon. We discuss the challenges that remain and present a roadmap for continued community-driven development with the ultimate aim of providing best practices in this rapidly evolving field. The NUScon software package and all data from evaluating the challenge problems are hosted on the NMRbox platform