Anthropometrics

This document summarizes the rationale, equipment, measurement, protocol and data cleaning procedures for each of the anthropometric measures collected at Wave V. It also documents how constructed variables were derived from the anthropometric measures collected in the field. Whenever possible, data collection and methods in Wave V mirrored those of Wave IV to ensure comparability of data between waves. This document is one in a set of Wave V user guides

The Telehealth Skills, Training, and Implementation Project: An evaluation protocol

External stabilization is reported to improve reliability of hand held dynamometry, yet this has not been tested in burns. We aimed to assess the reliability of dynamometry using an external system of stabilization in people with moderate burn injury and explore construct validity of strength assessment using dynamometry. Participants were assessed on muscle and grip strength three times on each side. Assessment occurred three times per week for up to four weeks. Within session reliability was assessed using intraclass correlations calculated for within session data grouped prior to surgery, immediately after surgery and in the sub-acute phase of injury. Minimum detectable differences were also calculated. In the same timeframe categories, construct validity was explored using regression analysis incorporating burn severity and demographic characteristics. Thirty-eight participants with total burn surface area 5 – 40% were recruited. Reliability was determined to be clinically applicable for the assessment method (intraclass correlation coefficient \u3e0.75) at all phases after injury. Muscle strength was associated with sex and burn location during injury and wound healing. Burn size in the immediate period after surgery and age in the sub-acute phase of injury were also associated with muscle strength assessment results. Hand held dynamometry is a reliable assessment tool for evaluating within session muscle strength in the acute and sub-acute phase of injury in burns up to 40% total burn surface area. External stabilization may assist to eliminate reliability issues related to patient and assessor strength

Ten Years of Experience Training Non-Physician Anesthesia Providers in Haiti.

Surgery is increasingly recognized as an effective means of treating a proportion of the global burden of disease, especially in resource-limited countries. Often non-physicians, such as nurses, provide the majority of anesthesia; however, their training and formal supervision is often of low priority or even non-existent. To increase the number of safe anesthesia providers in Haiti, Médecins Sans Frontières has trained nurse anesthetists (NAs) for over 10 years. This article describes the challenges, outcomes, and future directions of this training program. From 1998 to 2008, 24 students graduated. Nineteen (79%) continue to work as NAs in Haiti and 5 (21%) have emigrated. In 2008, NAs were critical in providing anesthesia during a post-hurricane emergency where they performed 330 procedures. Mortality was 0.3% and not associated with lack of anesthesiologist supervision. The completion rate of this training program was high and the majority of graduates continue to work as nurse anesthetists in Haiti. Successful training requires a setting with a sufficient volume and diversity of operations, appropriate anesthesia equipment, a structured and comprehensive training program, and recognition of the training program by the national ministry of health and relevant professional bodies. Preliminary outcomes support findings elsewhere that NAs can be a safe and effective alternative where anesthesiologists are scarce. Training non-physician anesthetists is a feasible and important way to scale up surgical services resource limited settings

Renal Function

This document summarizes the rationale, equipment, protocol, assay, internal quality control, data cleaning, external quality control, and procedures for the measurement and classification of kidney (renal) function at the Wave V home exam. Whenever possible, data collection and methods in Wave V mirrored those of Wave IV to ensure comparability of data between waves, although important inter-Wave differences exist and are grey highlighted herein. This document is one in a set of Wave V user guides

Measures of Inflammation and Immune Function

This document summarizes the rationale, equipment, protocol assays, internal quality control, data cleaning, external quality control, and procedures for the measurement and classification of inflammation at the Wave V home exam. Whenever possible, data collection and methods in Wave V mirrored those of Wave IV to ensure comparability of data between waves, although important inter-Wave differences exist and are grey-highlighted herein. This document is one in a set of Wave V user guides

Measures of Inflammation and Immune Function

This document summarizes the rationale, equipment, protocol assays, internal quality control, data cleaning, external quality control, and procedures for the measurement and classification of inflammation at the Wave V home exam. Whenever possible, data collection and methods in Wave V mirrored those of Wave IV to ensure comparability of data between waves, although important inter-Wave differences exist and are grey-highlighted herein. This document is one in a set of Wave V user guides. User guides are also available to describe protocols for the following biological measures in Wave V: Anthropometrics, Cardiovascular Measures, Medication Use – Home Exam, Baroreflex Sensitivity & Hemodynamic Recovery, Glucose Homeostasis, Lipids, Renal Function Additional assays were subsequently performed using archived blood samples from Wave V to mirror those measures that will be analyzed in Add Health Wave VI. None of these additional assays were performed during Wave IV. Those user guides include: Hepatic Injury, Neurodegeneratio

Lipids

This document summarizes the rationale, equipment, protocol, assay, internal quality control, data cleaning, external quality control, and procedures for the measurement and classification of lipid concentrations at the Wave V home exam. Whenever possible, data collection and methods in Wave V mirrored those of Wave IV to ensure comparability of data between waves, although important inter-Wave differences exist and are grey-highlighted herein. This document is one in a set of Wave V user guides