Using the Ages and Stages Questionnaire to teach medical students developmental assessment: a descriptive analysis

BACKGROUND: After a survey of medical graduates' skills found a lack of confidence in developmental assessment, a program was introduced with the broad aims of increasing medical student confidence and respect for the parents' role in childhood developmental assessment. Research has shown that parents' concerns are as accurate as quality screening tests in assessing development, so the program utilised the Ages and Stages Questionnaire, a parent completed, child development assessment tool. METHOD: To evaluate the program, an interpretative analysis was completed on the students' reports written during the program and a questionnaire was administered to the parents to gain their perception of the experience. As well, student confidence levels in assessing growth and development were measured at the end of the paediatric term. RESULTS: Although there was an increase in student confidence in developmental assessment at the end of the term, it was not statistically significant. However the findings indicated that students gained increased understanding of the process and enhanced recognition of the parental role, and the study suggested there was increased confidence in some students. Parents indicated that they thought they should be involved in the teaching of students. CONCLUSION: The ASQ was shown to have been useful in an education program at the level of advanced beginners in developmental assessment

Rationale, design and protocol of a longitudinal study assessing the effect of total knee arthroplasty on habitual physical activity and sedentary behavior in adults with osteoarthritis

Background: Physical activity levels are decreased and sedentary behaviour levels are increased in patients with knee osteoarthritis (OA). However, previous studies have shown that following total knee arthroplasty (TKA), objectively measured physical activity levels do not change compared to before the surgery. Very few studies have objectively assessed sedentary behaviour following TKA. This study aims to assess patterns of objective habitual physical activity and sedentary behaviour in patients with knee OA and to determine whether these change following TKA. Methods: Patients diagnosed with knee osteoarthritis and scheduled for unilateral primary total knee arthroplasty will be recruited from the Orthopaedic Division at the Charlotte Maxeke Johannesburg Academic Hospital. Eligible participants will have assessments completed one week before the scheduled arthroplasty, six weeks, and six months post-operatively. The primary outcomes are habitual physical activity and sedentary behaviour which will be measured using accelerometry (Actigraph GTX3+ and activPal monitors) at the specific time points. The secondary outcomes will be improvements in osteoarthritis-specific quality of life measures using the following questionnaires: Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Knee injury and Osteoarthritis Outcome Score (KOOS), Oxford Knee Score (OKS), Knee Society Clinical Rating System (KSS), UCLA activity index; subjective pain scores, and self reported sleep quality.Discussion: The present study will contribute to the field of musculoskeletal health by providing a rich detailed description of the patterns of accumulation of physical activity and sedentary behaviour in patients with knee OA. These data will contribute to existing knowledge using an objective measurement for the assessment of functional ability after total knee arthroplasty. Although studies have used accelerometry to measure physical activity in knee OA patients, the data provided thus far have not delved into the detailed patterns of how and when physical activity is accumulated before and after TKA. Accurate assessment of physical activity is important for physical activity interventions that target special populations

It's like being in another world--patients' lived experience of magnetic resonance imaging.

Aim. The aim of this study was to illuminate patients' lived experience during magnetic resonance imaging. Background. Magnetic resonance imaging has increased in importance since the early 1980s and is today a common useful diagnostic tool. Although magnetic resonance imaging are non-invasive and considered painless, many patients experience anxiety, sometimes so strong that the scan has to be terminated. Design and methods. The study had an inductive design and a hermeneutic phenomenological methodology was used. Results. The essential theme of going through magnetic resonance imaging was a feeling of being in another world. The strange environment and isolation inside the scanner made the participants' experiences unusual, with varying degrees of difficulty dealing with it. Being in the other world caused a threat to the participants' self-control. There was a relation between threat to self-control, effort and need for support in the sense that the magnitude of threat to self-control had an impact on the effort it took to handle the situation and on the need for support, and conversely that the support received could affect the effort and threat to self-control. Conclusions. The study shows that the information received and the interaction between patients and staff have a significant influence on patients' lived experiences. Relevance to clinical practice. The individual experience of threat to self-control requires the need for support to be individualized and care need to be adjusted for each patient