10 research outputs found

    Validation of a new test that assesses functional performance of the upper extremity and neck (FIT-HaNSA) in patients with shoulder pathology

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    <p>Abstract</p> <p>Background</p> <p>There is a lack of standardized tests that assess functional performance for sustained upper extremity activity. This study describes development of a new test for measuring functional performance of the upper extremity and neck and assesses reliability and concurrent validity in patients with shoulder pathology.</p> <p>Methods</p> <p>A series of developmental tests were conducted to develop a protocol for assessing upper extremity tasks that required multi-level movement and sustained elevation. Kinematics of movement were investigated to inform subtask structure. Tasks and test composition were refined to fit clinical applicability criteria and pilot tested on 5 patients awaiting surgery for shoulder impingement and age-sex matched controls. Test-retest reliability was assessed on 10 subjects. Then a cohort of patients with mild to moderate (n = 17) shoulder pathology and 19 controls (17 were age-sex matched to patients) were tested to further validate the Functional Impairment Test-Hand, and Neck/Shoulder/Arm (FIT-HaNSA) by comparing it to self-reported function and measured strength. The FIT-HaNSA, DASH and SPADI were tested on a single occasion. Impairments in isometric strength were measured using hand-held dynamometry. Discriminative validity was determined by comparing scores to those of age-sex matched controls (n = 34), using ANOVA. Pearson correlations between outcome measures (n = 41) were examined to establish criterion and convergent validity.</p> <p>Results</p> <p>A test protocol based on three five-minute subtasks, each either comprised of moving objects to waist-height shelves, eye-level shelves, or sustained manipulation of overhead nuts/bolts, was developed. Test scores for the latter 2 subtasks (or total scores) were different between controls as compared to either surgical-list patients with shoulder impingement or a variety of milder shoulder pathologies (p < 0.01). Test 1 correlated the highest with the DASH (r = -0.83), whereas Test 2 correlated highest with the SPADI (r = -0.76).</p> <p>Conclusion</p> <p>Initial data suggest the FIT-HaNSA provides valid assessment of impaired functional performance in patients with shoulder pathology. It discriminates between patients and controls, is related to self-reported function, and yet provides distinct information. Longitudinal testing is warranted.</p

    sj-png-1-whs-10.1177_21650799231214275 – Supplemental material for Posture Evaluation of Firefighters During Simulated Fire Suppression Tasks

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    Supplemental material, sj-png-1-whs-10.1177_21650799231214275 for Posture Evaluation of Firefighters During Simulated Fire Suppression Tasks by Tara Kajaks, Christina Ziebart, Vickie Galea, Brenda Vrkljan and Joy C. MacDermid in Workplace Health & Safety</p

    Charting a future for epidemiologic training.

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    PurposeTo identify macro-level trends that are changing the needs of epidemiologic research and practice and to develop and disseminate a set of competencies and recommendations for epidemiologic training that will be responsive to these changing needs.MethodsThere were three stages to the project: (1) assembling of a working group of senior epidemiologists from multiple sectors, (2) identifying relevant literature, and (3) conducting key informant interviews with 15 experienced epidemiologists.ResultsTwelve macro trends were identified along with associated actions for the field and educational competencies. The macro trends include the following: (1) "Big Data" or informatics, (2) the changing health communication environment, (3) the Affordable Care Act or health care system reform, (4) shifting demographics, (5) globalization, (6) emerging high-throughput technologies (omics), (7) a greater focus on accountability, (8) privacy changes, (9) a greater focus on "upstream" causes of disease, (10) the emergence of translational sciences, (11) the growing centrality of team and transdisciplinary science, and (12) the evolving funding environment.ConclusionsAddressing these issues through curricular change is needed to allow the field of epidemiology to more fully reach and sustain its full potential to benefit population health and remain a scientific discipline that makes critical contributions toward ensuring clinical, social, and population health

    Charting a future for epidemiologic training

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    PURPOSE: To identify macro level trends that are changing the needs of epidemiologic research and practice and to develop and disseminate a set of competencies and recommendations for epidemiologic training that will be responsive to these changing needs. METHODS: There were three stages to the project: 1) assembly of a working group of senior epidemiologists from multiple sectors, 2) Identifying relevant literature, and 3) conducting key informant interviews with 15 experienced epidemiologists. RESULTS: Twelve macro trends were identified along with associated actions for the field and educational competencies. The macro trends include: 1) “Big Data”/ informatics, 2) the changing health communication environment, 3) the Affordable Care Act/health care system reform, 4) shifting demographics, 5) globalization, 6) emerging high throughput technologies (“omics”), 7) a greater focus on accountability, 8) privacy changes, 9) a greater focus on “upstream” causes of disease, 10) the emergence of translational sciences, 11) the growing centrality of team and trans-disciplinary science, and 12) the evolving funding environment. CONCLUSION: Addressing these issues through curricular change is needed to allow the field of epidemiology to more fully reach and sustain its full potential to benefit population health and remain a scientific discipline that makes critical contributions to ensuring clinical, social, and population health

    Protocol for the development of a multidisciplinary clinical practice guideline for the care of patients with chronic subdural haematoma [version 1; peer review: 1 approved, 2 approved with reservations]

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    Introduction: A common neurosurgical condition, chronic subdural haematoma (cSDH) typically affects older people with other underlying health conditions. The care of this potentially vulnerable cohort is often, however, fragmented and suboptimal. In other complex conditions, multidisciplinary guidelines have transformed patient experience and outcomes, but no such framework exists for cSDH. This paper outlines a protocol to develop the first comprehensive multidisciplinary guideline from diagnosis to long-term recovery with cSDH.  Methods: The project will be guided by a steering group of key stakeholders and professional organisations and will feature patient and public involvement.  Multidisciplinary thematic working groups will examine key aspects of care to formulate appropriate, patient-centered research questions, targeted with evidence review using the GRADE framework.  The working groups will then formulate draft clinical recommendations to be used in a modified Delphi process to build consensus on guideline contents.  Conclusions: We present a protocol for the development of a multidisciplinary guideline to inform the care of patients with a cSDH, developed by cross-disciplinary working groups and arrived at through a consensus-building process, including a modified online Delphi
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