A lower limb assessment tool for athletes at risk of developing patellar tendinopathy

PURPOSE: Patellar tendon abnormality (PTA) on diagnostic imaging is part of the diagnostic criteria for patellar tendinopathy. PTA and altered landing strategies are primary risk factors that increase the likelihood of asymptomatic athletes developing patellar tendinopathy. Therefore, the aim of this study was to examine the risk factors that are predictors of the presence and severity of a PTA in junior pre-elite athletes. METHODS: Ten junior pre-elite male basketball athletes with a PTA were matched with 10 athletes with normal patellar tendons. Participants had patellar tendon morphology, Victorian Institute of Sport Assessment (VISA) score, body composition, lower limb flexibility, and maximum vertical jump height measured before performing five successful stop-jump tasks. During each stop-jump task, both two-dimensional and three-dimensional kinematics and ground reaction forces were recorded. Multiple regression analyses were used to identify factors for estimating PTA presence and severity, and discriminate analysis was used to classify PTA presence. RESULTS: Sixty-eight percent of variance for presence of a PTA was accounted for by hip joint range of motion (ROM) and knee joint angle at initial foot-ground contact (IC) during stop-jump task and quadriceps flexibility, whereas hip joint ROM during stop-jump task and VISA score accounted for 62% of variance for PTA severity. Prediction of the presence of a PTA was achieved with 95% accuracy and 95% cross-validation. CONCLUSIONS: An easily implemented, reliable, and valid movement screening tool composed of three criteria enables coaches and/or clinicians to predict the presence and severity of a PTA in asymptomatic athletes. This enables identification of asymptomatic athletes at higher risk of developing patellar tendinopathy, which allows the development of effective preventative measures to aid in the reduction of patellar tendinopathy injury prevalence.

A structured framework improves clinical patient assessment and nontechnical skills of early career emergency nurses: a pre-post study using full immersion simulation

AIMS AND OBJECTIVES: The aim of this study was to evaluate the effect of the new evidence-informed nursing assessment framework HIRAID (History, Identify Red flags, Assessment, Interventions, Diagnostics, reassessment and communication) on the quality of patient assessment and fundamental nontechnical skills including communication, decision making, task management and situational awareness. BACKGROUND: Assessment is a core component of nursing practice and underpins clinical decisions and the safe delivery of patient care. Yet there is no universal or validated system used to teach emergency nurses how to comprehensively assess and care for patients. DESIGN: A pre-post design was used. METHODS: The performance of thirty eight emergency nurses from five Australian hospitals was evaluated before and after undertaking education in the application of the HIRAID assessment framework. Video recordings of participant performance in immersive simulations of common presentations to the emergency department were evaluated, as well as participant documentation during the simulations. Paired parametric and nonparametric tests were used to compare changes from pre to postintervention. RESULTS: From pre to postintervention, participant performance increases were observed in the percentage of patient history elements collected, critical indicators of urgency collected and reported to medical officers, and patient reassessments performed. Participants also demonstrated improvement in each of the four nontechnical skills categories: communication, decision making, task management and situational awareness. CONCLUSION: The HIRAID assessment framework improves clinical patient assessments performed by emergency nurses and has the potential to enhance patient care. RELEVANCE TO CLINICAL PRACTICE: HIRAID should be considered for integration into clinical practice to provide nurses with a systematic approach to patient assessment and potentially improve the delivery of safe patient care.

Efficacy of ACL injury risk screening methods in identifying high-risk landing patterns during a sport-specific task

Screening methods sensitive to movement strategies that increase anterior cruciate ligament (ACL) loads are likely to be effective in identifying athletes at-risk of ACL injury. Current ACL injury risk screening methods are yet to be evaluated for their ability to identify athletes' who exhibit high-risk lower limb mechanics during sport-specific maneuvers associated with ACL injury occurrences. The purpose of this study was to examine the efficacy of two ACL injury risk screening methods in identifying high-risk lower limb mechanics during a sport-specific landing task. Thirty-two female athletes were screened using the Landing Error Scoring System (LESS) and Tuck Jump Assessment. Participants' also completed a sport-specific landing task, during which three-dimensional kinematic and kinetic data were collected. One-dimensional statistical parametric mapping was used to examine the relationships between screening method scores, and the three-dimensional hip and knee joint rotation and moment data from the sport-specific landing. Higher LESS scores were associated with reduced knee flexion from 30 to 57 ms after initial contact (P = 0.003) during the sport-specific landing; however, no additional relationships were found. These findings suggest the LESS and Tuck Jump Assessment may have minimal applicability in identifying athletes' who exhibit high-risk landing postures in the sport-specific task examined.

A preliminary study of open learner model representation formats to support formative assessment

Open learner models provide a way of showing teachers and students the learning progress of a student against expectations. Creating an effective interface to present a learner model is an important part in open learner modeling. Usefulness of the learner model relies on using a clear andeffective representation format to facilitate users’understanding of the information presented. In this paper, wepropose a range of open learner model representation formatsto display students’ learning task status and achievement interms of learning outcomes. We investigate different types ofrepresentation formats and data useful for users to inspect thelearner model. An interface design prototype has been built toprovide potential users with an evaluation platform thatenables investigation of these aspects. The results obtained willallow us to develop a more effective new open learner modelvisualisation tool.

Assessment of a six-week computer-based remediation program for social cognition in chronic schizophrenia

Background: Programs to remediate cognitive deficits have shown promising results in schizophrenia, but remediation of social cognition deficits is less well understood. Social cognitive deficits may cause more disability than the widely recognized neurocognitive deficits, suggesting that this is an area worthy of further investigation. Aim: Implement and evaluate a brief computerized cognitive remediation program designed to improve memory, attention, and facial affect recognition (FAR) in outpatients with chronic schizophrenia.

Methods: Baseline assessments of FAR and of clinical, cognitive, and psychosocial functioning were completed on 20 males with schizophrenia enrolled in an outpatient rehabilitation program at the Shanghai Mental Health Center (the intervention group) and on 20 males with schizophrenia recruited from among regular outpatients at the Center (the control group). Both groups received treatment as usual, but the intervention group also completed an average of 12.7 sessions of a computer-based remediation program for neurocognitive, social, and FAR functioning over a 6-week period. The baseline measures were repeated in both groups at the end of the 6-week trial.

Results: There were no statistically significant differences in the changes in clinical symptoms (assessed by the Positive and Negative Syndrome Scale, PANSS) or cognitive measures (assessed using the Hong Kong List Learning Test and the Letter-Number Sequencing Task) between the intervention and control groups over the 6-week trial, but there were modest improvements on the PANSS for the intervention group between baseline and after the intervention. There was a significantly greater improvement in the social functioning measure (the Personal and Social Performance scale, PSP) in the intervention group than in the control group. The pre-post change in the total facial recognition score in the intervention group was statistically significant (paired t-test=-2.60, p=0.018), and there was a statistical trend of a greater improvement in facial recognition in the intervention group than in the control group (F(1,37)=2.93; p=0.092).

Conclusions: Integration of FAR training with a short, computer-administrated cognitive remediation program may improve recognition of facial emotions by individuals with schizophrenia, and, thus, improve their social functioning. But more work on developing the FAR training modules and on testing them in larger, more diverse samples will be needed before this can be recommended as a standard part of cognitive remediation programs.

Reaction Mechanisms Booster (Self-assessment resources)

This is a set of resources aimed at promoting the development of the skills required to successfully identify and generate organic mechanisms in order to demonstrate a good understanding of the underlying chemical principles. Students complete a task independently, and then mark their own work as they watch talking mark scheme videos where an expert explains how to get to the correct answers. Our research has shown that engagement with these resources is perceived to be highly beneficial by students, and leads to an increase in their confidence to tackle mechanistic problems. If you are a non-UK (or non-A-level) teacher, the terms AS and A2 may be meaningless to you, but the resources should still be useful for anyone studying organic reaction mechanisms. The worksheets are available in Word format, and you should feel free to edit these to meet the needs of your students and the course you are teaching. You can download the files individually by selecting them on the left and clicking download. Please watch the short briefing video on You Tube and read the teachers' notes carefully. Contact me on d.read@soton.ac.uk if you have and questions or comments. Additionally, I would like to thank Henry Pearson for suggesting the format of the alternative self-assessment proformas which you may choose to use with your students.

Field-oriented assessment of agricultural crops through temporal segmentation of modis VI data.

Monitoring agricultural crops constitutes a vital task for the general understanding of land use spatio-temporal dynamics. This paper presents an approach for the enhancement of current crop monitoring capabilities on a regional scale, in order to allow for the analysis of environmental and socio-economic drivers and impacts of agricultural land use. This work discusses the advantages and current limitations of using 250m VI data from the Moderate Resolution Imaging Spectroradiometer (MODIS) for this purpose, with emphasis in the difficulty of correctly analyzing pixels whose temporal responses are disturbed due to certain sources of interference such as mixed or heterogeneous land cover. It is shown that the influence of noisy or disturbed pixels can be minimized, and a much more consistent and useful result can be attained, if individual agricultural fields are identified and each field's pixels are analyzed in a collective manner. As such, a method is proposed that makes use of image segmentation techniques based on MODIS temporal information in order to identify portions of the study area that agree with actual agricultural field borders. The pixels of each portion or segment are then analyzed individually in order to estimate the reliability of the temporal signal observed and the consequent relevance of any estimation of land use from that data. The proposed method was applied in the state of Mato Grosso, in mid-western Brazil, where extensive ground truth data was available. Experiments were carried out using several supervised classification algorithms as well as different subsets of land cover classes, in order to test the methodology in a comprehensive way. Results show that the proposed method is capable of consistently improving classification results not only in terms of overall accuracy but also qualitatively by allowing a better understanding of the land use patterns detected. It thus provides a practical and straightforward procedure for enhancing crop-mapping capabilities using temporal series of moderate resolution remote sensing data.

The Scored Patient-Generated Subjective Global Assessment (PG-SGA) and its Association with Quality of Life in Ambulatory Patients Receiving Radiotherapy

OBJECTIVE: To evaluate the scored Patient-generated Subjective Global Assessment (PG-SGA) tool as an outcome measure in clinical nutrition practice and determine its association with quality of life (QoL). DESIGN: A prospective 4 week study assessing the nutritional status and QoL of ambulatory patients receiving radiation therapy to the head, neck, rectal or abdominal area. SETTING: Australian radiation oncology facilities. SUBJECTS: Sixty cancer patients aged 24-85 y. INTERVENTION: Scored PG-SGA questionnaire, subjective global assessment (SGA), QoL (EORTC QLQ-C30 version 3). RESULTS: According to SGA, 65.0% (39) of subjects were well-nourished, 28.3% (17) moderately or suspected of being malnourished and 6.7% (4) severely malnourished. PG-SGA score and global QoL were correlated (r=-0.66, P<0.001) at baseline. There was a decrease in nutritional status according to PG-SGA score (P<0.001) and SGA (P<0.001); and a decrease in global QoL (P<0.001) after 4 weeks of radiotherapy. There was a linear trend for change in PG-SGA score (P<0.001) and change in global QoL (P=0.003) between those patients who improved (5%) maintained (56.7%) or deteriorated (33.3%) in nutritional status according to SGA. There was a correlation between change in PG-SGA score and change in QoL after 4 weeks of radiotherapy (r=-0.55, P<0.001). Regression analysis determined that 26% of the variation of change in QoL was explained by change in PG-SGA (P=0.001). CONCLUSION: The scored PG-SGA is a nutrition assessment tool that identifies malnutrition in ambulatory oncology patients receiving radiotherapy and can be used to predict the magnitude of change in QoL.