bluuebunny/crossref_metadata_2025 huggingface dataset:
Understanding the Context of Multidisciplinary Design: Establishing Ecological Validity in the Study of Design Problem Solving
Authors: McNeese Michael D. , Zaff Brian S. , Brown Clifford E. , Citera Maryalice , Selvaraj Jonathan
Published: July 2017

The need to understand the design process in all its complexity is motivated by an interest in the development of tools and technologies that would be capable of aiding collaborative design teams. This development effort depends upon an understanding of design activities as they occur within a real world context. Observations of design activities that are made without direct communication with the design team members may fail to capture many of the subtler aspects of the process - aspects that are best understood when described by the design team members themselves. In order to supplement observational studies, this paper presents a case study in which a dialog with members of a variety of collaborative design teams was established in order to elicit information about the nature of collaborative design. A knowledge acquisition technique, concept mapping, was used to achieve an understanding of the role of human factors specialists within the collaborative design process specific to the Air Force's system acquisition program. Results highlight various findings about the nature of design problem solving such as the way different organizational settings influence human factors input in the design process/product. The paper discusses the usefulness of concept mapping to capture in-depth design knowledge and how this type of knowledge complements other approaches to understanding design.
Bringing Human Performance Data to the Design Table
Authors: Cona Thomas R. , Monk Donald L.
Published: July 2017

Product design is often viewed as being a heterarchical and iterative process, possessing both systematic and chaotic qualities. However, a common denominator across all design activities is the access and utilization of information. In today's computer-aided design market, most of the available tools are narrowly focused on specific computational details for individual stages of design. Aids are needed to support information access and utilization during all stages of the design process.

The application of human engineering and ergonomics data by designers is an increasingly challenging problem. Locating and understanding relevant information so that it can be applied to specific design issues is difficult given the abundance of existing and new data available. This is further complicated, in that the data are typically written to communicate research results to other human factors specialists.

A new software product, Computer Aided Systems Human Engineering: Performance Visualization Subsystem (CASHE:PVS), is described which will assist the designer during the decision making process, maximizing creative and analytical abilities while minimizing costs due to design time and errors. The software contains several features to enhance the designer's ability to interpret and apply the human factors data available in the product. Phenomena descriptions in text, figures, and tables are combined with experiential information via simulations, animations, and audio. This provides the user a unique and rich understanding of human performance phenomena and how they relate to the design of new products.
Perspectives on Decision Analysis for Decision Support System Design
Authors: Barnett Barbara J.
Published: July 2017

This symposium addresses the characterization of human decision making within a complex environment for the purpose of developing improved decision support systems. All of the work presented in this symposium was conducted under a Navy research program entitled “Tactical Decision Making Under Stress” (TADMUS). The overall objective of the TADMUS program is to improve tactical decision making of anti-air warfare (AAW) crew members within the Aegis cruiser's combat information center (CIC) under conditions of stress and uncertainty. The unique aspect of this effort is that each presentation addresses decision making behavior, within a single domain, from a different perspective. The goal of each effort is to characterize some aspect of expert decision making performance within the AAW task environment, and to make recommendations for the resulting decision support system design based upon these characterizations. The result is a multi-faceted, human-centered approach to information organization and interface display design for a decision support system.
Decision Making Bias in Complex Task Environments
Authors: Perrin Bruce M. , Barnett Barbara J. , Walrath Larry C.
Published: July 2017

This presentation summarizes the results of an empirical study examining human judgment bias under conditions of uncertainty and time pressure in surface Anti-Air Warfare (AAW). A substantial body of research has demonstrated that humans apply a limited set of heuristics to simplify decision making in complex and ambiguous situations. Most of this research, however, has used college students making logical, but unfamiliar judgments. This study was designed to assess whether Naval personnel, trained and experienced in AAW operations, exhibit these biases when performing their normal duties. Specifically, we studied whether the judgments of Naval tactical action officers in a realistic task simulation exhibit characteristics of the biases of availability, representativeness, anchoring-contrast, and confirmation. Our prediction that experienced subjects would disregard lack of reliability in otherwise representative data was only partially supported by the study. On the other hand, each of our other predictions was strongly supported. Our subjects ignored baseline trends when other case-specific information was available (representativeness and availability). They were significantly influenced by the order they received evidence, showing a recency effect characteristic of contrast. Additionally, as is characteristic of confirmation bias, they recalled much more of the information that was consistent with their final hypothesis and evaluated it as more informative than the inconsistent data, regardless of which hypothesis they had adopted. Implications for Naval decision support systems information and display are discussed.
On-Screen Keyboards: Which Arrangements Should be Used?
Authors: Quill Laurie L. , Biers David W.
Published: July 2017

The purpose of the present study was to test and evaluate three onscreen keyboard arrangements with indirect input devices. Studies conducted for hard keyboard arrangements have considered various factors affecting typing; however, differences between the nature of the hard and on-screen keyboards tasks preclude extrapolation from hard keyboard studies to onscreen keyboard designs. In this study, Finger Placement and Non-Finger Placement typists provided data for Stimuli (Word vs. Non-Words), Devices (Mouse vs. Arrow Keys), and Keyboards (1-Row Alphabetical, 3-Row Alphabetical, and QWERTY arrangements). The primary data collection tasks were two movement tasks and a typing task. The typing task consisted of having the user type a given Stimulus utilizing one of the on-screen keyboard arrangements and input devices. The movement task served as a control for movement time in the typing task. At the conclusion of the study, users were asked to rank order their preference for keyboard arrangement and input device. The QWERTY keyboard resulted in the fastest overall input times, and was the most preferred arrangement overall. Interaction between Device and Keyboard showed that with the mouse, input times for the 1-Row Alphabetical were slower than the QWERTY; whereas, with the arrow keys, input times were equivalent. However, this change in relative performance under the 1-Row Alphabetical arrangement for the two devices can be simply attributed to movement time. After statistically removing the effects of movement time from the typing task, the 1-Row Alphabetical arrangement was equivalent to the QWERTY for both input devices. Conclusions suggest potential incompatibility between the mouse interface and the 1-Row Alphabetical arrangement used in this study.
Meta-Analysis of Multiple-Task Performances: Cumulating the First two Decades of Research Findings across Studies
Authors: Green Georgia K.
Published: July 2017

Meta-analytic procedures were used to cumulate research findings across studies of multiple-task performances published between 1965 and 1985 (inclusive). Exhaustive literature search yielded 94 reports of studies of multiple-task performances that were sufficiently detailed to be statistically combined using the Hunter-Schmidt-Jackson procedure. These studies yielded a total of 202 statistical values and a total subject N of 3091. Meta-analysis was performed overall (resulting in a significant test statistic) and then as a function of secondary task (13 types), primary task (18 types), and specific secondary-primary task combination. (The secondary tasks were Choice Reaction Time (CRT), Classification, Detection, Memory, Mental Math, Monitoring, Motor Response, Problem Solving, Reaction Time, Shadowing, Speech, Task Battery (Multiple Tasks), and Tracking; the primary tasks were Association, CRT, Classification, Decision Making, Detection, Driving, Flight (Simulation), Memory, Mental Math, Monitoring, Motor Response, Problem Solving, Reading, Shadowing, Sketching, Speech, Tapping, and Tracking.) Ten external variables (Carbon Monoxide, Control-Display Compatibility, Drug Use, Feedback, Intelligence Tests, Neuroticism, Noise, Rating of Job Performance, Sinus Arrhythmia, and Temperature) as correlates of multiple-task performances were also examined. A generally positive relationship between secondary task performance alone and in combination with the primary task was found, along with moderating effects of secondary task type and primary task type. No substantial variation of results within a given combination of secondary and primary task types occurred in most cases, although four external variables (Carbon Monoxide, Feedback, Noise, and Temperature) displayed within-factor variation of results. All results were discussed in terms of integration of the past literature and directions for future research.
Real-Time Simulation of Multiple Parallel Approaches
Authors: Neiderman Eric C.
Published: July 2017

This paper describes an ongoing program of real-time, interactive air traffic control simulations to test and evaluate the feasibility of conducting closely-spaced, Independent, instrument approaches to dual, triple, and quadruple parallel runways. Real-time simulations are used to test and evaluate the human, technological, and systemic issues critical to the implementation of independent multiple parallel approaches. These simulations quantitatively evaluate controller performance, pilot/aircraft performance, and airport capacity issues. Simulation data are also used in the assessment of risk associated with the operation. To address human capabilities and limitations, qualitative analyses are used to assess the opinions of controllers, flight crew members, simulation technical observers, and recognized subject matter experts. This paper describes the planning, implementation, data collection, analysis, and related issues involved in real-time simulation for the development of national standards for independent multiple parallel approaches.
A Comparison of Test Methodologies for Air Traffic Control Systems
Authors: Guidi Mark A. , Merkle Michele
Published: July 2017

The Federal Aviation Administration (FAA) is currently involved in a tremendous effort to upgrade the nation's Air Traffic Control (ATC) system. Included in this effort is a new communications system called the Voice Switching and Control System (VSCS) for use primarily in the Air Route Traffic Control Centers (ARTCCs). The critical nature of the communications system, the complex Computer Human Interface (CHI) and functionality, and technology differences from the existing communications system caused the FAA to involve an Air Traffic Controller user group early in the design process. This group of subject matter experts was intended to help ensure adequate operational testing which would help secure user acceptance when VSCS was fielded. This paper discusses the methodology developed for the operational evaluation of the prototype VSCS in the Design Competition Phase (DCP) of the program. The methodology exposed problems in the areas of specification compliance, system stability, voice quality, CHI and operational suitability beyond those identified by the formal development test program called Factory Acceptance Testing (FAT). It was discovered that individual system functions that worked properly when exercised in isolation during FAT did not always work properly when exercised in realistic operational scenarios by controllers. The comparison of results between FAT and the operational evaluations show that controller evaluations should be included throughout the development process of FAA programs, and that the methodology used plays a fundamental role in uncovering issues.
Preparation for Pastoral Counseling and Spiritual Care: Strengthening Pastoral “Felt Knowledge” and Empathy through the Appreciation and Use of Contemporary Films
Authors: Baard Ronald W.
Published: July 2017

Contemporary film offers something unique in the preparation and practice of pastoral counselors and spiritual caregivers by expanding both “felt knowledge” and strengthening empathic responses to care seekers. By experiencing well-chosen films, pastoral counselors and other spiritual caregivers will be better prepared to work with relevant feelings in various caregiving contexts, and clients will gain many rewards, as both their healing and growth will be enhanced. This will be especially true when pastoral and spiritual caregivers are working in areas of need where they have limited personal or professional experience.
Alternative Visions for Pastoral Work with LGBTQ Individuals, Families, and Communities: A Response
Authors: Marshall Joretta L.
Published: July 2017

Multiple theological perspectives provide frameworks for pastoral work with lesbian, gay, bisesxual and trans individuals, families, and communities. One model is offered by those who argue for celibacy or heterosexual marriages for those who self-identify as part of LGBTQ communities. This article names other theologically grounded perspectives with the goal of inviting practitioners to broaden their understandings and wrestle with the implications of their theological and ethical stances. When reflecting on the intersection of spirituality and sexuality, the meaning of theological terms such as sin, contributions from queer theologians and pastoral counselors, and the limitations of binary categories common in our theological history, this article encourages pastoral counselors and spiritual care providers to re-examine theological assumptions they bring to their work. The article ends with questions and opportunities for ongoing pastoral theological work and reflection.
Portfolio GP: Pre-hospital acute care opportunities
Authors: White James
Published: July 2017

There are many pre-hospital acute care opportunities in which GPs can become involved. These are often far removed from the warmth and comfort of a hospital or GP surgery. Team working, rapid decision-making and clinical expertise are crucial for providing care to patients at the ‘ground zero’ of their health problem or injury. This article looks at the issues for consideration before embarking on any pre-hospital acute practice, and some examples of the vast array of opportunities available. Distinction is deliberately drawn between event medical cover and other pre-hospital acute care opportunities. It is hoped that this article sheds light on sometimes overlooked, but fascinating ways in which to practice.
Antibiotic over-prescribing
Authors: James Laura
Published: July 2017

When antibiotics were developed for therapeutic use in the 1940s, they transformed medicine. Many lives were saved during the Second World War by the use of antibiotics for sepsis resulting from battle wounds. Since then new antibiotics have been discovered and used to treat a vast array of infections, both minor and life-threatening. However, microbes are also evolving and becoming resistant to these valuable medicines, thereby rendering them increasingly ineffective. The greater the use of antibiotics, the faster resistance occurs. The majority of antibiotics in the NHS are prescribed in general practice, and there is pressure on GPs to prescribe fewer antibiotics. This article explores how GPs can help to meet the challenge of safely prescribing fewer antibiotics.
Health promotion and screening for people with an intellectual disability
Authors: Awan Hassan , Chauhan Umesh
Published: July 2017

People with intellectual disability have significantly worse health than those without, and have a higher level of complex health needs. The life expectancy for men and women is 13 and 20 years shorter, respectively, than the general population. The increasing role of general practice in delivering and coordinating care across health and social care settings requires expert generalist skills to implement an integrated approach to care. This article explores how general practice can improve the health of people with intellectual disability, by making reasonable adjustments within health promotion, disease prevention, screening and detection.
Small group teaching in primary care
Authors: Hopwood Jenny
Published: July 2017

Being a GP provides a wide range of opportunities to teach on a vast number of topics. GPs can inspire, support and stimulate colleagues, including medical students, junior doctors, other GPs and the wider practice multidisciplinary team. Getting involved in teaching develops the GP’s own knowledge, provides job variety and can be very rewarding. However, teaching sessions can sometimes be challenging to run. This article gives an understanding of how people learn in small groups, some practical guidance on planning and running teaching sessions, and advice on how to be a more effective teacher.
Diverticulosis and diverticular disease: Current concepts
Authors: Whatling Philip J
Published: July 2017

Colonic diverticula constitute the most common endoscopic anomaly in the Western world. They are responsible for a spectrum of disease. Most presentations associated with colonic diverticula can safely be managed in primary care. The distinction between those patients who are suitable for primary care management and those who require secondary care referral can be difficult to formulate. This article aims to provide a framework, informed by current guidelines, for the management of diverticular disease in primary care, and the identification of patients likely to benefit from referral to secondary care. An overview of the secondary care management of diverticular disease is also provided.
Benign ano-rectal disorders
Authors: Kynaston James
Published: July 2017

Benign ano-rectal disorders are a common adult presentation to primary care; they also generate a significant number of secondary referrals. The exact prevalence of these conditions is difficult to determine, due to under-reporting of symptoms, which patients can find embarrassing and difficult to disclose. It can be challenging to distinguish between different ano-rectal disorders which present with similar symptoms. A high index of suspicion is required to detect serious malignant pathology. The aim of this article is to outline the epidemiology, pathophysiology, diagnosis and management of common benign ano-rectal disorders in primary care. The indications for surgical referral and important cancer referral guidelines are included.
Controlling the spread of HIV and its consequences by measures based on HIV surveillance
Authors: Weaving P
Published: July 2017

HIV presents a serious infection control challenge, globally and nationally. This article examines how surveillance of the virus is carried out in the UK and how the data from that surveillance can be used to help reduce the spread of the virus, principally through health education.
Confidentiality of Patient Identifiable Data
Authors: Rayner Moira
Published: July 2017

A paper delivered to a Medicolegal Seminar conducted by the Medical Record Association of Australia - WA Branch entitled “Medicolegal Countdown - Do your Health Records meet Ethical and Legal Requirements?” in Perth, 25 August, 1989
Medical Records in Litigation: The Dalkon Shield Story
Authors: Byrne Kathleen
Published: July 2017

The Dalkon Shield was manufactured by A.H. Robins Inc. in the early and mid seventies, before it was withdrawn from sale because of the influx of lawsuits against the manufacturers. The case has become the largest tort case in history, with approximately 200,000 claimants worldwide and will not be wound up for years to come. Slater and Gordon is an Australian firm of solicitors with offices in three states. They have the largest Dalkon Shield practice in the world and represent almost 3,000 claimants. One of their most difficult tasks in preparing the cases is the gathering of medical evidence to substantiate claimants' assertions. This entails collecting relevant medical records from across the country and around the world going back almost twenty years for almost 2,000 women. The project has magnified the importance of accurate and complete documentation, kept intact and made accessible. The influence of medical record administrators is highlighted. (AMRJ, 1990, 20(2), 62–65).
Assessing the Accuracy of a Computerised Cancer Data Base
Authors: Lloyd Sheree , Walker Sue , Thorne Jill
Published: July 2017

The usefulness of a cancer registry to clinicians, administrators and researchers depends heavily on the reliability of the information the data base contains. In order to assess the accuracy of data maintained on the Mater Hospitals' Cancer Registry in Brisbane, a quality assurance study was designed. Data from the medical records of fifty cancer patients were recoded independently and then checked against that recorded on the computerised data base. Results showed that identifying and some clinical details can be collected with a high degree of accuracy. Less accurate details regarding primary site and morphology were found to be due mainly to differences in coding practices and to problems with accessing the medical records of cancer patients on a regular basis. This study has highlighted a perceived need for more specialised postgraduate training for data managers, in particular tumour registrars (AMRJ, 1990, 20(2), 66–68).
The Use of Medical Records in Epidemiology: A Case Study Using Asthma Hospitalisations in New South Wales, 1979–86
Authors: Bauman Adrian , Lyle David , Taylor Lee , Thomson Peter
Published: July 2017

In this paper the authors review the use of hospital separation records in epidemiological research. The health problem of asthma admissions in NSW between 1979 and 1986 is reviewed. The overall number and rate of asthma admissions increased in NSW during this period, but the total number of bed days attributable to asthma did not change. Geographical variations in asthma admissions for metropolitan Sydney are presented, and the standardised rates of asthma admissions appeared highest in central and outer western Sydney. The use of medical records in epidemiology is illustrated by this study, and the research skills illustrated are within the capabilities of any health information manager. (AMRJ, 1990, 20(3), 101–105).
An Investigation of the Expanding Managerial Role of Medical Record Administrators
Authors: Robinson Kerin , Ell Mary , Simpson Dianne , Grain Heather
Published: July 2017

The medical record administration profession in Australia has assumed additional and more varied managerial responsibilities following changes in the health industry during the 1980s. A nationwide study of the profession ascertained the nature and extent of these responsibilities and their implications for undergraduate and postgraduate curriculum planning. The study found that medical record administrators have a wide employment base and substantial managerial responsibility. It highlights the increasing range and diversity of general and profession-specific managerial responsibilities held by medical record administrators in Australia. (AMRJ, 1990, 20(4), 144–151).
Looking to Solutions for Deficiencies in Medical Records
Authors: Wilson Lionel
Published: July 2017

Based on an address to the ACHS Seminar: “Interpreting ACHS Accreditation Standards for the Medical Record Service” held in Sydney on Friday, 19 October 1990
Complaints Procedures against Health Services: Some Victorian Developments
Authors: Stewart Donald E.
Published: July 2017

The all-party Social Development Committee of the Victorian Parliament reported in 1984 that the existing system of dealing with complaints and grievances about health services was totally inadequate and in need of urgent changes. The Committee recommended that a model complaints mechanism should be set up to provide a clear, coherent and consistent system for dealing with complaints about health services. The Government responded by setting up the Office of the Health Services Commissioner to assist consumers and providers to resolve complaints about health services and, through the monitoring of complaints and analysis of health system data, to recommend improvements in the quality of health service provision. Aside from redress of grievances, this response was motivated by a desire to improve management and accountability of health care services. The data generated by the improved complaints system became a performance measure against clear objectives set by all publicly-funded health care institutions. The data generated by consumer perceptions became a central element in the formulation of future health policies.
Getting Serious about the Evaluation of Health Services — The Need for Data Linkage in the Measurement of Health Outcomes
Authors: Close Glenn R. , Westbrook Johanna I. , Rushworth R. Louise , Rubin George L.
Published: July 2017

In the past two decades there has been a growth in the establishment of large health databases and the development of sophisticated analytic techniques. This has led to concern about a potential conflict between the privacy rights of individuals over access to health information, and the requirements of population health research conducted in the public interest. There is an increasing demand for valid measures of the outcomes of health services. Inability to follow individuals as they pass through the health care system seriously restricts the ability to evaluate outcomes. Though Australian experience is limited, overseas studies have demonstrated the benefit to service evaluation of linking health data collections. It is concluded that the ability to link disparate sources of health information is essential for measuring and evaluating the outcomes of health services. Given appropriate provisions for data security, this linkage is feasible.
Limited Adverse Occurrence Screening: A Program with Significant Benefits for the Medical Record Department
Authors: Dooling Catherine , Wolff Alan
Published: July 2017

Quality is a major issue in industry. However, the performance of hospitals is predominantly measured by quantity. There is little accurate measurement of, and control over, the quality of patient care provided. Traditional medical quality assurance methods do not meet the basic criteria of an effective control system as defined in management theory. Occurrence screening is a method of medical quality control that overcomes many of these deficiencies. It detects adverse patient occurrences by screening medical records using outcome criteria and selective medical record review. The implementation of an occurrence screening program using a small number of criteria and retrospective review in the Medical Record Department of a 200 bed base hospital is described. Screening has been integrated into daily work practices in an efficient and cost effective manner. Medical record staff have become more aware of the importance of complete documentation and the profile of the department in the hospital has risen. Significant patient care problems have been detected by the screening process.
Using the International Classification of Primary Care to Examine the Profile of Patients Utilising Hospital Accident and Emergency Services
Authors: Westbrook Johanna , Braithwaite Jeffrey
Published: July 2017

Changes in the management and financing of health care are resulting in increased demands for better information about patients who are treated on an ambulatory basis in hospitals. A pilot study was conducted with the aim of determining the profile of patients who utilise accident and emergency services at St. Vincent's Hospital, Sydney. The International Classification of Primary Care (ICPC) was used to classify both the diagnoses and treatments of patients in the study. 50% of patients fell into two diagnostic categories, 40% of patients resided outside the Eastern Sydney area, no significant difference in the morbidity profiles according to area of residence of patients was found and 25% of patients returned to the hospital within a five month period. The application of the ICPC in an accident and emergency setting is discussed.
Severity of Illness: How Do We Measure it and How Does it Relate to Casemix?
Authors: Okine Roslyn
Published: July 2017

Severity of illness (S.O.I.) systems have traditionally been a useful clinical tool for measuring the physical effects of disease on the patient, planning treatment and predicting outcomes. However, they are now becoming a useful management tool to help explain and justify above average treatment costs within casemix classes and are of particular value for large tertiary referral hospitals which tend to treat more severely ill patients.

There are three different categories of S.O.I. and several different systems and approaches for measuring it. All have their uses as analytical tools for categorising patients so as to maximise the homogeneity within casemix classes and make any Output or Casemix based Funding System based on such classes more equitable.
The National Coding Centre – An Overview
Authors: Watson Phyllis J.
Published: July 2017

Medical Record Administrators have been aware of the need for a National Coding Authority in Australia for many years. With the establishment of the National Reference Centre for Classification in Health in 1991 and the subsequent call for tenders for the establishment of a Coding Authority the movement to develop much needed standards, improve data and coding quality began to take shape.

This paper outlines the lead up to the call for tenders, the terms of reference and objectives of the Coding Centre, the proposed staff, and the work program for the first three years.
Semimembranosus Tendinopathy
Authors: Bylund William E. , de Weber Kevin
Published: July 2017

Context:

Semimembranosus tendinopathy (SMT) is an uncommon cause of chronic knee pain that is rarely described in the medical literature and may be underdiagnosed or inadequately treated owing to a lack of understanding of the condition.

Evidence Acquisition:

A search of the entire PubMed (MEDLINE) database using the terms knee pain semimembranosus and knee tendinitis semimembranosus, returned only 5 references about SMT—4 case series and 1 case report—and several relevant anatomical or imaging references.

Results:

The incidence of SMT is unknown in the athletic population and is probably more common in older patients. The usual presentation for SMT is aching posteromedial knee pain. Physical examination can usually localize the area of tenderness to the distal semimembranosus tendon or its insertion on the medial proximal tibia. In unclear cases, bone scan, magnetic resonance imaging, or ultrasound may distinguish SMT from other causes of posteromedial knee pain. Treatment should begin with relative rest, ice, nonsteroidal anti-inflammatory drugs, and rehabilitative exercise. In the minority of cases that persist greater than 3 months, a corticosteroid injection at the tendon insertion site may be effective. Surgery to reroute and reattach the tendon is rarely needed but may be effective.

Conclusion:

SMT is an uncommon cause of knee pain, but timely diagnosis can lead to effective treatments.
An Electromyographic Evaluation of Subdividing Active-Assistive Shoulder Elevation Exercises
Authors: Gaunt Bryce W. , McCluskey George M. , Uhl Tim L.
Published: July 2017

Background:

Active-assistive range of motion exercises to gain shoulder elevation have been subdivided into gravity-minimized and upright-assisted exercises, yet no study has evaluated differences in muscular demands.

Hypothesis:

Compared with gravity-minimized exercises, upright-assisted exercises will generate larger electromyographic (EMG) activity. Compared with all active-assistive exercises, upright active forward elevation will generate more EMG activity.

Study design:

Controlled laboratory study.

Methods:

Fifteen healthy individuals participated in this study. The supraspinatus, infraspinatus, and anterior deltoid were evaluated. The independent variables were 11 exercises performed in random order. The dependent variable was the maximum EMG amplitude of each muscle that was normalized to a maximal voluntary isometric contraction (MVIC).

Results:

Each muscle demonstrated significant differences between exercises ( P < .001), with upright active forward elevation producing the greatest EMG for all muscles (95% confidence interval [CI], 12% to 50% MVIC). The orders of exercise varied by muscle, but the 5 gravity-minimized exercises always generated the lowest EMG activity. The upright-assisted exercises (95% CI, 23% to 42% MVIC) for the anterior deltoid generated more EMG activity than did the gravity-minimized exercises (95% CI, 9% to 21% MVIC) ( P < .05). The infraspinatus and supraspinatus demonstrated increasing trends in EMG activity from gravity minimized to upright assisted ( P > .05).

Conclusion:

The results suggest a clear distinction between gravity-minimized exercises and upright-assisted exercises for the anterior deltoid but not for the supraspinatus and infraspinatus. Between the 2 types of assisted exercises, the results also suggest a clear distinction in terms of active elevation of the arm for the supraspinatus and anterior deltoid but not for the infraspinatus.

Clinical Relevance:

Muscle activation levels increase as support is removed, but subdivision of active-assistive range of motion to protect the supraspinatus and infraspinatus may not be necessary.
Superficial Precooling on a 4-Week Static Stretching Regimen
Authors: Rancour Jessica L. , Terry Megan E. , Holmes Clayton , Cipriani Daniel J.
Published: July 2017

Background:

The influence of superficial precooling on range of motion (ROM) as part of a stretching program has not been extensively studied. It is not clear if the analgesic effect can benefit a stretching program.

Hypotheses:

Superficial precooling will result in greater gains in ROM as part of a stretching program, compared with stretching without a precooling intervention. Superficial precooling will also result in greater retention in ROM gains following cessation of stretching, compared with stretching without a precooling intervention.

Study Design:

Prospective randomized single-blind test-retest design.

Methods:

Twenty-nine participants were randomly assigned to 1 of 2 static stretching protocols: a standard protocol (n, 14; age, 24.6 ± 5.4 years) or a precool protocol (n, 15; age, 25.1 ± 7.3 years). These samples allowed for 80% power for statistical significance testing. Both groups performed static hamstring stretching daily for 4 weeks. The precool group applied ice to the hamstring for 10 minutes before stretching. Both groups stretched for 4 weeks and then stopped stretching for the last 4 weeks. Hip ROM measures were obtained each week for 8 weeks.

Results:

For the standard group, mean hip ROM increased from 71.4° ± 18.5° to 90.6° ± 20.5° and for the precool group, 71.5° ± 22.3° to 91.8° ± 20.9°. For the standard group, mean hip ROM decreased from 90.6° ± 20.5° to 83.9° ± 20.3° and for the precool group, 91.8° ± 20.9 to 85.0° ± 19.4°. There were no differences between groups at any time in the study ( P > .05).

Conclusions:

Precooling had no beneficial effects on ROM or on retention of ROM.

Clinical Relevance:

Cold application, before stretching, does not provide any benefit to a stretching program.
Cerebral Microhemorrhages in a Collegiate Football Player
Authors: Asif Irfan M. , Harmon Kimberly G. , Drezner Jonathan A. , O’Kane John W.
Published: July 2017

Most concussions in sports medicine are managed without advanced neurological imaging. However, computed tomography and magnetic resonance imaging are sometimes used in the management of complex sports concussions to identify acute/delayed intracranial bleeding or other associated pathology. Advances in imaging techniques have led to greater resolution and the identification of pathology of uncertain clinical significance. This report describes the presence of persistent cerebral microhemorrhages identified on magnetic resonance imaging in a collegiate football player who suffered a concussion. The associated risks and clinical significance of cerebral microhemorrhages have not been determined in the young athletic population. This case highlights provocative issues in the management of sports concussions as related to findings on modern neurological imaging and their potential implication on to return-to-play considerations.
The Effectiveness of Prophylactic Knee Bracing in American Football
Authors: Salata Michael J. , Gibbs Aimee E. , Sekiya Jon K.
Published: July 2017

Context:

Knee injuries, particularly of the medial collateral ligament (MCL), are the most common injury sustained in American football. In 1979, Anderson et al described a knee brace that could protect uninjured knees from MCL injuries resulting from lateral impact. Since then, a number of light and free-moving bracing devices have been developed. However, the efficacy of prophylactic knee bracing remains in question.

Objective:

A systematic review of the efficacy of prophylactic knee bracing in preventing MCL injuries in football players.

Data Sources:

Based on MedSearch and PubMed, articles from 1985 to November 2009 were identified with the following keywords and their combinations: prophylactic, prevent injury, knee brace, prevention, medial collateral ligament, MCL, football, and bracing.

Study Selection:

One randomized controlled trial (level 1 study) and 5 prospective cohort studies (level 2 studies) were selected.

Results:

The results of the studies were inconsistent; only 1 study showed that prophylactic knee bracing significantly reduced MCL injuries ( P < .05). In contrast, 2 studies found that knee bracing was associated with an increase in knee injuries.

Conclusions:

Prophylactic bracing in American football has not consistently reduced MCL injuries. There remains a lack of evidence to support the routine use of prophylactic knee bracing in uninjured knees. There is limited high-level evidence, bias in the available literature, and confounding variables that limit the current literature.
The Effect of an Exercise Program in Conjunction With Short-Period Patellar Taping on Pain, Electromyogram Activity, and Muscle Strength in Patellofemoral Pain Syndrome
Authors: Kaya Defne , Callaghan Michael James , Ozkan Huseyin , Ozdag Fatih , Atay Ozgur Ahmet , Yuksel Inci , Doral Mahmut Nedim
Published: July 2017

Background:

McConnell recommended that patellar tape be kept on all day, until patients learn how to activate their vastus medialis obliquus (VMO) during an exercise program. This application may pose problems because prolonged taping may be inadvisable for some patients or even contraindicated owing to skin discomfort, irritation, or allergic reaction.

Hypothesis:

Wearing patellofemoral tape for a shorter duration during an exercise program would be just as beneficial as a prolonged taping application.

Study Design:

Prospective cohort.

Methods:

Twelve patients and 16 healthy people participated. Patients underwent short-period patellar taping plus an exercise program for 3 months. Numeric pain rating, muscle strength of the knee extensors, and electromyogram activity of the vastus lateralis and VMO were evaluated.

Results:

There were significant differences in electromyogram activity ( P = .04) and knee extensor muscle strength ( P = .03) between involved and uninvolved sides before treatment. After treatment, pain scores decreased, and there were no significant differences between involved and uninvolved sides in electromyogram activity ( P = .68) and knee extensor strength ( P = .62). Before treatment, mean VMO activation started significantly later than that of vastus lateralis, as compared with the matched healthy control group ( P = .01). After treatment, these differences were nonsignificant ( P = .08).

Conclusion:

Short-period patellar taping plus an exercise program improves VMO and vastus lateralis activation.

Clinical Relevance:

A shorter period of taping for the exercise program may be as beneficial as a prolonged taping application.
Cardiovascular Disease in Industry a Summary
Authors: Paul Oglesby
Published: July 2017

One of the most popular programs at the 1962 AAIN Conference was a refresher course for nurses on Cardiovascular Disease in Industry. Because of the great interest in this special course the Journal is publishing in the following section the remarks by Oglesby Paul, M.D., a summary of modern health techniques of cardiovascular control, which served as the inductory statement of the panel, and the paper presented on the panel by Capitola B. Mattingly, R.N., M.A., Associate Professor of Nursing and Director of Graduate Studies, Duke University School of Nursing.
The Industrial NURSE and Occupational Deafness
Authors: Sataloff Joseph
Published: July 2017

The three-day hearing course for industrial nurses conducted by Colby College in Waterville, Maine this past August was the impetus for this special issue on hearing conservation in industry. We are indebted to Mrs. Anne J. Murphy of Scott Paper Company and an AAIN Board member for her help and guidance in the preparation of this issue as well as for her editorial contribution to it.
Medical Monitoring of Toxic Exposures in the Fire Atmosphere
Authors: Hohman Bertha A. , Levine Marshal S.
Published: July 2017

The role of nursing personnel in the medical monitoring of occupational exposures to the fire atmosphere is presented. The rationale and the techniques of the investigation and its impact on prevention are discussed.
Priorities in Trauma Management
Authors: Witter Marie
Published: July 2017

Trauma management requires a systematic approach. Certain priorities have been identified to organize the initial care of the trauma victim. Shock as a clinical syndrome accompanying trauma is defined and the symptoms are listed. Management of shock in terms of obtaining a patent airway, adequate ventilation and circulation, and the stabilizatin of the cervical spine are discussed.
Occupational Injury and Illness for Health Science Center Employees: Presenting Data in a Clear Manner to Management
Authors: Wilkinson William E.
Published: July 2017

Occupational hazards to U.S. health sciences employees are outlined and discussed. Methods for analyses and presentations of when, where, and what groups of employees at a Southwestern state university health science center reporting job-related injuries during part of fiscal 1982 are set forth. The four tables and three figures included are examples of how to use data routinely kept, though often ignored, for creating information and displaying it to communicate quickly and effectively with management.
Effect of Nurses' Attitudes toward Alcoholism on Their Referral Rate for Treatment
Authors: Reisman Betty L. , Shrader Ralph W.
Published: July 2017

The attitudes of 27 industrial nurses at Ford's Rouge Plant were determined by use of a questionnaire. The score on the questionnaire was correlated to the number of referrals each nurse had made to the company's Employee Recovery Program during a two-year span. A positive correlation of + .54 was found. A comparison of high referral nurses to low referral nurses found major differences between the two groups in the response to some of the items on the instrument. High referral nurses reported more experience with alcoholics in their family. Low referral nurses had some of the same stereo-types that previous researchers have found. Recommendations for improvement are given.
The Comparison of State and Trait Anxiety Scores of Managerial and Non-Managerial Personnel When Controlling for Stressful Life Events
Authors: Boehm Toni Stawinski
Published: July 2017

The purpose of this study was to compare the state and trait anxiety scores of managerial and non-managerial personnel with the somatic complaint of headache after controlling for stressful life events.

The subjects were limited to those presenting to the Medical Department of a large Kansas City corporation with the somatic complaint of headache. The first ten management and ten non-management subjects were given the Holmes-Rahe questionnaire, the Schedule of Recent Life Events. After completing this, the subjects were given the State-Trait anxiety test by Spielberger, measuring for anxiety levels at the moment and propensity for anxiety, respectively.

The responses were evaluated by the analysis of covariance. This was utilized to explore between group differences in State anxiety and in Trait anxiety scores, with scores on the Schedule of Recent Life Events as the covariant. Results showed no difference in state and trait anxiety levels when controlling for Recent Life Events between management and non-management groups.
Occupational Injury and Illness Profile of Developmental Center Workers in New York
Authors: Lu Paul C. , Giordano Rosemarie
Published: July 2017

This study investigates the incidence of occupational injury and illess among developmental center employees, a relatively unstudied population. Most of these employees work for state-operated institutes that are exempted from OSHA regulations; thus, data on the occupational injuries and illnesses of these employees often are not readily available for study. The purpose of this study was to investigate the extent or concern shown by the employers for the health and safety of these employees and the feasibility of improving their productivity through reduction of occupational incident.

The overall 1980 disabling-injury-frequency rate for the workers surveyed was 107, about 2.5 times higher than that for workers in the private sector nationwide, whereas the disabling-injury-severity rate was 16,483.5, a shocking 50 times higher than that for private sector workers. The attendant category employees of state-operated institutes lost 25.8 out of 100 workdays on the job, due to job-related incidents as opposed to 0.3 for private sector workers. These incident-prone workers represent roughly 45% of the total population studied. Their incidents could have been prevented by meaningful safety measures.

This study tends to support the argument that improvements in the work environment can reduce occupational injury and illness and lead to greater worker productivity.
Stress and Survival of Illness: A Study of Disability-Work Groups and Their Effect on Employee Productivity and Weil-Being
Authors: Morrow Eileen T.
Published: July 2017

This paper explores how nursing therapy in a disability-work group can increase employees' feelings of psychological well-being and productivity, after surviving a serious illness. The theories of survival, stress, loss, and the grief process are applied to the human response to illness, and its effect on self-esteem and productivity. The paper examines how the process of change, involved in the recovery of illness, is facilitated by a structured support group in an occupational health setting. Holistic health concepts and existentialist philosophy along with group dynamics form the basis in developing nursing strategies for intervention. A pilot study is proposed to study the actual cost benefits to American corporations. It is hypothesized that employees will improve with regular participation in a support group compared to non-membership.