bluuebunny/crossref_metadata_2025 huggingface dataset:
Inter-Tester Reliability of a Tactile Gnosis Test: The STI-Test™
Authors: Rosén Birgitta
Published: July 2017

Assessment of tactile gnosis is an important part in the evaluation of outcome after nerve injuries. The STI-test™ (Shape/Texture Identification test) is a recently introduced instrument for assessment of tactile gnosis. The test is performed according to a standardised procedure and is based on active touch, in contrast to the commonly used two-point discrimination (2PD) test. The content and construct validity and intra-tester reliability of the STI-test™, as well as sensitivity to changes over time, have been demonstrated in earlier studies. The purpose of this study was to investigate the inter-tester reliability. A total of 91 patients with a median age of 32 years (range 10-79 years) with severe nerve injuries were included. Repeated assessments were performed and analysed using weighted kappa statistics to calculate the chance-corrected agreement between test results. Good inter-tester reliability was demonstrated with a kappa value of 0.66 (95% C.I. 0.59 to 0.73), and there was a good distribution of the data along the scoring scale. The minimal detectable change (MDC) for the STI-test™ is also discussed and it is concluded that the STI-test™ is a good choice for evaluative purposes when assessing tactile gnosis in patients with severe nerve injuries.
An Ergonomic Case Study of a person with De Quervain's Tenosynovitis Relating to the use of a Mobile Telephone
Authors: Carr Elaine
Published: July 2017

This article consists of a case study analysing the ergonomic influence of the mobile telephone with relevance to De Quervain's tenosynovitis. The prime causative factors were identified as hand position, frequency of dialling and static postures. Critical analysis of each of these components is presented, along with the physiological implications and current work regulations. Treatment discussed includes change of telephone technique, rest, education, trigger-point release, heat, exercise and stretches. The importance of ergonomic changes to decrease De Quervain's is highlighted.
Measurement of Joint Stiffness in the Hand: A Preliminary Investigation of the Reliability and Validity of Torque Angle Curves
Authors: Glasgow Celeste , James Melissa , O'Sullivan Joanne , Tooth Leigh
Published: July 2017

The principal aim of this study was to examine aspects of the reliability and validity of the Torque Angle Curve (TAC) technique as a measure of joint stiffness. Specifically, inter-rater and intra-rater reliability were examined as well as the percent agreement of therapist evaluation of joint ‘end feel’ (i.e. springy or non-springy). Convergent validity of the TAC technique was studied by assessing the extent of agreement between TAC scores and therapist ratings of end feel. Thirty-eight joints were assessed in 24 subjects. Inter-rater reliability ICC (2,2) of the TAC technique was .80 and intra-rater reliability ICC (3,1) was .76 for rater A and ICC (3,1) .64 for rater B. Percent agreement for the end-feel technique was 68.4% with Kappa = .42. A significant difference was found between TAC scores for springy joints (mean [SD] 12.0° [3.7]) and TAC scores for non-springy joints (mean [SD] 7.2° [2.8]), when raters agreed on end feel (p = .000). When raters did not agree on end feel, the mean TAC score was 9.6° [2.2]. Results from this preliminary investigation suggest that the TAC technique provides a more reliable estimate of joint stiffness than the use of end feel. Further research with a larger sample size is required to replicate findings.
Is Eight Weeks' Immobilisation of the Distal Interphalangeal Joint Adequate Treatment for Acute Closed Mallet Finger Injuries of the Hand? A Critical Review of the Literature
Authors: Pratt Anna L
Published: July 2017

The evidence for the period of splint immobilisation for mallet finger injuries was systematically reviewed in order to establish if eight weeks of distal interphalangeal joint immobilisation was adequate treatment for acute closed injuries and hence to develop a more evidence-based treatment regime. Databases were searched and relevant studies identified using a list of keywords. All articles reporting outcomes from the use of splints in the conservative treatment of acute closed mallet finger injuries published between January 1981 and December 2001 were included in this review. A total of nine papers met the inclusion criteria and were reviewed using a critical appraisal checklist. No randomised controlled trials were found. There was a lack of consistency in the treatment immobilisation period and evaluation outcomes, which made direct comparison of data impossible. The lack of robust evidence does not allow us to establish if an eight-week immobilisation period using a dorsal splint with the distal interphalangeal joint in extension is best practice. However, most papers advocate a regime to minimise skin complications and that additional protection at night following the immobilisation period is important.
Use of the ‘Typing Capacity Cycle’ Test as an Assessment Tool for Keyboard Users with Work-Related Upper Limb Disorder
Authors: Povlsen Bo , Rose Robyn-Lee , Probert Sara
Published: July 2017

This paper describes a ‘typing capacity cycle’ test (first typing period + recovery time) for keyboard users with Type II Work-Related Upper Limb Disorder. The test was implemented on both control and patient groups on a standardised VDU in a neutral location. The patients’ test results showed that the typing speed and the typing endurance were not directly correlated with the required recovery period. This is a new finding. We therefore suggest that measuring the ‘typing capacity cycle’ represents true work capacity more accurately than recording typing speed in patients with Type II Work Related Upper Limb Disorder. Performance of a small group of Type II WRULD patients following rehabilitation is also reported.
Compliance, Adherence and Concordance: A Review of Engaging Patients in their Treatment
Authors: Steward Barbara
Published: July 2017

Problems of non-attendance in hand therapy clinics are frequently recorded and linked to poor outcomes in treatment. This paper reviews the therapy and medical literature on compliance, adherence and concordance, and explores ways of gaining the closer involvement and cooperation of patients in their treatment. It suggests that while client-centred approaches and education are important aspects of gaining users’ participation, patients need active encouragement and real opportunities to become involved in health care. Hand therapists need to explore ways in which to negotiate and tailor care to individual client needs.
The Impact of Complex Regional Pain Syndrome Type I on an Individual's Occupational Performance
Authors: Brincat Roberta
Published: July 2017

This research study examined the effect of Complex Regional Pain Syndrome (CRPS) Type I, on a person's occupational performance. Ten subjects with a diagnosis of CRPS Type I were investigated by using a semi-structured interview followed by two standardised assessments: the Canadian Occupational Performance Measure (COPM) and a Visual Analogue Scale (VAS). The COPM measured occupational performance, and the VAS measured pain intensity. Descriptive data on participants’ views and their perspectives on responsibilities regarding work, leisure and self-care were collected. The effects of CRPS ranged from loss of movement, impairment in sensation, physical symptoms such as drowsiness and general malaise, hand function problems and a variety of emotional and psychological problems. Statistical analysis, which evaluated performance and satisfaction scores attained from the COPM showed a significant positive correlation between satisfaction and performance scores (r=0.982, p<0.05). A significant correlation was also found between performance and pain intensity and satisfaction and pain intensity.

Results suggest that both the professional team together with CRPS I sufferers are insufficiently informed about this disease and its development. Within the local context, it was evident that there is lack of knowledge in relation to the condition. Therefore a medical oriented model of treatment is being followed, without consideration of patients’ perceptions and needs. It is suggested that the management of CRPS I patients needs to be focused upon the individual. A further cross-sectional study would assist in the analysis of the physical and psychological effects of CRPS I on the individual.
An Investigation into the Degree of Precision achieved by a Team of Hand Therapists and Surgeons using Hand Goniometry with a Standardised Protocol
Authors: Pratt Anna L , Burr Nicola , Stott David
Published: July 2017

A multidisciplinary team of 26 plastic surgeons and hand therapists assessed the range of motion of one patient with Dupuytren's disease. Flexion of the middle and ring fingers (six joints) were assessed using a hand-held goniometer. Initially, team members took measurements using their own usual method of range of motion assessment and later the procedure was repeated utilising the standardised goniometry protocol provided. Results indicate that the hand therapists' precision changed very little throughout the study, as many were already aware of and utilising a standardised assessment protocol. The introduction of the standardised protocol positively influenced the precision results in the surgeon group. The findings would support the need for the use of standardised goniometry protocol when assessing range of motion to improve clinicians’ precision with the tool and therefore maintain reliability of their results.
Intra- and inter-instrument reliability of Grip-Strength Measurements: GripTrack™ and Jamar® hand dynamometers
Authors: Svens Birgit , Lee Hoe
Published: July 2017

The purpose of this research was to compare the computer-connected GripTrack dynamometer and the manual Jamar dynamometer to determine the intra- and inter-instrument reliability. Using a repeated-measures design the instruments were calibrated three times. Forty-six uninjured female health workers (mean age 29.7 years) performed three consecutive grip strength trials per hand and per instrument with the handle bar in the second position, alternating which dynamometer was used first.

Intra-instrument reliability and concurrent validity were tested using certified standard weights. Both the Jamar dynamometer and GripTrack dynamometer demonstrated concurrent validity with certified standard weights (Jamar r = 1.0, GripTrack dynamometer r ≥ 0.9994). While inter-instrument reliability was good, starting with the Jamar dynamometer as the first instrument (ICC 0.80 to 0.83), and excellent, starting with the GripTrack dynamometer (ICC 0.94 to 0.95), the Bland and Altman method of analysing the differences between the two instruments’ grip strength readings revealed instrument bias. The large spread of limits of agreement from –2.37 kg to 7.87 kg (± 2 SD from the mean 2.75 kg) suggests variation in readings of up to 10.24 kg.

While both dynamometers retain adequate calibration, the human interfaces are sufficiently different to cause large differences in readings between the dynamometers, making them non-interchangeable.
The Effects of Early Rheumatoid Arthritis on Dominant and Non-dominant Hand Impairment and Function
Authors: Adams Jo , Burridge Jane , Hammond Alison , Cooper Cyrus
Published: July 2017

Rheumatoid arthritis (RA) is defined as a symmetrical disease yet there is evidence that hand joint damage sustained in RA is related to use, and hand dominance could affect the degree of structural impairment evident in the wrist and hand. This exploratory research aimed to examine the relationship of dominant and non-dominant wrist and hand joint impairment and function in an early rheumatoid population. A multi-centre cohort study was conducted, recruiting consenting patients with early rheumatoid arthritis from eight outpatient occupational therapy departments. Wrist and hand joint impairment and function were assessed by measuring joint pain and swelling, range of motion and joint deviation, handgrip and hand dexterity. The results demonstrated that the non-dominant hand showed less pathological structural and functional involvement than the dominant hand in all but one outcome measure. These differences reached statistical significance between dominant and non-dominant hands on active range of motion in the wrist and some digits. Dominant hand structural impairment and dysfunction in this early RA sample was consistently greater than the non-dominant hand and bilateral handgrip ratio did not reflect healthy values for norms. Individuals with early RA showed a greater level of impairment in their dominant hands.
Influence of Wrist Joint Position and Metacarpophalangeal Joint Range of Motion on Extensor Digitorum Communis (edc) Activity: An Electromyographic Study
Authors: Sakellariou Dikaios , Sawada Yuji , Tsubota Sadako
Published: July 2017

Early controlled stress on the healing tendon has proved to have many positive effects such as reduction of oedema and improved excursion. The purpose of this study was to investigate the effect of the position of the wrist and metacarpophalangeal (MCP) joints on the EDC muscle activity during MCP movement and thus: i) provide an electromyographic basis for dynamic extensor splinting, and ii) examine the safest position for early active motion in extensor tendon injuries.

Electromyography was used to monitor EDC activity during MCP extension from various wrist positions. The least muscle activity was observed when the wrist was in flexion and the greatest when the wrist was at 45° extension. A statistically significant difference (p 0.05) was established among the various MCP ranges of motion, with the greatest activity per time unit occurring when the MCP joints moved up to 20° hyperextension. The results suggest that slight MCP flexion may effectively reduce EDC activity. Further research is needed to provide evidence on the influence of slight MCP flexion on the quality of repair and functional outcomes after extensor tendon repair.
An analysis of the Inner and Outer Grip Strength of Rock Climbers and Matched Healthy Non-Climbers
Authors: Godtschailk Mal , Adams Jo
Published: July 2017

Normative volar power handgrip data have already been published, but there remain little data available for power handgrip strength for specific populations. This study examined the inner and outer power handgrip strength of male and female rock climbers, provided normative data on the range of rock climbers’ inner and outer power grip strength and compared this with matched healthy non-climbers. Inner power grip strength was measured on setting two of the Jamar dynamometer and outer power grip on setting four. A total of 32 participants were recruited and both inner and outer power grip were measured. Rock climbers’ inner power grip strength was on average 14% stronger than non-climbers and inner grip strength for both hands was significantly higher for rock climbers (p=0.02). Outer grip strength that replicates the position of crimping routinely used in rock climbing, was not statistically significantly different between the two groups (p=0.39).

The assessment of population-specific grip strength is useful for clinicians when assessing and treating individuals who are likely to have different ranges of grip strength due to hobbies or lifestyle occupations.
Assessment of Activities in Patients with Hand Injury: A Review of Instruments in Use
Authors: Van De Ven-Stevens Lucelle , Munneke Marten , Spauwen Paul Hm , Van Der Linde Harmen
Published: July 2017

Physical impairments are not necessarily coupled with functional limitations. For this reason, it is important to assess not only body functions and structures, but also activities and/or participation to decide which intervention is indicated and to evaluate the effect of the intervention in a valid way.

The purpose of this review was to examine available instruments for assessing the limitations in activity and their application within the clinical reasoning process in patients with hand injuries.

A literature search identified instruments that met four selection criteria: quality of information, target population, percentage items related to hand function, and a focus on activities. The selected instruments were categorised according to three items: the specific components, the aspects of activity that could be assessed with it and how activity was assessed (questionnaire or otherwise). Seventy two instruments were identified, of which 23 met the selection criteria. These selected instruments showed important differences in the constructs they assessed and in the manner of assessment.

Instruments to assess limitations of activity as a result of hand injury should be evaluated further in terms of reliability and validity, before their use within the clinical reasoning process can be standardised.
Comparative Study of the Test-Re-Test Reliability of Four Instruments to Measure Grip Strength in a Healthy Population
Authors: Ward Caroline , Adams Jo
Published: July 2017

Outcome measures need to have an acceptable level of reliability for sound use in clinical and research practice. This study compared the test-re-test reliability of four hand dynamometers measuring grip strength. Using a counterbalanced, repeated measures design, 30 healthy individuals performed three consecutive grip measurements on the MIE digital grip analyser, Baseline Bulb, Jamar® and Lafayette hand dynamometers in a random order on two separate days at the same time. Results indicated that all tools showed a similar and acceptable level of reliability, with a minimum of 90% of the repeat grip data falling within 95% of agreed levels of agreement. The dominant hand showed less variation in grip strength than the non-dominant. Hand pressure was seen to be no less reliable than hand force in a healthy population. Clinicians and researchers can be reassured that the test-re-test reliability of four commonly available dynamometers is acceptable for clinical and research work.
A Retrospective Review of Cold Intolerance Following Corrective Surgery for Dupuytren's Disease
Authors: W Mckirdy Stuart , Jacobs Neal , Nassab Reza , F Starley Ian
Published: July 2017

Cold intolerance is a cause of significant morbidity following trauma to the upper limb and hand, yet very little research has been undertaken to investigate the phenomenon following elective hand surgery. This retrospective study, incorporating a postal questionnaire and case note review, investigates incidence and risk factors of cold intolerance in a series of patients who underwent corrective surgery for Dupuytren's disease. The incidence of cold intolerance following surgery for Dupuytren's disease was 44%, and no association was found between the development of cold intolerance and either age, gender, smoking status or employment status. Further research investigating cold intolerance following surgery for Dupuytren's disease and other elective hand surgery is required. The present study demonstrates that cold intolerance is a significant complication, not only following traumatic hand injury, but also following elective surgery for Dupuytren's disease.
A Phenomenological Investigation Of The Experience Of Patients During A Rehabilitation Programme Following A Flexor Tendon Injury To Their Hand
Authors: Fitzpatrick Niall
Published: July 2017

Following a traumatic hand injury, people experience a significant disruption to their lives. This qualitative study attempts to describe the lived experience of five people coping with the consequences of an extrinsic flexor tendon injury to their hands. Individual open-ended interviews were undertaken and a phenomenological analysis was used. The findings highlighted several themes, four of which were common to each participant:

i) minimising the impact of the injury;

ii) struggling and coping;

iii) trying to elicit help from others, and

iv) feelings of dependency.

Implications for the provision of hand therapy services to this client group, suggested by this research, are the need to identify people on whom patients will be dependent and to include them in treatment planning; the need to monitor patients’ mood states; the need for hand therapists to be more wide ranging when identifying and negotiating strategies for managing their rehabilitation time and to take a broader view of the rehabilitation process and not to focus exclusively upon exercise and splinting guidelines.
Mirror Therapy in Hand Rehabilitation: A Review of the Literature, the St Gallen Protocol for Mirror Therapy and Evaluation of a Case Series of 52 Patients
Authors: Grünert-Plüss Nicole , Hufschmid Ursina , Santschi Lilian , Grünert Jörg
Published: July 2017

Over the past ten years, mirror visual feedback has been reported as a new treatment modality for chronic pain by several authors using different methods. Pioneering studies of mirror therapy for different clinical problems and its application in key studies are presented. Mirror therapy (MT) involves the use of the non-injured side reflected in the mirror, thus giving an illusion of function in a missing or injured side. Some neurophysiological aspects are illuminated to get an impression of what mirror therapy causes in the brain. The first aim of this study was to look at the available literature and to study the usefulness of MT in different diagnoses in hand rehabilitation as a basis for developing the St Gallen protocol for mirror therapy, which has been used with 52 patients since the end of 2005. The secondary aim is to describe the St Gallen protocol and present the results from the cases of 52 patients treated with MT. Two selected case studies provide a more detailed illustration of the method of application. Our experience confirms the positive effect of MT, specifically in reducing pain, improving function of movements and sensibility already reported in the literature.
The Effectiveness of Origami on Overall Hand Function After Injury: A Pilot Controlled Trial
Authors: M Wilson Lesley , W Roden Paul , Taylor Yukiyo , Marston Louise
Published: July 2017

This pilot study measured the effectiveness of using origami to improve the overall hand function of outpatients attending an NHS hand injury unit. The initiative came from one of the authors who had used origami informally in the clinical setting and observed beneficial effects. These observed effects were tested experimentally. The design was a pilot non-randomised controlled trial with 13 participants. Allocation of the seven control group members was based on patient preference. The experimental group members attended a weekly hour of origami for six weeks, in addition to their conventional rehabilitation. Hand function of all participants was measured using the Jebsen-Taylor Hand Function Test before and after the six-week period, and additional qualitative data were gathered in the form of written evaluations from patients. The quantitative data were analysed using the Mann Whitney U test or Fisher's exact test. Themes were highlighted from the qualitative data.

The results show that there was a greater difference in the total score of the experimental group using the impaired hand between pre- and post-intervention of 11.8 seconds, compared with 4.3 seconds in the control group, but this was not statistically significant at the 5% level (p=0.06). Additionally, differences in the sub-test scores show a markedly larger improvement in the experimental group. Qualitative data indicate that the experimental group experienced the origami sessions as being enjoyable and beneficial. Further research with a larger sample and randomised group allocation is recommended to verify and expand these preliminary findings.
A Mallet Injury Case Study with Recommendations for Practice
Authors: Mclinot Cara Lesley Easton Ba
Published: July 2017

A case report of a 46-year-old female physiotherapist who sustained a right middle finger tendinous mallet injury, while adjusting a pillow under a patient in the intensive care unit (ITU) is described below. Initial treatment consisted of immobilisation of the distal interphalangeal (DIP) joint in slight hyperextension 24 hours a day for eight weeks. Ten days after reduction in splint-wearing time, a 15° extension lag developed at the DIP joint, which was actively correctable with hyperextension of the proximal interphalangeal (PIP) joint. Blocked strengthening of the terminal extensor tendon combined with prevention of hyperextension at the PIP joint resulted in a good outcome. Considerations for practice including prolonged splint protection and graded exercise programmes for tendinous mallet injuries and suggestions for splinting combined mallet and swan neck deformities are discussed.
A Novel Method of Delivering Tap Water Galvanism for Management of Hyperhidrosis: A Case Report
Authors: W Bellew James , M Baker Ryan , Williams Juliet
Published: July 2017

Use of tap water galvanism (TWG) in the management of hyperhidrosis (HH) is supported by the literature. However, many therapists are unaware of their ability to treat HH. This report describes the use of an iontophoresis device for delivery of TWG in the management of primary focal palmar HH.

Two males with chronic primary focal HH and no prior treatment received direct current mediated tap water galvanism for 10 sessions (five x per week for two weeks). Quantitative measures of sweat production were taken before and after intervention by gravimetric assessment, while qualitative measures of area and density of sweat production were made using the Minor starch-iodine and ninhydrine amino acid reactivity tests. Participant 1 demonstrated an average decrease in sweat production of 85 per cent, while Participant 2 demonstrated an average decrease of 54 per cent. Qualitative assessments demonstrated a substantial reduction in the area and density of sweat production in each participant.

While use of direct current mediated tap water galvanism is well documented, most reports have used specialised devices not common or available to most clinicians. Because many clinicians have access to iontophoresis devices and these devices generate direct current, they may be used to render tap water galvanism. This report describes the efficacious use of such application in two participants with primary focal palmar hyperhidrosis.
Which Splint? Dynamic versus Static Progressive Splinting to Mobilise Stiff Joints in the Hand
Authors: Glasgow Celeste , Tooth Leigh , Fleming Jenny
Published: July 2017

Mobilising splinting is a common tool used by hand therapists to improve movement in stiff joints, by holding them at the end of available range of motion (ROM) under light tension, for extended periods of time. Both dynamic and static progressive splints are classified as mobilising splints. Many clinicians believe that static progressive splints are more effective than dynamic splints for improving ROM in particularly stiff joints. This paper reviews the limited available research evidence behind the assumptions that currently guide splint choice in clinical practice. Joint stiffness theory and the visco-elastic nature of the soft tissue response to stress are also revised. A rationale for the use of dynamic splints in preference to static progressive splints to mobilise the chronically stiff joint is presented. The need for further research, ideally in the form of a randomised controlled clinical trial, is highlighted.
Skin Infections: Which Student-Athletes Are at Greatest Risk?
Authors: Weesner Tim
Published: July 2017

Skin infections are a common ailment that affect all students, with increased risk to those students participating in sport and specifically contact sports. The types of skin infections that students are likely to encounter are categorized into three types: (a) bacterial, (b) viral, and (c) fungal. All three types of infection can appear benign at onset but can grow into serious disease and illness if not correctly identified and treated in a timely manner. A strong prevention program should be in place at all schools with appropriate resources in place (human and financial) to carry out proper cleaning of facilities, on-site examination by the school nurse or athletic trainer, and sufficient education of coaches, athletes, parents and administrators.
Historic Leadership: One Courageous School Nurse’s Heroic Journey—Part 4
Authors: Johnsen Ellen F. , Pohlman Katherine J.
Published: July 2017

School nursing practice establishes itself in the midst of both education and nursing philosophies, ethics, standards, laws, and regulations. Treading these two worlds is difficult at times and requires that a school nurse possess a strong foundational knowledge base, seek professional collaboration, and navigate conflicting professional demands in order to promote student and public safety. This article is Part 4 of a four-part series that recounts the inspiring story of a school nurse, Ellen Johnsen, who did just that back in the 1980s in Broken Arrow, Oklahoma. Part 4 offers lessons to be learned by reflecting on Ellen Johnsen’s experience when she challenged the illegal and unsafe medication administration policy in the Broken Arrow Public Schools. The purpose of this series is to enhance understanding of the legal parameters governing school nurse practice, provide examples of ethical decision making, and review the challenges associated with serving as a leader.
State-level Collaborations Among School Nurse Organizations: A Year in Review
Authors: Galemore Cynthia A.
Published: July 2017

The passage of the Every Student Succeeds Act provides an impetus for school nurse organizations to advocate for student health and climate goals at the state level. Collaboration between state agencies and associations is a starting point for advocacy. Advocacy also includes legislative involvement. This article explores state advocacy and collaboration efforts among school nurse organizations over the past year identifying common themes, with a focus on Every Student Succeeds Act involvement, as well as listing unique activities by state.
Transformational Learning and Role of Self-Authorship in Developing Women Leaders
Authors: Collay Michelle , Cooper Joanne
Published: July 2017

Given the challenges of the workplace and the historic exclusion of women and people of color from positional leadership, this dual case study explores women's experiences in two graduate programs designed to support transformational learning of educational leaders. Data included participants' structured reflections on learning about leadership, examined through the lens of two adult learning theories: self-authorship (Baxter Magolda, 1998, 2004) and transformational learning (Brooks, 2000; Kegan, 2000). Cross-case analysis indicated that participants developed confidence in their own knowledge, articulated the importance of personal support and collaboration, gained voice to advocate for themselves and their students, and experienced a fundamental change in their sense of themselves as leaders in their schools. These findings have implications for the provision of systematic graduate instruction that supports reflection and critique, offers multiple opportunities to step into leadership roles, and integrates informational and transformational learning.
Increasing Aspiring Principals' Readiness to Serve: Knowledge and Skill Application Laboratories
Authors: Eiseman Jeffrey W. , Militello Matthew
Published: July 2017

Most leadership programs emphasize knowledge over skills, being skillful over how to be skillful, knowledge about skills over skill application, and ad hoc and hard-to-assess field activities over focused and observable skill practice. “Knowledge and skill application laboratories” provide opportunities to experiment with — and receive criteria-based feedback from multiple observers on — new ways of thinking and behaving. They challenge students to integrate course-specific content with universally applicable skills: diagnosis, goal setting, communication, teamwork, and conflict management. We describe the purpose, history, and objectives of this kind of laboratory, sample lab activities, design considerations, and what we learned.
Legislative Advocacy for High Quality Leadership Preparation: Perspectives and Implications for Teaching and Learning Educational Leadership
Authors: Mansfield Katherine Cumings , Carpenter Bradley W.
Published: July 2017

This article interrogates the value of leadership preparation programs connecting academic and political spheres as endorsed in the 2008 revised ISLLC Standards. Specifically, a number of exemplar teaching and learning practices are shared that led to the planning and implementation of legislative advocacy projects for educational leadership professors and students in Washington, DC. Major findings include that although many educators are not adequately prepared nor encouraged to participate in policy making at the state or national levels, purposeful efforts to engage educators in legislative advocacy projects results in positive outcomes for professors, students, and policymakers alike.
Recommendations for the clinical management of patients receiving macitentan for pulmonary arterial hypertension (PAH): A Delphi consensus document
Authors: Rahaghi Franck F. , Alnuaimat Hassan M. , Awdish Rana L.A. , Balasubramanian Vijay P. , Bourge Robert C. , Burger Charles D. , Butler John , Cauthen C. Gregory , Chakinala Murali M. , deBoisblanc Bennett P. , Eggert Michael S. , Engel Peter , Feldman Jeremy , McConnell J. Wesley , Park Myung , Sager Jeffrey S. , Sood Namita , Palevsky Harold I.
Published: July 2017

In patients treated with macitentan (Opsumit®, Actelion Pharmaceuticals Ltd., Basel, Switzerland) for pulmonary arterial hypertension (PAH), prevention and/or effective management of treatment‐related adverse events may improve adherence. However, management of these adverse events can be challenging and the base of evidence and clinical experience for macitentan is limited. In the absence of evidence, consensus recommendations from physicians experienced in using macitentan to treat PAH may benefit patients and physicians who are using macitentan. Consensus recommendations were developed by a panel of physicians experienced with macitentan and PAH using a modified Delphi process. Over three iterations, panelists developed and refined a series of statements on the use of macitentan in PAH and rated their agreement with each statement on a Likert scale. The panel of 18 physicians participated and developed a total of 118 statements on special populations, add‐on therapy, drug–drug interactions, warnings and precautions, hospitalization and functional class, and adverse event management. The resulting consensus recommendations are intended to provide practical guidance on real‐world issues in using macitentan to treat patients with PAH.
Who We are — What We Do
Authors: Frisk June
Published: July 2017

The occupational health nurse is often the only full-time health worker in her place of employment. Compared to nurses in other fields, she is in the greatest danger of professional isolation. The hospital nurse, for example, is in daily contact with other professional workers, nurses, physicians, and technicians. Her co-workers talk her own language; she learns from them and keeps abreast of new developments in her specialty. On the other hand, most of the co-workers of the occupational health nurse are lay people and not professionally concerned with health problems or nursing. Any professional person needs the knowledge, stimulation and critical appraisal of other workers in her field. This need for professional contact is the principal reason for the existence of the American Association of Industrial Nurses. AAIN was founded in 1942 as the national specialty organization for occupational health nurses. It publishes material on occupational health nursing and provides opportunities for education and contact with others in this field.

Through its educational programs, publications and guides, AAIN is constantly striving to improve the services and standards of occupational health nursing. It believes that improving the services which occupational health nurses can give is the best way of ensuring greater rewards and economic security to them. This is a basic philosophy of AAIN.
Worksite High Blood Pressure Control Programs: How to Get Started
Authors: Coburn Helen O.
Published: July 2017

Under a contract with the National Heart, Lung, and Blood Institute, the Blue Cross and Blue Shield Associations carried out a demonstration project to determine how health insurers could utilize in-place systems and personnel to make worksite high blood pressure control programs more available to employee groups. When this project was initiated two and a half years ago, effective worksite-based programs had been developed in academic settings and tested in industry. Blue Cross and Blue Shield of Connecticut was selected by the national Blue Cross and Blue Shield Associations to serve as one of two demonstration test sites. The program is expanding to involve five additional Blue Cross and Blue Shield plans.
Research and the Band Director: Marriage not Divorce
Authors: Byo James L.
Published: July 2017

The pair of articles in the Instrumental Division of this issue of Update seem to be perfect companion pieces. James Byo speaks of intellectually aggressive band directors who get past the artificial barriers between researchers and teachers and apply research results to their own situations. His article illustrates the process of transferring knowledge so that research can be more meaningful to practitioners. He discusses the responsibility of the practitioner as well as of the researcher to establish a mutually inclusive relationship.

James Arnold, the author of the second article, has shown himself to fit Byo's characterization of an intellectually aggressive teacher. He is an experienced band director who has taught in isolated rural settings and who now teaches at Columbus High School in Columbus, Georgia. The article relates some of his experiences in applying research findings to his teaching. He read research from many disparate sources and apparently unrelated settings and made the transfers to his own unique situation. He tried to implement a certain type of rehearsal strategy in his teaching that he had encountered in reading the research literature. As a result of his reading, he also knew that there might be a difference between what he perceived he was doing and what he actually did, so he used videotape self analysis, which he had also read about, to assess his efforts.

Between these two articles—Byo's recommendations and examples and Arnold's actions—we have an illustration of the relevance of research and its implementation. The purpose of research in music education is to enhance music teaching and understanding. Without interaction between the teacher/experimenter and the researcher/teacher leading to the application of research, both lose, and ultimately the students will suffer from music settings that might have been made more rewarding.
Oxygen mass transfer in a stirred tank bioreactor using different impeller configurations for environmental purposes
Authors: Karimi Ali , Golbabaei Farideh , Mehrnia Momammad Reza , Neghab Masoud , Mohammad Kazem , Nikpey Ahmad , Pourmand Mohammad Reza
Published: July 2017

In this study, a miniature stirred tank bioreactor was designed for treatment of waste gas containing benzene, toluene and xylene. Oxygen mass transfer characteristics for various twin and single-impeller systems were investigated for 6 configurations in a vessel with 10 cm of inner diameter and working volume of 1.77L. Three types of impellers, namely, Rushton turbine, Pitched 4blades and Pitched 2blades impellers with downward pumping have been used. Deionized water was used as a liquid phase. With respect to other independent variables such as agitation speed, aeration rate, type of sparger, number of impellers, the relative performance of these impellers was assessed by comparing the values of (KLa) as a key parameter. Based on the experimental data, empirical correlations as a function of the operational conditions have been proposed, to study the oxygen transfer rates from air bubbles generated in the bioreactor. It was shown that twin Rushton turbine configuration demonstrates superior performance (23% to 77% enhancement in KLa) compared with other impeller compositions and that sparger type has negligible effect on oxygen mass transfer rate. Agitation speeds of 400 to 800 rpm were the most efficient speeds for oxygen mass transfer in the stirred bioreactor.
RETRACTED ARTICLE: Esoteric Connective Tissue Therapy for chronic low back pain to reduce pain, and improve functionality and general well-being compared with physiotherapy: study protocol for a randomised controlled trial
Authors: Schnelle Christoph , Messerschmidt Steffen , Minford Eunice J. , Greenaway-Twist Kate , Szramka Maxine , Masiorski Marianna , Sheldrake Michelle , Jones Mark
Published: July 2017

Background

Low back pain causes more global disability than any other condition. Once the acute pain becomes chronic, about two-thirds of sufferers will not fully recover after 1–2 years. There is a paucity of effective treatments for non-specific, chronic low back pain.

It has been noted that low back pain is associated with changes in the connective tissue in the affected area, and a very low-impact treatment, Esoteric Connective Tissue Therapy (ECTT), has been developed to restore flexibility in connective tissue. ECTT uses patterns of very small, circular movements, to the legs, arms, spine, sacrum and head, which anecdotally are effective in pain relief. In an unpublished single-arm phase I/II trial with chronic pain patients, ECTT showed a 56% reduction in pain after five treatments and 45% and 54% improvements at 6 months and 7–9 years of follow-up respectively.

Methods

The aim of this randomised controlled trial is to compare ECTT with physiotherapy for reducing pain and improving physical function and physical and mental well-being in patients with chronic low back pain.

The trial will be held at two hospitals in Vietnam. One hundred participants with chronic low back pain greater than or equal to 40/100 on the visual analogue scale will be recruited and randomised to either ECTT or physiotherapy. Four weekly treatments will be provided by two experienced ECTT practitioners (Treatment Group, 40 minutes each) and hospital-employed physiotherapy nurses (Control Group, 50 minutes).

The primary outcomes will be changes in pain, physical function per the Quebec Pain Functionality Questionnaire and physical and mental well-being recorded by the Short Form Health Survey (SF-36), with mixed modelling used as the primary statistical tool because the data are longitudinal. Initial follow-up will be at either 4 or 8 months, with a second follow-up after 12 months.

Discussion

The trial design has important strengths, because it is to be conducted in hospitals under medical supervision, because ECTT is to be compared with a standard therapy and because the assessor and analyst are to be blinded. The findings from this trial will provide evidence of the efficacy of ECTT for chronic low back pain compared with standard physiotherapy treatment.

Trial registration

Australian New Zealand Clinical Trials Registry, ACTRN12616001196437. Registered on 30 August 2016.
Patterns of lifestyle-related behaviors and parents’ overweight are associated with increased body adiposity in schoolchildren: a cross-sectional study in Portugal
Authors: Rodrigues Paulo Rogério Melo , Pereira Rosangela Alves , Santana Ana Margarida Sebastião , Gama Augusta , Carvalhal Isabel Mourão , Nogueira Helena , Rosado-Marques Vitor , Padez Cristina
Published: July 2017

Background

This study evaluated the association between lifestyle-related behavior patterns and weight status indicators in schoolchildren.

Methods

Cross-sectional study includes nationally representative sample of Portuguese schoolchildren (6–9 years old; n = 10,258). Weight status was assessed using the body mass index (BMI) and waist circumference (WC). Principal component analysis was used to identify lifestyle-related behavior patterns. Multiple linear regression models were used to estimate the association between behavior patterns, BMI, and WC.

Results

Six lifestyle-related behavior patterns were identified: pattern 1: consuming iced tea and soft drinks ≥2 times/week, having a television (TV) in the bedroom, watching TV ≥2 h/day, and consuming <2 portions of fruits/day; pattern 2: parents and children remaining physically inactive during leisure time; pattern 3: consuming ≤1 portion of vegetables and milk/day; pattern 4: having parents with excess weight; pattern 5: consuming ≤3 daily meals and skipping breakfast; and pattern 6: not participating in physical education classes. After the adjustment, all of the patterns were associated with increased BMI z-score (P ≤ 0.02) and WC (P ≤ 0.03).

Conclusions

Lifestyle-related behavior patterns were associated with an increased risk of excess weight and the central distribution of body fat. Taking a public health perspective toward preventing childhood obesity, special attention should be given to identify subgroups with simultaneous occurrence of multiple risk behaviors, which is useful for planning prevention programs.
Breast Cancer Beliefs as Potential Targets for Breast Cancer Awareness Efforts to Decrease Late-Stage Presentation in Uganda
Authors: Scheel John R. , Molina Yamile , Anderson Benjamin O. , Patrick Donald L. , Nakigudde Gertrude , Gralow Julie R. , Lehman Constance D. , Thompson Beti
Published: July 2017

Purpose

To assess breast cancer beliefs in Uganda and determine whether these beliefs are associated with factors potentially related to nonparticipation in early detection.

Methods

A survey with open- and close-ended items was conducted in a community sample of Ugandan women to assess their beliefs about breast cancer. Linear regression was used to ascertain associations between breast cancer beliefs and demographic factors potentially associated with early detection, including socioeconomic factors, health care access, prior breast cancer knowledge, and personal detection practices.

Results

Of the 401 Ugandan women surveyed, most had less than a primary school education and received medical care at community health centers. Most women either believed in or were unsure about cultural explanatory models for developing breast cancer (> 82%), and the majority listed these beliefs as the most important causes of breast cancer (69%). By comparison, ≤ 45% of women believed in scientific explanatory risks for developing breast cancer. Although most believed that regular screening and early detection would find breast cancer when it is easy to treat (88% and 80%, respectively), they simultaneously held fatalistic attitudes toward their own detection efforts, including belief or uncertainty that a cure is impossible once they could self-detect a lump (54%). Individual beliefs were largely independent of demographic factors.

Conclusion

Misconceptions about breast cancer risks and benefits of early detection are widespread in Uganda and must be addressed in future breast cancer awareness efforts. Until screening programs exist, most breast cancer will be self-detected. Unless addressed by future awareness efforts, the high frequency of fatalistic attitudes held by women toward their own detection efforts will continue to be deleterious to breast cancer early detection in sub-Saharan countries like Uganda.
Splenic trauma during abdominal wall liposuction: a case report
Authors: Harnett Paul , Koak Yashwant , Baker Daryl
Published: July 2017

Summary

A 35-year-old woman collapsed 18 hours after undergoing abdominal wall liposuction. Abdominal CT scan revealed a punctured spleen. She underwent an emergency splenectomy and made an uneventful recovery.