bluuebunny/crossref_metadata_2025 huggingface dataset:
O uso do geoprocessamento na espacialização e avaliação das Áreas de Preservação Permanente: Cidade de Porto Velho-RO
Authors: Silva Helen Rose Oliveira da , Guimarães Siane Cristhina Pedroso , Oliveira Liliana Borges de
Published: March 2017

Este estudo tem por objetivo delimitar as Áreas de Preservação Permanente (APP) da área urbana do município de Porto Velho. Com faixa de 15m e 30m, utilizou-se como base de verificação o geoprocessamento associado ao uso do sensoriamento remoto. Estas técnicas permitem viabilizar e aumentar a eficácia na fiscalização de combate à degradação dessas áreas, podendo ser facilmente utilizadas por parte dos órgãos de monitoramento atentas ao cumprimento da legislação vigente. Foram utilizadas imagens SPOT, de resolução espacial 2,5 m e WorldView resolução espacial 50cm. Os mapas foram elaborados utilizando o software SPRING 5.2, versão livre do Instituto Nacional de Pesquisas Espaciais-INPE. Foi utilizado como base, também, o mapa de população por bairros da Secretaria Municipal de Planejamento-SEMPLA. Durante a manipulação dos dados foi possível calcular um total de 1267,03 ha de APP de 30m, sendo que deste total 65,4% de APPs já tinham sido desmatadas. As APPs de 15m somaram 956.46 ha, tendo um desmatamento de 66,4%. Foi possível observar ao final da pesquisa que, mesmo com a redução da faixa de vegetação para 15m, conforme sugerido por lei completar de uso e ocupação do solo urbano de Porto Velho, ha um déficit de APP preservada para o município, sinal de que o desmatamento dessas áreas continua constante, reflexo da antropização cada vez mais frequente nos centros urbanos. O resultado final mostrou, ainda, que os bairros que mais desmataram essas APPs foram o, Nova Floresta, Floresta e Mato Grosso.
E Belém? A questão da apropriação do patrimônio numa freguesia de Lisboa.
Authors: Teixeira-da-Silva Rafael H.
Published: March 2017

Independente de ser celebrado ou repudiado, o passado é onipresente. Enquanto os traços pessoais imbuídos nestes elementos vão sucumbindo ao tempo, os aspectos coletivos dos mesmos mantêm-se infindáveis. O que já foi um passado diletante apresenta-se, atualmente, como uma interminável e implacável cruzada pelo patrimônio, fato que tem consequências imediatas na apropriação do território urbano. Somada à tendência pela adoção de uma abordagem padronizada sobre o patrimônio – patrimonialização – encontra-se neste entrelaçar, o tema do presente artigo. O desenvolvimento desta problemática realiza-se mediante um caso de estudo - a freguesia de Santa Maria de Belém (Lisboa), dotada de um importante conjunto arquitetônico. Nesse sentido, foi realizada uma investigação de cariz etnográfico, com recurso a métodos de pesquisa qualitativos. Através da pesquisa realizada foi possível apreender os espaços mais significativos na vida de bairro dos entrevistados, que buscam manter os seus costumes e práticas tradicionais, ao mesmo tempo que novos hábitos e vivências são criados pelos processos de patrimonialização e turistificação do lugar.
Indicadores ambientais de sustentabilidade para uma instituição federal de ensino superior
Authors: Nunes Andréia Castro de Paula , Reis Leci Martins Menezes , Silva Robson Garcia da
Published: March 2017

Na atualidade, as discussões acerca do tema sustentabilidade têm permeado o cotidiano e, por conseguinte, a esfera acadêmica. Nesse contexto, as Instituições de Ensino Superior (IES) podem cumprir papel primordial na aplicação de práticas sustentáveis. Este trabalho buscou selecionar, sob a perspectiva de especialistas, indicadores ambientais de sustentabilidade para a Universidade Federal do Rio Grande do Norte (UFRN) no ano de 2015. Para tanto, a partir de pesquisas bibliográfica e documental, foram levantados, na literatura nacional e internacional, 110 indicadores ambientais de sustentabilidade para IES. Em seguida, foram excluídos os indicadores repetidos e os 50 remanescentes foram enviados, por meio de questionários, para 6 especialistas ponderarem o nível de relevância conforme a Escala de Likert. Dentre o universo de 50 indicadores ponderados pelos especialistas, 6 obtiveram as maiores médias aritméticas simples de pesos e, portanto, foram considerados os indicadores ambientais de sustentabilidade mais relevantes para a UFRN.
Systèmes agricoles et système d’indicateurs: évaluation de l’impact du changement climatique sur la sécurité alimentaire dans un bassin d’inondation amazonien
Authors: Doyen Marie Flore , Laques Anne Elisabeth , Gurgel Helen , Garcia Lucas
Published: March 2017

En Amazonie, le changement climatique se traduit principalement par un dérèglement du régime des crues, perturbant les systèmes agricoles des populations riveraines de l’Amazone et les rendant potentiellement sensibles à l’insécurité alimentaire. Afin de faciliter l’analyse des systèmes agricoles de la zone étudiée (le Lago Grande de Curuaï), une typologie a été effectuée via la matrice de Bertin, permettant d’identifier quatre systèmes types : les systèmes agro-forestier, agricole spécialisé, agro-pastoral et pisci-pastoral. A partir des informations relatives aux systèmes agricoles et ayant pour principale base deux piliers de la sécurité alimentaire (la disponibilité et l’accès aux denrées alimentaires), un système d’indicateurs a été créé suivant la méthode « Principe, Critères, Indicateurs ». Un principe, trois critères et sept indicateurs ont évalué la sécurité alimentaire à l’échelle des systèmes agricoles types et ce, suivant deux scénarios : avec ou sans survenance d’évènements extrêmes. Une dégradation de l’état de la sécurité alimentaire est observée avec la survenance d’évènements extrêmes et c’est le système agro-pastoral qui est le plus affecté par ces crises.
Les émissions de gaz à effet de serre du tourisme des Brésiliens
Authors: Ceron Jean Paul , Dubois Ghislain
Published: March 2017

Le tourisme des Brésiliens reste très méconnu, les statistiques se focalisant d’abord sur les arrivées internationales de visiteurs, sources de devises. Le développement économique et la réduction relative des inégalités des vingt dernières années ont pourtant permis l’accès à la mobilité touristique d’une part croissante de la population, à destination du Brésil et de l’étranger, ce qui constitue aussi un poids économique considérable. Mais le tourisme, en raison de son intensité en transports, notamment aériens, constitue une part croissante des émissions de gaz à effet de serre. Il devra être pris en compte dans la définition des politiques climatiques consécutives à l’accord de Paris. A ce titre la situation du Brésil illustre – sans en être représentative, tant la diversité des situations est grande – le cas des pays émergents, dont l’accès au tourisme de masse va constituer l’essentiel de la croissance du secteur dans l’avenir.Cet article part des statistiques de flux de touristes "domestiques" (données par l’enquête FIPE du 2010), combinées avec d’autres sources, pour évaluer la contribution du tourisme brésilien aux émissions de gaz à effet de serre du pays. Les émissions actuelles du tourisme brésilien sont de 34 millions de tonnes d’équivalent CO2, mais atteignent 55 millions de tonnes si on introduit un facteur multiplicatif pour tenir compte des contributions spécifiques de l'aviation. Elles représentaient en 2001 plus de 3% des émissions nationales (5% effets spécifiques de l’avion inclus), la moyenne mondiale correspondante étant de 4,9%. Les perspectives laissent envisager une contribution croissante aux émissions nationales.
Indigenous Chinese Management Philosophies
Authors: Garg Ritam , Berning Sue Claire
Published: March 2017

Increasing internationalization of Chinese firms is continuously attracting the attention of management scholars across the world. Hence, one of the main questions in this context is whether the unique cultural concepts that are indigenous to China support or aggravate the success of Chinese firms. The main objective of this study is therefore to review the cultural aspects prevalent in China from an indigenous management perspective. In particular, we explore whether and how the ancient Chinese teachings and philosophies, such as Guanxi or Mianzi, are relevant in the modern Chinese management context. This study specifically seeks to contribute to the understanding of management culture of Chinese firms and, more generally, to cross-cultural and indigenous management research.
The Contribution of Maria Montessori's Pedagogy and her Educational Action to Modern Inclusive Policies
Authors: Curatola Annamaria
Published: March 2017

Maria Montessori's influence on modern inclusive policies, in particular in relation to school education, is really remarkable. Her culture, pedagogical intuitions, her institutional projects and her methodological and didactic innovations influenced profoundly our views on education, offering a detailed and original understanding of childhood as the foundation of a mature, critical and democratic society. Maria Montessori's ideas, based on solid philosophical and anthropological grounds, not only found validation by embracing and implementing the achievements of various sciences pertaining to human evolutional development and its social community, but also shed light on research topics that are still object of scholarly attention. This is testified to by the fact that her educational methods are still relevant today, and they can be easily adapted to the change in life conditions and the widespread use of new media technologies. Cooperative work, mutual assistance, individually tailored education, reading, curricular and extracurricular activities, the tailoring of learning environments to the individual pupil, the need to monitor and evaluate learning outcomes, the design and experimentation of teaching, social involvement, use of technological aides, as well as inclusive and integrative education, are but a few of the foundations of her philosophy. Hence the importance of her ideas to this day.
Training and Maintaining: Developing a Successful and Dynamic Continuous Renal Replacement Therapy Program
Authors: Przybyl Heather , Evans Jill , Haley Laurie , Bisek Jodi , Beck Emily
Published: March 2017

Continuous renal replacement therapy (CRRT) is commonly used to support critically ill patients with acute kidney injury or chronic renal disease whose condition is too unstable for them to tolerate intermittent hemodialysis. Current publications related to CRRT programs in the United States and Canada note key themes related to the development and maintenance of CRRT training programs. A successful CRRT training program should consider and incorporate adult learning principles whenever possible. A variety of teaching methods to deliver information to nurses, including online learning modules, didactic lecture, return demonstration, and high-fidelity patient simulation are key to training programs for this high-risk complex therapy. This article outlines the approach to training nurses to care for patients receiving CRRT at a health care system in Arizona.
IL-6 Production by TLR-Activated APC Broadly Enhances Aged Cognate CD4 Helper and B Cell Antibody Responses In Vivo
Authors: Brahmakshatriya Vinayak , Kuang Yi , Devarajan Priyadharshini , Xia Jingya , Zhang Wenliang , Vong Allen Minh , Swain Susan L.
Published: March 2017

Naive CD4 T cell responses, especially their ability to help B cell responses, become compromised with aging. We find that using APC pretreated ex vivo with TLR agonists, polyinosinic-polycytidylic acid and CpG, to prime naive CD4 T cells in vivo, restores their ability to expand and become germinal center T follicular helpers and enhances B cell IgG Ab production. Enhanced helper responses are dependent on IL-6 production by the activated APC. Aged naive CD4 T cells respond suboptimally to IL-6 compared with young cells, such that higher doses are required to induce comparable signaling. Preactivating APC overcomes this deficiency. Responses of young CD4 T cells are also enhanced by preactivating APC with similar effects but with only partial IL-6 dependency. Strikingly, introducing just the activated APC into aged mice significantly enhances otherwise compromised Ab production to inactivated influenza vaccine. These findings reveal a central role for the production of IL-6 by APC during initial cognate interactions in the generation of effective CD4 T cell help, which becomes greater with age. Without APC activation, aging CD4 T cell responses shift toward IL-6–independent Th1 and CD4 cytotoxic Th cell responses. Thus, strategies that specifically activate and provide Ag to APC could potentially enhance Ab-mediated protection in vaccine responses.
MicroRNA-3570 Modulates the NF-κB Pathway in Teleost Fish by Targeting MyD88
Authors: Chu Qing , Sun Yuena , Cui Junxia , Xu Tianjun
Published: March 2017

The inflammatory response, a protective process to clear detrimental stimuli, constitutes the defense against infectious pathogens. However, excessive inflammation disrupts immune homeostasis, which may induce autoimmune and inflammatory diseases. In this study, we report that microRNA (miR)-3570 plays a negative role in the bacteria-induced inflammatory response of miiuy croaker. Upregulation of miR-3570 by Vibrio anguillarum and LPS inhibits LPS-induced inflammatory cytokine production, thus avoiding an excessive inflammation response. Evidence showed that miR-3570 targets MyD88 and posttranscriptionally downregulates its expression. Overexpression of miR-3570 in macrophages suppresses the expression of MyD88, as well as its downstream signaling of IL-1R–associated kinases 1 and 4 and TNFR-associated factor 6. These results suggest that miR-3570 plays a regulatory in the bacteria-induced inflammatory response through the MyD88-mediated NF-κB signaling pathway by targeting MyD88.
The role of reverse shoulder arthroplasty in management of proximal humerus fractures with fracture sequelae: a systematic review of the literature
Authors: Holton James , Yousri Tahir , Arealis George , Levy Ofer
Published: March 2017

Fracture sequelae of the proximal humerus poses a complex management decision due to the frequent deformity and its consequences on the peri-articular soft tissues. These patients are frequently elderly with significant medical comorbidities. Due to the age of the patient there is frequently rotator cuff deficiency and therefore the reverse shoulder arthroplasty (RSA) becomes the arthroplasty of choice. We have performed a systematic review of the literature and report nine studies presenting RSA for the treatment of fracture sequelae of the proximal humerus. It is clear that RSA can improve the range of movement and function following proximal humerus fracture sequelae. However, there is a risk of significant complications including dislocation (16.7%), infection (6.7%), intra-operative fracture (3%) and neurological injury (2.6%). There is a need to invest in future prospective comparative studies and randomised trials to further test RSA in fracture sequelae patients. This will provide us with information regarding the longevity of different prosthesis, outcomes and costeffectiveness of treatment.
Intrarater Reliability of the Adductor Squeeze Test in Gaelic Games Athletes
Authors: Delahunt Eamonn , McEntee Barry L. , Kennelly Colm , Green Brian S. , Coughlan Garrett F.
Published: March 2017

Context: Groin pain is commonly experienced by athletes involved in field-based sports and is particularly prevalent in Gaelic Games athletes. The adductor squeeze test is commonly used in the assessment of groin pain and injuries. To date, no evidence in the literature provides the reliability of the adductor squeeze test using a sphygmomanometer in assessing the adductor muscle integrity of Gaelic Games athletes. Given the high proportion of groin pain encountered in Gaelic Games athletes, establishing the reliability of the adductor squeeze test will allow clinicians to monitor injury responses and to assess return-to-play criteria.

Objective: To evaluate the intrarater reliability of a commercially available sphygmomanometer for measuring adductor squeeze values in Gaelic Games athletes and to determine if different squeeze values are associated with the 3 commonly used test positions.

Design: Descriptive laboratory study.

Setting: University clinical skills laboratory.

Patients or Other Participants: Eighteen male Gaelic Games athletes without any previous or current history of groin or pelvic pain.

Intervention(s): Each participant performed the adductor squeeze test in 3 positions of hip joint flexion (0°, 45°, and 90°) on 2 test days separated by at least 1 week.

Main Outcome Measure(s): Adductor squeeze test values (mm Hg) quantified by a commercially available sphygmomanometer.

Results: Intrarater reliability intraclass correlation values ranged from 0.89 to 0.92 (intraclass correlation coefficients were 0°, 0.89; 45°, 0.92; and 90°, 0.90). The highest squeeze values were recorded in the 45° of hip flexion test position, and these values differed from those demonstrated in the 0° and 90° hip flexion test positions (P < .05).

Conclusions: A commercially available sphygmomanometer is a reliable device for measuring adductor squeeze test values.
A Profile of Glenohumeral Internal and External Rotation Motion in the Uninjured High School Baseball Pitcher, Part I: Motion
Authors: Hurd Wendy J. , Kaplan Kevin M. , ElAttrache Neal S. , Jobe Frank W. , Morrey Bernard F. , Kaufman Kenton R.
Published: March 2017

Context: The magnitude of motion that is normal for the throwing shoulder in uninjured baseball pitchers has not been established. Chronologic factors contributing to adaptations in motion present in the thrower's shoulder also have not been established.

Objectives: To develop a normative profile of glenohumeral rotation motion in uninjured high school baseball pitchers and to evaluate the effect of chronologic characteristics on the development of adaptations in shoulder rotation motion.

Design: Cohort study.

Setting: Baseball playing field.

Patients or Other Participants: A total of 210 uninjured male high school baseball pitchers (age = 16±1.1 years, height = 1.8 + 0.1 m, mass = 77.5±11.2 kg, pitching experience = 6±2.3 years).

Intervention(s): Using standard goniometric techniques, we measured passive rotational glenohumeral range of motion bilaterally with participants in the supine position.

Main Outcome Measure(s): Paired t tests were performed to identify differences in motion between limbs for the group. Analysis of variance and post hoc Tukey tests were conducted to identify differences in motion by age. Linear regressions were performed to determine the influence of chronologic factors on limb motion.

Results: Rotation motion characteristics for the population were established. We found no difference between sides for external rotation (ER) at 0° of abduction (t209 = 0.658, P = .51), but we found side-to-side differences in ER (t209 = −13.012, P<.001) and internal rotation (t209 = 15.304, P<.001) at 90° of abduction. Age at the time of testing was a significant negative predictor of ER motion for the dominant shoulder (R2 = 0.019, P = .049) because less ER motion occurred at the dominant shoulder with advancing age. We found no differences in rotation motion in the dominant shoulder across ages (F4,205 range, 0.451–1.730, P>.05).

Conclusions: This range-of-motion profile might be used to assist with the interpretation of normal and atypical shoulder rotation motion in this population. Chronologic characteristics of athletes had no influence on range-of-motion adaptations in the thrower's shoulder.
Diagnostic Accuracy of History and Physical Examination of Superior Labrum Anterior-Posterior Lesions
Authors: Michener Lori A. , Doukas William C. , Murphy Kevin P. , Walsworth Matthew K.
Published: March 2017

Context: Type I superior labrum anterior-posterior (SLAP) lesions involve degenerative fraying and probably are not the cause of shoulder pain. Type II to IV SLAP lesions are tears of the labrum.

Objective: To determine the diagnostic accuracy of patient history and the active compression, anterior slide, and crank tests for type I and type II to IV SLAP lesions.

Design: Cohort study.

Setting: Clinic.

Patients or Other Participants: Fifty-five patients (47 men, 8 women; age = 40.6 ± 15.1 years) presenting with shoulder pain.

Intervention(s): For each patient, an orthopaedic surgeon conducted a clinical examination of history of trauma; sudden onset of symptoms; history of popping, clicking, or catching; age; and active compression, crank, and anterior slide tests. The reference standard was the intraoperative diagnosis. The operating surgeon was blinded to the results of the clinical examination.

Main Outcome Measure(s): Diagnostic utility was calculated using the receiver operating characteristic curve and area under the curve (AUC), sensitivity, specificity, positive likelihood ratio (+LR), and negative likelihood ratio (−LR). Forward stepwise binary regression was used to determine a combination of tests for diagnosis.

Results: No history item or physical examination test had diagnostic accuracy for type I SLAP lesions (n = 13). The anterior slide test had utility (AUC = 0.70, +LR = 2.25, −LR = 0.44) to confirm and exclude type II to IV SLAP lesions (n = 10). The combination of a history of popping, clicking, or catching and the anterior slide test demonstrated diagnostic utility for confirming type II to IV SLAP lesions (+LR = 6.00).

Conclusions: The anterior slide test had limited diagnostic utility for confirming and excluding type II to IV SLAP lesions; diagnostic values indicated only small shifts in probability. However, the combination of the anterior slide test with a history of popping, clicking, or catching had moderate diagnostic utility for confirming type II to IV SLAP lesions. No single item or combination of history items and physical examination tests had diagnostic utility for type I SLAP lesions.
Lateral Scapular Slide Test and Scapular Mobility in Volleyball Players
Authors: Ozunlu Nihan , Tekeli Hatice , Baltaci Gul
Published: March 2017

Context: The stability of the scapula in relation to the entire moving upper extremity is the key in the throwing sequence. The importance of scapular positioning in volleyball players has been well documented in the literature, but no one has compared scapular positioning between volleyball players and sedentary people.

Objective: To compare measurements of scapular mobility obtained using the lateral scapular slide test between volleyball players and sedentary participants without shoulder impairments and to compare changes in scapular mobility in players according to the number of years of sport participation.

Design: Cross-sectional study.

Setting: University research laboratory.

Patients or Other Participants: A total of 121 people at a single university volunteered. Of these, 67 were sedentary (age = 24.3 ± 2.34 years, height = 1.69 ± 0.09 m, mass = 65.1 ± 11.91 kg); 54 were volleyball players from 4 professional teams and were separated into 2 groups according to their years of sport participation. The first group was named young players (n = 31; age = 17.7 ± 2.58 years, height = 1.83 ± 0.10 m, mass = 68.3 ± 12.21 kg, sport participation ≤ 9 years), and the second group was named old players (n = 23; age = 26.9 ± 3.39 years, height = 1.95 ± 4.38 m, mass = 90.7 ± 5.75 kg, sport participation ≥ 10 years).

Main Outcome Measure(s): Study participants completed a rating scale for pain and a questionnaire about demographic and shoulder problems. One assessor performed the lateral scapular slide test and additional flexibility measurements around the shoulder girdle. Flexibility (external rotation, internal rotation) and scapular position (1, 2, 3) were compared among groups (young players, old players, sedentary people) and between sides (dominant, nondominant).

Results: In sedentary participants, we found differences for position 1 (t66 = 3.327, P = .002), position 2 (t66 = 2.491, P = .004), position 3 (t66 = 2.512, P = .006), and internal rotation (t66 = 2.592, P = .001) between the dominant and nondominant sides. In old players, we found differences for position 2 between the dominant and nondominant sides (t22 = 2.956, P = .004). For position 2 (F2,118 = 4.265, P = .02) and position 3 (F2,118 = 4.702, P = .01), we found differences between young and old players. For internal rotation, we found differences between sedentary and old players (F2,118 = 6.578, P = .002) and between young and old players (F2,118 = 3.723, P = .01).

Conclusions: Clinicians evaluating overhead athletes need to remember that asymmetric scapular posture between the dominant and nondominant sides in unilateral overhead athletes might be normal and not necessarily related to injury.
Neuromuscular Changes After Aerobic Exercise in People with Anterior Cruciate Ligament– Reconstructed Knees
Authors: Dalton Elizabeth C. , Pfile Kate R. , Weniger Gerald R. , Ingersoll Christopher D. , Herman Daniel , Hart Joseph M.
Published: March 2017

Context: Anterior cruciate ligament (ACL) reconstructions are common, especially in young, active people. The lower extremity neuromuscular adaptations seen after aerobic exercise provide information about how previously injured patients perform and highlight deficits and, hence, areas for focused treatment. Little information is available about neuromuscular performance after aerobic exercise in people with ACL reconstructions.

Objective: To compare dynamic balance, gluteus medius muscle activation, vertical jump height, and hip muscle strength after aerobic exercise in people with ACL-reconstructed knees.

Design: Case-control study.

Setting: Research laboratory.

Patients or Other Participants: Of 34 recreationally active volunteers, 17 had a unilateral primary ACL reconstruction at least 2 years earlier and 17 were matched controls.

Intervention(s): All participants performed 20 minutes of aerobic exercise on a treadmill.

Main Outcome Measure(s): We recorded dynamic, single-legged balance electromyographic gluteus medius muscle activation, single-legged vertical jump height, and maximum isometric strength for hip abduction, extension, and external rotation preexercise and postexercise.

Results: Participants with ACL reconstructions exhibited shorter reach distances during dynamic balance tasks, indicating poorer dynamic balance, and less gluteus medius muscle electromyographic activation. Reductions in hip abduction and extension strength after exercise were noted in all participants; however, those with ACL reconstructions displayed greater hip extensor strength loss after aerobic exercise than did the control group.

Conclusions: Neuromuscular changes after aerobic exercise exist in both patients with ACL reconstructions and controls. The former group may experience greater deficits in hip extensor strength after aerobic exercise. Reduced reach distances in people with ACL reconstructions may represent a protective mechanism against excessive tibiofemoral rotation during dynamic balance. Clinicians should identify weaknesses in the resting state and after aerobic exercise in recreationally active patients and those with ACL reconstructions.
Risk of Injury in Basketball, Football, and Soccer Players, Ages 15 Years and Older, 2003–2007
Authors: Carter Elizabeth A. , Westerman Beverly J. , Hunting Katherine L.
Published: March 2017

Context: A major challenge in the field of sports injury epidemiology is identifying the appropriate denominators for injury rates.

Objective: To characterize risk of injury from participation in basketball, football, and soccer in the United States, using hours of participation as the measure of exposure, and to compare these rates with those derived using population estimates in the denominator.

Design: Descriptive epidemiology study.

Setting: United States, 2003–2007.

Participants: People ages 15 years and older who experienced an emergency department–treated injury while playing basketball, football, or soccer.

Main Outcome Measure(s): Rates of emergency department–treated injuries resulting from participation in basketball, football, or soccer. Injury rates were calculated for people ages 15 and older for the years 2003–2007 using the U.S. population and hours of participation as the denominators. The risk of injury associated with each of these sports was compared for all participants and by sex.

Results: From 2003 through 2007, annual injury rates per 1000 U.S. population were as follows: 1.49 (95% confidence interval [CI] = 1.30, 1.67) in basketball, 0.93 (95% CI = 0.82, 1.04) in football, and 0.43 (95% CI = 0.33, 0.53) in soccer. When the denominator was hours of participation, the injury rate in football (5.08 [95% CI = 4.46, 5.69]/10 000 hours) was almost twice as high as that for basketball (2.69 [95% CI = 2.35, 3.02]/10 000 hours) and soccer (2.69 [95% CI = 2.07, 3.30]/10 000 hours).

Conclusions: Depending on the choice of denominator, interpretation of the risk of an emergency department–treated injury in basketball, football, or soccer varies greatly. Using the U.S. population as the denominator produced rates that were highest in basketball and lowest in soccer. However, using hours of participation as a more accurate measure of exposure demonstrated that football had a higher rate of injury than basketball or soccer for both males and females.
Validity of Soccer Injury Data from the National Collegiate Athletic Association's Injury Surveillance System
Authors: Kucera Kristen L. , Marshall Stephen W. , Bell David R. , DiStefano Michael J. , Goerger Candice P. , Oyama Sakiko
Published: March 2017

Context: Few validation studies of sport injury-surveillance systems are available.

Objective: To determine the validity of a Web-based system for surveillance of collegiate sport injuries, the Injury Surveillance System (ISS) of the National Collegiate Athletic Association's (NCAA).

Design: Validation study comparing NCAA ISS data from 2 fall collegiate sports (men's and women's soccer) with other types of clinical records maintained by certified athletic trainers.

Setting: A purposive sample of 15 NCAA colleges and universities that provided NCAA ISS data on both men's and women's soccer for at least 2 years during 2005–2007, stratified by playing division.

Patients or Other Participants: A total of 737 men's and women's soccer athletes and 37 athletic trainers at these 15 institutions.

Main Outcome Measure(s): The proportion of injuries captured by the NCAA ISS (capture rate) was estimated by comparing NCAA ISS data with the other clinical records on the same athletes maintained by the athletic trainers. We reviewed all athletic injury events resulting from participation in NCAA collegiate sports that resulted in 1 day or more of restricted activity in games or practices and necessitated medical care. A capture-recapture analysis estimated the proportion of injury events captured by the NCAA ISS. Agreement for key data fields was also measured.

Results: We analyzed 664 injury events. The NCAA ISS captured 88.3% (95% confidence interval = 85.9%, 90.8%) of all time-lost medical-attention injury events. The proportion of injury events captured by the NCAA ISS was higher in Division I (93.8%) and Division II (89.6%) than in Division III (82.3%) schools. Agreement between the NCAA ISS data and the non–NCAA ISS data was good for the majority of data fields but low for date of full return and days lost from sport participation.

Conclusions: The overall capture rate of the NCAA ISS was very good (88%) in men's and women's soccer for this period.
Evaluation of Electromyographic Biofeedback for the Quadriceps Femoris: A Systematic Review
Authors: Wasielewski Noah J. , Parker Tonya M. , Kotsko Kevin M.
Published: March 2017

Objective: To critically review evidence for the effectiveness of electromyographic biofeedback (EMGB) of the quadriceps femoris muscle in treating various knee conditions.

Data Sources: Databases used to locate randomized controlled trials included PubMed (1980–2010), Cumulative Index of Nursing and Allied Health Literature (CINAHL, 1995–2007), Web of Science (1986–2010), SPORTDiscus (1990–2007), and Physiotherapy Evidence Database (PEDro). Key words were knee and biofeedback.

Study Selection: The criteria for selection were clinical randomized controlled trials in which EMGB of the quadriceps femoris was used for various knee conditions of musculoskeletal origin. Trials were excluded because of research designs other than randomized controlled trials, articles published in a non-English language, inclusion of healthy research participants, inability to identify EMGB as the source of clinical improvement, and lack of pain, functional outcome, or quadriceps torque as outcome measures.

Data Extraction: Twenty specific data points were abstracted from each clinical trial under the broad categories of attributes of the patient and injury, treatment variables for the EMGB group, treatment variables for the control group, and attributes of the research design.

Data Synthesis: Eight trials yielded a total of 319 participants with patellofemoral pain syndrome (n = 86), anterior cruciate ligament reconstruction (n = 52), arthroscopic surgery (n = 91), or osteoarthritis (n = 90). The average methodologic score of the included studies was 4.6/10 based on PEDro criteria. Pooled analyses demonstrated heterogeneity of the included studies, rendering the interpretation of the pooled data inappropriate. The EMGB appeared to benefit short-term postsurgical pain or quadriceps strength in 3 of 4 postsurgical investigations but was ineffective for chronic knee conditions such as patellofemoral pain and osteoarthritis in all 4 studies. Because the findings are based on limited data, caution is warranted until more randomized controlled trials are conducted to support or refute the general trends observed in this report.
Epidemiology of Adolescent Rugby Injuries: A Systematic Review
Authors: Bleakley Christopher , Tully Mark , O'Connor Sean
Published: March 2017

Objective: Despite recent increases in the volume of research in professional rugby union, there is little consensus on the epidemiology of injury in adolescent players. We undertook a systematic review to determine the incidence, severity, and nature of injury in adolescent rugby union players.

Data Sources: In April 2009, we performed a computerized literature search on PubMed, Embase, and Cochrane Controlled Trials Register (via Ovid). Population-specific and patient-specific search terms were combined in the form of MEDLINE subject headings and key words (wound$ and injur$, rugby, adolescent$). These were supplemented with related-citation searches on PubMed and bibliographic tracking of primary and review articles.

Study Selection: Prospective epidemiologic studies in adolescent rugby union players.

Data Synthesis: A total of 15 studies were included, and the data were analyzed descriptively. Two independent reviewers extracted key study characteristics regarding the incidence, severity, and nature of injuries and the methodologic design.

Conclusions: Wide variations existed in the injury definitions and data collection procedures. The incidence of injury necessitating medical attention varied with the definition, from 27.5 to 129.8 injuries per 1000 match hours. The incidence of time-loss injury (>7 days) ranged from 0.96 to 1.6 per 1000 playing hours and from 11.4/1000 match hours (>1 day) to 12–22/1000 match hours (missed games). The highest incidence of concussion was 3.3/1000 playing hours. No catastrophic injuries were reported. The head and neck, upper limb, and lower limb were all common sites of injury, and trends were noted toward greater time loss due to upper limb fractures or dislocations and knee ligament injuries. Increasing age, the early part of the playing season, and the tackle situation were most closely associated with injury. Future injury-surveillance studies in rugby union must follow consensus guidelines to facilitate interstudy comparisons and provide further clarification as to where injury- prevention strategies should be focused.
Active Stiffness and Strength in People With Unilateral Anterior Shoulder Instability: A Bilateral Comparison
Authors: Olds Margie , McNair Peter , Nordez Antoine , Cornu Christophe
Published: March 2017

Context: Active muscle stiffness might protect the unstable shoulder from recurrent dislocation.

Objective: To compare strength and active stiffness in participants with unilateral anterior shoulder instability and to examine the relationship between active stiffness and functional ability.

Design: Cross-sectional study.

Setting: University research laboratory.

Patients or Other Participants: Participants included 16 males (age range, 16–40 years; height = 179.4 ± 6.1 cm; mass = 79.1 ± 6.8 kg) with 2 or more episodes of unilateral traumatic anterior shoulder instability.

Main Outcome Measure(s): Active stiffness and maximal voluntary strength were measured bilaterally in participants. In addition, quality of life, function, and perceived instability were measured using the Western Ontario Stability Index, American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form, and Single Alpha Numeric Evaluation, respectively.

Results: We found less horizontal adduction strength (t15 = −4.092, P = .001) and less stiffness at 30% (t14 = −3.796, P = .002) and 50% (t12 = −2.341, P = .04) maximal voluntary strength in the unstable than stable shoulder. Active stiffness was not correlated with quality of life, function, or perceived instability (r range, 0.0–0.25; P > .05).

Conclusions: The observed reduction in stiffness in the unstable shoulder warrants inclusion of exercises in the rehabilitation program to protect the joint from perturbations that might lead to dislocation. The lack of association between active stiffness and quality of life, function, or perceived instability might indicate that stiffness plays a less direct role in shoulder stability.
Characterizations of a Quality Certified Athletic Trainer
Authors: Raab Scot , Wolfe Brent D. , Gould Trenton E. , Piland Scott G.
Published: March 2017

Context: Didactic proficiency does not ensure clinical aptitude. Quality athletic health care requires clinical knowledge and affective traits.

Objective: To develop a grounded theory explaining the constructs of a quality certified athletic trainer (AT).

Design: Delphi study.

Setting: Interviews in conference rooms or business offices and by telephone.

Patients or Other Participants: Thirteen ATs (men = 8, women = 5) stratified across the largest employment settings (high school, college, clinical) in the 4 largest districts of the National Athletic Trainers' Association (2, 3, 4, 9).

Data Collection and Analysis: Open-ended interview questions were audio recorded, transcribed, and reviewed before condensing. Two member checks ensured trustworthiness. Open coding reduced text to descriptive adjectives.

Results: We grouped adjectives into 5 constructs (care, communication, commitment, integrity, knowledge) and grouped these constructs into 2 higher-order constructs (affective traits, effective traits).

Conclusions: According to participants, ATs who demonstrate the ability to care, show commitment and integrity, value professional knowledge, and communicate effectively with others can be identified as quality ATs. These abilities facilitate the creation of positive relationships. These relationships allow the quality AT to interact with patients and other health care professionals on a knowledgeable basis that ultimately improves health care delivery. Our resulting theory supported the examination of characteristics not traditionally assessed in an athletic training education program. If researchers can show that these characteristics develop ATs into quality ATs (eg, those who work better with others, relate meaningfully with patients, and improve the standard of health care), they must be cultivated in the educational setting.
Acute Lower Extremity Running Kinematics After a Hamstring Stretch
Authors: Davis Hammonds Autumn L. , Laudner Kevin G. , McCaw Steve , McLoda Todd A.
Published: March 2017

Context:

Limited passive hamstring flexibility might affect kinematics, performance, and injury risk during running. Pre-activity static straight-leg raise stretching often is used to gain passive hamstring flexibility.

Objective:

To investigate the acute effects of a single session of passive hamstring stretching on pelvic, hip, and knee kinematics during the swing phase of running.

Design:

Randomized controlled clinical trial.

Setting:

Biomechanics research laboratory.

Patients or Other Participants:

Thirty-four male (age = 21.2 ± 1.4 years) and female (age = 21.3±2.0 years) recreational athletes.

Intervention(s):

Participants performed treadmill running pretests and posttests at 70% of their age-predicted maximum heart rate. Pelvis, hip, and knee joint angles during the swing phase of 5 consecutive gait cycles were collected using a motion analysis system. Right and left hamstrings of the intervention group participants were passively stretched 3 times for 30 seconds in random order immediately after the pretest. Control group participants performed no stretching or movement between running sessions.

Main Outcome Measure(s):

Six 2-way analyses of variance to determine joint angle differences between groups at maximum hip flexion and maximum knee extension with an α level of .008.

Results:

Flexibility increased between pretest and post-test in all participants (F1,30 = 80.61, P<.001). Anterior pelvic tilt (F1,30 = 0.73, P=.40), hip flexion (F1,30 = 2.44, P=.13), and knee extension (F1,30 = 0.06, P=.80) at maximum hip flexion were similar between groups throughout testing. Anterior pelvic tilt (F1,30 = 0.69, P=.41), hip flexion (F1,30 = 0.23, P=.64), and knee extension (F1,30 = 3.38, P=.62) at maximum knee extension were similar between groups throughout testing. Men demonstrated greater anterior pelvic tilt than women at maximum knee extension (F1,30 = 13.62, P=.001).

Conclusions:

A single session of 3 straight-leg raise hamstring stretches did not change pelvis, hip, or knee running kinematics.
Reliability of Thoracic Spine Rotation Range-of-Motion Measurements in Healthy Adults
Authors: Johnson Katherine D. , Kim Kyung-Min , Yu Byung-Kyu , Saliba Susan A. , Grindstaff Terry L.
Published: March 2017

Context:

The reliability of clinical techniques to quantify thoracic spine rotation range of motion (ROM) has not been evaluated.

Objective:

To determine the intratester and intertester reliability of 5 thoracic rotation measurement techniques.

Design:

Descriptive laboratory study.

Setting:

University research laboratory.

Patients or Other Participants:

Forty-six healthy volunteers (age = 23.6±4.3 years, height = 171.0±9.6 cm, mass = 71.4 ±16.7 kg).

Main Outcome Measure(s):

We tested 5 thoracic rotation ROM techniques over 2 days: seated rotation (bar in back and front), half-kneeling rotation (bar in back and front), and lumbar-locked rotation. On day 1, 2 examiners obtained 2 sets of measurements (sessions 1, 2) to determine the within-session intertester reliability and within-day intratester reliability. A single examiner obtained measurements on day 2 (session 3) to determine the intratester reliability between days. Each technique was performed 3 times per side, and averages were used for data analysis. Reliability was determined using intraclass correlation coefficients, standard error of measurement (SEM), and minimal detectable change (MDC). Differences between raters during session 1 were determined using paired t tests.

Results:

Within-session intertester reliability estimates ranged from 0.85 to 0.94. Ranges for the SEM were 1.0° to 2.3° and for the MDC were 2.8° to 6.3°. No differences were seen between examiners during session 1 for seated rotation (bar in front, both sides), half-kneeling rotation (bar in front, left side), or the lumbar locked position (both sides) (all values of P > .05). Within-day intratester reliability estimates ranged from 0.86 to 0.95. Ranges for the SEM were 0.8° to 2.1° and for the MDC were 2.1 ° to 5. 9°. Between-days intratester reliability estimates ranged from 0.84 to 0.91. Ranges for the SEM were 1.4° to 2.0° and for the MDC were 3.9° to 5.6°.

Conclusions:

All techniques had good reliability and low levels of measurement error. The seated rotation, bar in front, and lumbar-locked rotation tests may be used reliably when more than 1 examiner is obtaining measurements.
Perceived Frequency of Peer-Assisted Learning in the Laboratory and Collegiate Clinical Settings
Authors: Henning Jolene M. , Weidner Thomas G. , Snyder Melissa , Dudley William N.
Published: March 2017

Context:

Peer-assisted learning (PAL) has been recommended as an educational strategy to improve students' skill acquisition and supplement the role of the clinical instructor (CI). How frequently students actually engage in PAL in different settings is unknown.

Objective:

To determine the perceived frequency of planned and unplanned PAL (peer modeling, peer feedback and assessment, peer mentoring) in different settings.

Design:

Cross-sectional study.

Setting:

Laboratory and collegiate clinical settings.

Patients or Other Participants:

A total of 933 students, 84 administrators, and 208 CIs representing 52 (15%) accredited athletic training education programs.

Intervention(s):

Three versions (student, CI, administrator) of the Athletic Training Peer Assisted Learning Survey (AT-PALS) were administered. Cronbach α values ranged from .80 to .90.

Main Outcome Measure(s):

Administrators' and CIs' perceived frequency of 3 PAL categories under 2 conditions (planned, unplanned) and in 2 settings (instructional laboratory, collegiate clinical). Self-reported frequency of students' engagement in 3 categories of PAL in 2 settings.

Results:

Administrators and CIs perceived that unplanned PAL (0.39 ± 0.22) occurred more frequently than planned PAL (0.29 ± 0.19) regardless of category or setting (F1,282 = 83.48, P < .001). They perceived that PAL occurred more frequently in the collegiate clinical (0.46 ± 0.22) than laboratory (0.21 ± 0.24) setting regardless of condition or category (F1,282 = 217.17, P < .001). Students reported engaging in PAL more frequently in the collegiate clinical (3.31 ± 0.56) than laboratory (3.26 ± 0.62) setting regardless of category (F1,860 = 13.40, P < .001). We found a main effect for category (F2,859 = 1318.02, P < .001), with students reporting they engaged in peer modeling (4.01 ± 0.60) more frequently than peer mentoring (2.99 ± 0.88) (P < .001) and peer assessment and feedback (2.86 ± 0.64) (P < .001).

Conclusions:

Participants perceived that students engage in unplanned PAL in the collegiate clinical setting with a stronger inclination toward engagement in peer modeling. Educators should develop planned PAL activities to capitalize on the inherent desire of the students to collaborate with their peers.