bluuebunny/crossref_metadata_2025 huggingface dataset:
Etiology and outcome of Neonatal Acute Kidney Injury in a Special Care Baby Unit
Authors: Afroz Shireen , Ferdous Tahmina , Hanif Mohammed , Mollah Md Abid Hossain , Banarjee Manisha , Khan Tofazzal Hossain
Published: September 2016

Background : The cause of acute kidney injury (AKI) in neonate is multifactorial. The short-term outcome of AKI in newborns is highly dependent on the underlying etiology, the condition of other organs, and the facilities for renal replacement therapy.Objective : The aims of the present study were to find out the etiology and immediate outcome of AKI in neonate.Methodology : This observational study was done over a period of six months, at special care baby unit (SCABU) in Dhaka Medical College Hospital (DMCH). Neonates (aged 3-28 days) admitted in SCABU, who had AKI were the study population. Among them 44 neonates with AKI were included purposivly. AKI was diagnosed and classified by pediatric RIFLE (pRIFLE) staging criteria. Etiology of AKI was find out by dividing pre renal, renal and post renal cause of AKI. All neonates were treated conservatively and with intermittent peritoneal dialysis (IPD) as needed. Immediate hospital outcome was determined by improved with normal renal functions; improved with impaired renal functions and death.Result : The diagnosis based on estimated creatinine clearance (eCCL) criteria of pRIFLE showed that 43.2% neonates were at risk (R) stage, 22.7% were at injury (I) stage and 34.1% of neonates were at Failure (F) stage of AKI. Among 44 neonates 21 were male and 23 were female. Pre renal cause of AKI is predominant in this series. More than two-thirds (68.2%) of the neonates experienced perinatal asphyxia stage-II and III and 52.3% were exposed to meconium stained liquor during delivery. Septicemia with shock, history of aminoglycoside use were reported to be 59.1%, 52.3% respectively. Post renal cause was found in 16% neonates, like obstructive uropathy due to posterior urethral valve, exstrophy bladder and cloacal exstrophy. Neonate at Failure stage of AKI (n=15) had a significantly longer stay at SCABU (p < 0.001). Multiorgan failure was found to be significantly higher in failure group (p = 0.026). Majority of the failure group needed dialysis (p < 0.001). Most of the neonate at risk and injury stage was improved with normal renal functions. The resolution from AKI was almost similar among the groups (p = 0.885). The mortality was progressively higher from Risk to Failure Groups (p = 0.106). Overall 27% of the neonates diagnosed as AKI died from this illness, 57% improved with normal renal function and 16% improved with impaired renal function.Conclusion : The study concluded that perinatal asphyxia, septicemia with shock and use of aminoglycosides were the commonest cause of AKI in neonate. The mortality was higher in Failure group.Northern International Medical College Journal Vol.7(2) Jan 2016: 127-130
Evaluation of Hematological Scoring System (HSS) for Early Diagnosis of Neonatal Sepsis
Authors: Yusuf Mir Mohammad , Yasmeen BH Nazma , Chowdhury MAK Azad
Published: September 2016

Background : Neonatal sepsis is a common occurrence and major health problem in Bangladesh and other developing countries, a devastating cause of morbidity and mortality during first 28 days of life.Objective: This study was carried out to evaluate the efficacy of hematological scoring system (HSS) in the early detection of neonatal sepsis.Study period : June 2014 to December 2014(Six months).Methods : This was a prospective study consisting of 218 neonates admitted at Intensive Care Unit (ICU) Dhaka Shishu Hospital who were clinically suspected to have septicaemia. Newborn babies with major congenital anomaly,inborn error of metabolism, severely jaundiced due to blood group incompatibilities or RDS (due to surfactant deficiency) were excluded. The hematological parameter were measured in all cases. Patients were scored according to hematological scoring system (HSS), incorporating increase or decrease in leucocytes count, absolute neutrophil count, immature neutrophil count (e.g. band form), presence of degenerative changes in neutrophil (e.g. toxic granulation, vacuolation). CRP estimation and blood culture were also performed. Blood culture is considered as gold standard for diagnosis of sepsis. Fourteen out of 128 (11%) had culture proven sepsis. They were predominantly preterm and of very low birth weight. Score of 3 was considered as positive.Results : On evaluation of various hematological parameters the HSS was found to have a sensitively of 71%, specificity of 73%, positive predictive value 24%, negative predictive value 95%.Conclusion: HSS is a simple, quick, readily available effective tool to detect early neonatal sepsis. Considering the high sensitivity, specificity, negative predictive value, this study implies that score ³3 were reliable as a screening tool for early neonatal sepsis.Northern International Medical College Journal Vol.7(2) Jan 2016: 135-138
Hygienic practices during menstruation among adolescent school girls
Authors: Salim Farhana , Begum Nasreen
Published: September 2016

Objective : To assess the hygienic practices during menstruation among adolescent school girls in selected secondary rural schools.Methods : This descriptive, cross-sectional study was conducted from November to December, 2015. Study area was selected on choice were four upazilas of Kishoreganj, Lakshmipur, Barguna and Sirajganj District. From the study area 15 schools were selected on the basis of convenience and accessibility. Data were collected from 438 purposively selected adolescent unmarried school girls aged 15-18 years and studying in class IX and X, through face to face interview by pretested questionnaire. Data were analyzed by using software SPSS version 20.Results : The result of the study revealed that majority (52%) participants were using cloths and 48.4% were using sanitary napkin for menstrual hygiene management. About half of the participants got the information about menstrual and reproductive health from family members. Thirty five percent (35%) girls do not attend school during first two days of menstruation. Majority (69%) of the girls never change pad and 45% complained about unavailability of water at school. However, knowledge of reproductive health issues like minimum age at marriage (18yrs, 85.8%), minimum age of child birth (20yrs, 89%) and need for extra nutrition during pregnancy (99.0%) was quite satisfactory. The level of maternal education and economic condition were significantly associated with sanitary napkin use.Conclusion : The study revealed that higher percentage of participants was not using sanitary napkins, although their knowledge regarding menstrual and reproductive health issues is satisfactory. Implementation of school health programs for adolescents should emphasis on menstrual hygiene management.Northern International Medical College Journal Vol.7(2) Jan 2016: 139-142
Nipah virus Infection: A fatal Emerging disease
Authors: Islam Mirza Md Ziaul , Rahman M Mizanur
Published: September 2016

Abstract not availableNorthern International Medical College Journal Vol.7(2) Jan 2016: 146-148
Pityriasis amiantacea : A reaction pattern of the scalp in psoriatic patient
Authors: Bhuiyan Ishrat , Hossain Md Shahadat , Rahman Md Moksedur , Joarder Yasmeen
Published: September 2016

Abstract not availableNorthern International Medical College Journal Vol.7(2) Jan 2016: 156-157
Faith in Reading: Revisiting the Midrash–Theory Connection
Authors: Freer Alexander
Published: September 2016

In the 1980s there was a brief but intense period of interest among literary critics and theorists in Classical Rabbinic interpretation, and, in particular, the genre of commentary known as Midrash. Interest concentrated around the apparent similarities between Midrash and the commentaries and criticism of Derrida, Lacan, Freud, Barthes and others. This essay examines this connection between Midrash and theory in light of the persistent charge from Foucault and others that all hermeneutics is essentially theological. It proceeds by drawing out the aims and frustrations of the literary critics and Jewish scholars involved, and considers in what ways the questions which arose in these years might be pertinent for contemporary literary criticism, theory and institutional practice.
Output Filter Design for a Novel Dual-Input PV-Wind Power Converter by Energy Balance Principle
Authors: Shen Chih-Lung , Shen You-Sheng
Published: September 2016

In this paper, a detailed and systematic derivation of the output filter in a novel dual-input photovoltaic (PV)-wind converter (DIPWC) is presented. The theoretical derivation is based on an energy balance principle. While the DIPWC operates in steady state, the amount of charged energy of the output filter will be equal to that of the energy pumped away within one switching cycle. From this zero net change in energy, the minimum value of the output filter can be found. With the determined value, the DIPWC is able to operate in continuous conduction for high power applications. The developed procedure of the inductance determination can be applied to other types of dual-input converters. Therefore, it makes significant contributions to the design toward a green-energy, multi-input converter. To verify the correctness of the mathematical analysis, the DIPWC—with the derived output inductance—is built and tested. Practical measurements and results have verified the inductance determination.
Numerical Simulation of the Application of Solar Radiant Systems, Internal Airflow and Occupants’ Presence in the Improvement of Comfort in Winter Conditions
Authors: Conceição Eusébio , Lúcio Mª
Published: September 2016

In this work, the use of numerical simulation in the application of solar radiant systems, internal airflow and occupants’ presence in the improvement of comfort in winter conditions is made. The thermal comfort, the local thermal discomfort and the air quality in an occupied chamber space are evaluated. In the experimental measurements, a wood chamber, a desk, two seats, two seated hygro-thermal manikins, a warm radiant floor, a solar radiation simulator and a water solar collector are used. The air velocity and the air temperature fluctuation are experimentally evaluated around 15 human body sections. The chamber surface temperature is experimentally measured. In the numerical simulation, a coupling human thermal comfort (HTC) integral model, a computational fluids dynamics (CFD) differential model and a building thermal response (BTR) integral model are applied. The human thermal comfort level is evaluated by the HTC numerical model. The airflow inside the virtual chamber, using the k-epsilon and RNG turbulence models, is evaluated by the CFD numerical model. The chamber surface and the collector temperatures are evaluated by the BTR numerical model. In the human thermal comfort level, in non-uniform environments, the predicted mean vote (PMV) and the predicted percentage of dissatisfied (PPD) people are numerically evaluated; in the local thermal discomfort level the draught risk (DR) is experimentally and numerically analyzed; and in the air quality, the carbon dioxide CO2 concentration is numerically calculated. In the validation tests, the experimental and numerical values of the chamber surface temperature, the air temperature, the air velocity, the air turbulence intensity and the DR are presented.
Quantifying the Relationship between the Built Environment Attributes and Urban Sustainability Potentials for Housing Areas
Authors: Osman Taher , Divigalpitiya Prasanna , Osman Mustafa , Kenawy Emad , Salem Muhammad , Hamdy Omar
Published: September 2016

The Greater Cairo Metropolitan Region (GCMR) in its seeking to sustainable development (SD) by the year of 2050 facing the serious challenge of around 65 percent of Cairenes live in unplanned settlements. In this respect, the authors examined the effect of urban characteristics of unplanned settlements on SD in the Egyptian context, focusing on the type of unplanned growth on agricultural land. The output of the analysis were fourfold. First of all, we provide a brief overview of previous research on the main types of unplanned settlements in GCMR and the sustainability definition according to the Egyptian context. Secondly, we had a discussion with the local government during our field survey in GCMR to determine the study samples, the main urban characteristics, and the sustainability evaluation criteria in the Egyptian context. Thirdly, through the comparative analysis and geographic information system (GIS), we examined how the character of urban development affected per capita four urban measures in a cross-section of two settlements, one represented the unplanned settlements and other as a comparative planned sample to determine the real gap. Finally, by using the evaluation matrix, the help and block items are estimated for each measure of urban characteristics, providing substantive evidence on how the four measures of urban characteristics have been affected by the urban sprawl.
Parental Protectiveness Mediates the Association between Parent-Perceived Child Self-Efficacy and Health Outcomes in Pediatric Functional Abdominal Pain Disorder
Authors: DuPen Melissa , Van Tilburg Miranda , Langer Shelby , Murphy Tasha , Romano Joan , Levy Rona
Published: September 2016

Previous studies have shown that parental protectiveness is associated with increased pain and disability in Functional Abdominal Pain Disorder (FAPD) but the role that perceived child self-efficacy may play remains unclear. One reason why parents may react protectively towards their child’s pain is that they perceive their child to be unable to cope or function normally while in pain (perceived low self-efficacy). This study sought to examine (a) the association between parent-perceived child pain self-efficacy and child health outcomes (symptom severity and disability); and (b) the role of parental protectiveness as a mediator of this association. Participants were 316 parents of children aged 7–12 years with FAPD. Parents completed measures of perceived child self-efficacy when in pain, their own protective responses to their child’s pain, child gastrointestinal (GI) symptom severity, and child functional disability. Parent-perceived child self-efficacy was inversely associated with parent-reported child GI symptom severity and disability, and parental protectiveness mediated these associations. These results suggest that parents who perceive their child to have low self-efficacy to cope with pain respond more protectively when they believe he/she is in pain, and this, in turn, is associated with higher levels of GI symptoms and disability in their child. This finding suggests that directly addressing parent beliefs about their child’s ability to manage pain should be included as a component of FAPD, and potentially other child treatment interventions.
Serum Resistin Level and Progression of Atherosclerosis during Glucocorticoid Therapy for Systemic Autoimmune Diseases
Authors: Tanaka Nahoko , Masuoka Shotaro , Kusunoki Natsuko , Nanki Toshihiro , Kawai Shinichi
Published: September 2016

Adipokines are important regulators of several processes, including inflammation and atherosclerosis. In patients with systemic autoimmune diseases, atherosclerosis is accelerated with higher cardiovascular morbidity and mortality. We prospectively investigated the association of adipokines and glucocorticoid therapy with progression of premature atherosclerosis in 38 patients starting glucocorticoid therapy for systemic autoimmune diseases. To detect premature atherosclerosis, carotid ultrasonography was performed at initiation of glucocorticoid therapy and after a mean three-year follow-up period. The ankle-brachial pressure index and cardio-ankle vascular index (CAVI) were measured. Serum adipokine levels were determined with enzyme-linked immunosorbent assay kits. Twenty-three patients (60.5%) had carotid artery plaque at baseline. The carotid artery intima-media thickness (IMT) increased significantly during follow-up. Glucocorticoids reduced the serum resistin level, while increasing serum leptin and high molecular weight-adiponectin. There was slower progression of atherosclerosis (carotid IMT and CAVI) at follow-up in patients with greater reduction of serum resistin and with higher cumulative prednisolone dose. In conclusion, progression of premature atherosclerosis occurred at an early stage of systemic autoimmune diseases before initiation of glucocorticoid therapy. Since resistin, an inflammation and atherosclerosis related adipokine, is reduced by glucocorticoids, glucocortidoid therapy may not accelerate atherosclerosis in patients with systemic autoimmune diseases.
Microarray Data Processing Techniques for Genome-Scale Network Inference from Large Public Repositories
Authors: Chockalingam Sriram , Aluru Maneesha , Aluru Srinivas
Published: September 2016

Pre-processing of microarray data is a well-studied problem. Furthermore, all popular platforms come with their own recommended best practices for differential analysis of genes. However, for genome-scale network inference using microarray data collected from large public repositories, these methods filter out a considerable number of genes. This is primarily due to the effects of aggregating a diverse array of experiments with different technical and biological scenarios. Here we introduce a pre-processing pipeline suitable for inferring genome-scale gene networks from large microarray datasets. We show that partitioning of the available microarray datasets according to biological relevance into tissue- and process-specific categories significantly extends the limits of downstream network construction. We demonstrate the effectiveness of our pre-processing pipeline by inferring genome-scale networks for the model plant Arabidopsis thaliana using two different construction methods and a collection of 11,760 Affymetrix ATH1 microarray chips. Our pre-processing pipeline and the datasets used in this paper are made available at http://alurulab.cc.gatech.edu/microarray-pp.
On the Effect of Microwave Energy on Lipase-Catalyzed Polycondensation Reactions
Authors: Pellis Alessandro , Guebitz Georg , Farmer Thomas
Published: September 2016

Microwave energy (MWe) is, nowadays, widely used as a clean synthesis tool to improve several chemical reactions, such as drug molecule synthesis, carbohydrate conversion and biomass pyrolysis. On the other hand, its exploitation in enzymatic reactions has only been fleetingly investigated and, hence, further study of MWe is required to reach a precise understanding of its potential in this field. Starting from the authors’ experience in clean synthesis and biocatalyzed reactions, this study sheds light on the possibility of using MWe for enhancing enzyme-catalyzed polycondensation reactions and pre-polymer formation. Several systems and set ups were investigated involving bulk and organic media (solution phase) reactions, different enzymatic preparations and various starting bio-based monomers. Results show that MWe enables the biocatalyzed synthesis of polyesters and pre-polymers in a similar way to that reported using conventional heating with an oil bath, but in a few cases, notably bulk phase polycondensations under intense microwave irradiation, MWe leads to a rapid enzyme deactivation.
Characterization of microsatellite loci in the lichen‐forming fungus Cetraria aculeata (Parmeliaceae, Ascomycota)
Authors: Lutsak Tetiana , Fernández‐Mendoza Fernando , Greshake Bastian , Dal Grande Francesco , Ebersberger Ingo , Ott Sieglinde , Printzen Christian
Published: September 2016

Premise of the study:

Polymorphic microsatellite markers were developed for the lichen species Cetraria aculeata (Parmeliaceae) to study fine‐scale population diversity and phylogeographic structure.

Methods and Results:

Using Illumina HiSeq and MiSeq, 15 fungus‐specific microsatellite markers were developed and tested on 81 specimens from four populations from Spain. The number of alleles ranged from four to 13 alleles per locus with a mean of 7.9, and average gene diversities varied from 0.40 to 0.73 over four populations. The amplification rates of 10 markers (CA01–CA10) in populations of C. aculeata exceeded 85%. The markers also amplified across a range of closely related species, except for locus CA05, which did not amplify in C. australiensis and C. “panamericana,” and locus CA10 which did not amplify in C. australiensis.

Conclusions:

The identified microsatellite markers will be used to study the genetic diversity and phylogeographic structure in populations of C. aculeata in western Eurasia.
Solvent-free synthesis of novel para-menthane-3,8-diol ester derivatives from citronellal using a polymer-supported scandium triflate catalyst
Authors: Mafu Lubabalo , Zeelie Ben , Watts Paul
Published: September 2016

The use of natural resources as a chemical feedstock for the synthesis of added-value products is gaining interest; as such we report an environmentally friendly method for the synthesis of para-menthane-3,8-diol from natural citronellal oil in 96% yield, under solvent free aqueous conditions. The acylation of para-menthane-3,8-diol with various acid anhydrides over polymer-supported scandium triflate (PS-Sc(OTf)3) catalyst was subsequently developed, where both hydroxy groups of para-menthane-3,8-diol could be simultaneous acylated under mild reaction conditions to form the corresponding diesters in good yields. The advantages of this method include a simple procedure from natural resources, using solvent-free reaction conditions.
La transformación de la topografía y del paisaje en la construcción del Monasterio de El Escorial
Authors: Chías Navarro P. , Abad Balboa T.
Published: September 2016

Aunque el lugar elegido para construir el monasterio fue una explanada soleada y protegida en la ladera del monte Abantos, lo que en un principio pareció ser una topografía amable pronto se reveló como un factor importante a tener en cuenta en el diseño y el proceso de construcción de la fábrica. Las importantes dimensiones de ésta requirieron la construcción de una plataforma sobre la que asentar el edificio y sus jardines, a la vez que la proximidad de la montaña hizo necesario retirar las tierras inmediatas a las fachadas septentrional y occidental. En consecuencia fue necesario prever la construcción de potentes muros de contención, rellenar de tierra la plataforma, explanar, y retirar las tierras sobrantes a zonas próximas como Terreros. La reconstrucción de la topografía original y del paisaje circundante, y las alteraciones que sufrieron durante el siglo xvi, son el objeto de la presente investigación.
Oral sores: a rare presentation of Herpes zoster
Authors: Nagakeerthana Sunder , Rangaraj Murugaiyan
Published: September 2016

Herpes zoster is one of the common dermatological diseases in elderly. It is clinically diagnosed by the presence of vesicles in a zosteriform pattern, appearing along one or two dermatomes. We report a rare presentation of herpes zoster occurring over hard palate. Early recognition of such rare presentations of Herpes zoster and treatment with antivirals at the appropriate time is the most essential step required to decrease the morbidity.
Comparison of two balance training programs on balance in community dwelling older adults
Authors: Walia Shefali , Noohu Majumi M.
Published: September 2016

Impaired balance has been associated with an increased risk for falls and a resulting increase in the mortality rate of elder people. Thus, balance-training interventions have an important place in fall prevention. This study was designed with the purpose of identifying the appropriate balance-training program for community dwelling elderly adults with an active lifestyle. A sample of 70 elderly adults were randomly allocated into two groups: group 1 (n=35) received general balance and mobility exercise; group 2 (n=35) received specific balance strategy training. The intervention consisted of 5 sessions/week for 4 weeks. The outcome measures were Timed up and go test (TUGT) and Berg balance scale (BBS). An inter-group (2-way mixed model analysis of co-variance) and intra-group (repeated measures) analysis was done to find the change in balance scores. After the intervention, the TUGT scores in group 1 were, mean=10.38 s, standard deviation (SD)=1.59 s and in group 2 were, mean=9.27 s, SD=1.13 s. Post training, BBS scores for group 1 were, mean=54.69, SD=1.13, and for group 2 were, mean=55.57, SD =0.56. There was a significant group × time effect for TUGT and BBS score. All the subjects showed significant changes in balance scores after balance training interventions. The subjects who participated in the specific balance-strategy training significantly improved their functional mobility, as shown on the TUGT, compared to the general training group.
Evaluating Perceptions of Culminating Clinical Education Experiences of Senior Athletic Training Students
Authors: Aronson Patricia A. , Bowman Thomas G. , Mazerolle Stephanie M.
Published: September 2016

Context

The perceptions of athletic training students (ATSs) regarding their clinical education experiences are not fully understood. It is important to investigate ATS perceptions of clinical education to allow athletic training educators to provide educational experiences that will maximize learning.

Objective

To determine what ATSs value during their clinical education experiences.

Design

Qualitative study.

Setting

Participants completed an electronic preceptor evaluation.

Patients or Other Participants

Nineteen (14 female, 5 male; average age = 22 ± 1 years) senior ATSs over 2 years enrolled in a Commission on Accreditation of Athletic Training Education–accredited athletic training program participated in our study. Participants came from 1 Commission on Accreditation of Athletic Training Education–accredited athletic training program in the Mid-Atlantic region.

Data Collection and Analysis

We asked seniors to evaluate their final clinical education experience by completing an open-ended questionnaire. We analyzed the data following the principles of grounded theory. We negotiated over the coding scheme until we reached full agreement, performed a peer review, and conducted member checks to ensure trustworthiness of the results.

Results

Three major themes emerged from the data. Athletic training students enjoy interacting with preceptors who act as appropriate professional role models. Our participants also found value in being able to develop their clinical skills with appropriate situational supervision. Finally, ATSs appreciate when preceptors teach them new information by stimulating their critical thinking skills.

Conclusions

To help provide positive learning environments for senior ATSs, athletic training education administrators should select preceptors who can successfully model professional responsibilities, present ATSs with authentic learning experiences, and promote higher-level thinking. We believe providing ATSs with exposure to preceptors who can meet these criteria may better prepare students for professional practice, alter persistence decisions, and should be a goal of clinical experiences for the benefit of ATSs.
Supervising Athletic Trainers' Perceptions of Graduate Assistant Athletic Trainers' Professional Preparation
Authors: Thrasher Ashley B. , Walker Stacy E. , Hankemeier Dorice A. , Pitney William A.
Published: September 2016

Context

Recent debate has ensued regarding the readiness of newly credentialed athletic trainers (ATs) to function as independent clinicians. Some ATs believe the professional preparation of athletic training students is not adequate.

Objective

To describe supervisors' perceptions regarding the preparation of college graduate assistants (GAs) to practice as independent practitioners.

Design

Consensual qualitative research.

Setting

Individual phone interviews.

Patients or Other Participants

Twenty-one collegiate ATs who had supervised GAs in the collegiate setting for a minimum of 8 years (16 men, 5 women; years of supervision experience, 14.6 ± 6.6 years). Participants who met the inclusion criteria were recruited via e-mail from the Board of Certification database and through snowball sampling. Interviews were conducted until data saturation occurred.

Main Outcome Measure(s)

Data were collected via phone interviews, which were recorded and transcribed verbatim. Data were analyzed by a 4-person consensus team, who independently coded the data and compared ideas until consensus was reached and a codebook was created. Trustworthiness was established through member checks and multi-analyst triangulation.

Results

Three themes emerged: (1) previous preparation, (2) shortcomings in GAs, and (3) suggestions for athletic training program improvement. Supervisors felt GAs were prepared academically, but there were some gaps in preparation, such as their ability to independently practice and their rehabilitation skills. Shortcomings were professional communication, role execution, and personality. Supervisors felt preparation could be improved by increasing time in clinical education, developing communication skills, and having increased experience with psychosocial intervention, rehabilitation, and nonorthopedic conditions.

Conclusions

Didactic preparation of GAs is the best it has ever been, yet new ATs still need more experience while being mentored by experienced ATs. Professional programs could implement standardized patient experiences to provide opportunities for new ATs to practice in communication or in other areas of weakness.
Athletic Trainers' Skills in Identifying and Managing Athletes Experiencing Psychological Distress
Authors: Cormier Marc L. , Zizzi Sam J.
Published: September 2016

Context

Athletic trainers (ATs) commonly use psychological skills during sport rehabilitation. However, little is known about their ability to accurately implement these skills.

Objective

To assess ATs' skills in identifying psychological symptoms, selecting appropriate strategies, and making referral decisions for athletes experiencing various degrees of psychological distress.

Design

Cross-sectional study.

Setting

Participants were recruited using the National Athletic Trainers' Association professional member database.

Patients or Other Participants

Of the 2998 ATs who were selected randomly, 494 (16.5%) partially completed the questionnaire and 326 (10.9%) completed the entire survey (mean age = 34.7 ± 10.8 years, mean years of experience = 11.3 ± 9.9).

Main Outcome Measure(s)

Using the Web-based questionnaire created for this study, we collected ATs' demographic information and assessed their perceptions about responsibilities as ATs, psychosocial competencies, training in sport psychology, and referral behaviors. Additionally, respondents were asked to identify symptoms, match psychological strategies (eg, goal setting, imagery, progressive muscle relaxation), and make referral decisions for athletes in 3 case vignettes.

Results

The ATs demonstrated high accuracy in identifying symptoms and making referral decisions but struggled in selecting appropriate psychosocial strategies for athletes. Stepwise regression analyses revealed that ATs who had had specific coursework in sport psychology were able to more accurately identify symptoms (t = 3.01, P < .01), and those ATs with more experience reported lower accuracy scores for their intended course of action (t  =  −2.25, P < .05).

Conclusions

Our analogue research design provided new insights into ATs' knowledge and use of sport psychology in practice. The results highlighted the importance of coursework focusing on applied areas of sport psychology in the training of ATs.
Previous Knee Injury and Health-Related Quality of Life in Collegiate Athletes
Authors: Lam Kenneth C. , Thomas Steven St , Valier Alison R. Snyder , McLeod Tamara C. Valovich , Bay R. Curtis
Published: September 2016

Context: 

Patient-rated outcome measures (PROMs) capture changes that are important and meaningful to patients, such as health-related quality of life (HRQOL). Although group differences in HRQOL have been reported, little is known about the effect of injury history on HRQOL in collegiate athletes.

Objective: 

To determine whether knee-specific function (International Knee Documentation Committee Subjective Knee Evaluation Form [IKDC]) and HRQOL (Short Form 12 [SF-12]) differs in collegiate athletes based on sex and the severity of a previous knee injury.

Design: 

Cross-sectional study.

Setting: 

Athletic training facilities.

Patients or Other Participants: 

Healthy collegiate athletes (n = 263) were grouped based on self-report of a previous knee injury: severe (n = 47), mild (n = 40), and no (n = 176) knee injury.

Intervention(s): 

Participants completed the IKDC and SF-12 during their preparticipation examinations.

Main Outcome Measure(s): 

Generalized linear models were used to assess interactions and main effects of all scores.

Results: 

An interaction effect was observed for the SF-12 role physical subscale (P = .02), with men in the mild- and severe-injury groups reporting worse scores than men with no injury history. We noted a main effect for injury group for the IKDC total score (P < .001) and SF-12 physical functioning (P = .04) and role emotional (P = .04) subscales, with the severe-injury group reporting worse scores than the mild- and no-injury groups. No main effects of sex were reported (P > .05).

Conclusions: 

Despite returning to full participation, collegiate athletes who previously sustained severe knee injuries tended to report worse knee-specific function and less ability to complete activities due to physical health. In addition, individuals with a history of severe knee injury tended to report more emotional concerns than athletes with a history of mild or no knee injury. Region-specific PROMs may be more sensitive in detecting deficits than generic PROMs after return to full participation. Researchers should investigate the role of PROMs, particularly region-specific PROMs, as potential screening tools for clinical care.
Patient-Reported Outcomes in Male and Female Collegiate Soccer Players During an Athletic Season
Authors: Hoch Johanna M. , Druvenga Beth , Ferguson Brittany A. , Houston Megan N. , Hoch Matthew C.
Published: September 2016

Context

 Clinicians are urged to document patient-based outcomes during rehabilitation to measure health-related quality of life (HRQOL) from the patient's perspective. It is unclear how scores on patient-reported outcome instruments (PROs) vary over the course of an athletic season because of normal athletic participation.

Objective

 Our primary purpose was to evaluate the effect of administration time point on HRQOL during an athletic season. Secondary purposes were to determine test-retest reliability and minimal detectable change scores of 3 PROs commonly used in clinical practice and if a relationship exists between generic and region-specific outcome instruments.

Design

 Cross-sectional study.

Setting

 Athletic facility.

Patients or Other Participants

 Twenty-three collegiate soccer athletes (11 men, 12 women).

Main Outcome Measure(s)

 At 5 time points over a spring season, we administered the Disablement in the Physically Active Scale (DPA), Foot and Ankle Ability Measure-Sport, and Knee Injury and Osteoarthritis Outcome Score (KOOS).

Results

 Time effects were observed for the DPA (P = .011) and KOOS Quality of Life subscale (P = .027). However, the differences between individual time points did not surpass the minimal detectable change for the DPA, and no post hoc analyses were significant for the KOOS-Quality of Life subscale. Test-retest reliability was moderate for the KOOS-Pain subscale (intraclass correlation coefficient = 0.71) and good for the remaining KOOS subscales, DPA, and Foot and Ankle Ability Measure-Sport (intraclass correlation coefficients > 0.79). The DPA and KOOS-Sport subscale demonstrated a significant moderate relationship (P = .018).

Conclusions

 Athletic participation during a nontraditional, spring soccer season did not affect HRQOL. All 3 PROs were reliable and could be used clinically to monitor changes in health status throughout an athletic season. Our results demonstrate that significant deviations in scores were related to factors other than participation, such as injury. Finally, both generic and region-specific instruments should be used in clinical practice.
Ankle-Dorsiflexion Range of Motion After Ankle Self-Stretching Using a Strap
Authors: Jeon In-cheol , Kwon Oh-yun , Yi Chung-Hwi , Cynn Heon-Seock , Hwang Ui-jae
Published: September 2016

Context

 A variety of ankle self-stretching exercises have been recommended to improve ankle-dorsiflexion range of motion (DFROM) in individuals with limited ankle dorsiflexion. A strap can be applied to stabilize the talus and facilitate anterior glide of the distal tibia at the talocrural joint during ankle self-stretching exercises. Novel ankle self-stretching using a strap (SSS) may be a useful method of improving ankle DFROM.

Objective

 To compare the effects of 2 ankle-stretching techniques (static stretching versus SSS) on ankle DFROM.

Design

 Randomized controlled clinical trial.

Setting

 University research laboratory.

Patients or Other Participants

 Thirty-two participants with limited active dorsiflexion (<20°) while sitting (14 women and 18 men) were recruited.

Main Outcome Measure(s)

 The participants performed 2 ankle self-stretching techniques (static stretching and SSS) for 3 weeks. Active DFROM (ADFROM), passive DFROM (PDFROM), and the lunge angle were measured. An independent t test was used to compare the improvements in these values before and after the 2 stretching interventions. The level of statistical significance was set at α = .05.

Results

 Active DFROM and PDFROM were greater in both stretching groups after the 3-week interventions. However, ADFROM, PDFROM, and the lunge angle were greater in the SSS group than in the static-stretching group (P < .05).

Conclusions

 Ankle SSS is recommended to improve ADFROM, PDFROM, and the lunge angle in individuals with limited DFROM.
Current Health-Related Quality of Life in Former National Collegiate Athletic Association Division I Collision Athletes Compared With Contact and Limited-Contact Athletes
Authors: Simon Janet E. , Docherty Carrie L.
Published: September 2016

Previous researchers have shown that current health-related quality of life (HRQoL) is lower in former National Collegiate Athletic Association Division I athletes than in nonathletes. However, evidence supports the idea that individuals in collision sports (football) may suffer more serious injuries that may affect them later in life.Context:

To measure HRQoL in former Division I collision, contact, and limited-contact athletes.Objective:

Cross-sectional study.Design:

Research laboratory.Setting:

A total of 374 former Division I athletes between the ages of 40 and 65 years were separated into collision, contact, and limited-contact groups.Patients or Other Participants:

All individuals completed the Short Form 36 version 2 via a computer.Intervention(s):

The dependent variables were the physical component and mental component summary scores and the physical functioning, physical role functioning, bodily pain, general health, vitality, social role functioning, emotional role functioning, and mental health scales. An initial multivariate analysis of covariance included data from the 2 domains: physical component and mental component summary scores. The second multivariate analysis of covariance included data from the 8 dimensions: physical function, role physical, bodily pain scale, general health, mental health, role emotional, social function, and vitality scales. The α level was set at P < .05 with a covariate of sex.Main Outcome Measures(s):

The responses were significantly lower (worse) for the former collision athletes compared with the contact and limited-contact athletes for the summary scores (F2,370 = 90.09, P < .01) and all 8 scales (F8,364 = 24.33, P < .01). The largest differences were between the collision and limited-contact athletes for the bodily pain and role physical scales, with mean differences of 12.91 and 11.80 points, respectively.Results:

Competing at the Division I level can be strenuous on an athlete's physical, mental, and social dimensions, which can affect the athlete later in life. Based on these data, collision athletes may sacrifice their future HRQoL compared with contact and limited-contact athletes.Conclusions:
High School Rowing Injuries: National Athletic Treatment, Injury and Outcomes Network (NATION)
Authors: Baugh Christine M. , Kerr Zachary Y.
Published: September 2016

Data on high school (HS) rowing injuries are lacking.Context:

To describe the epidemiology of HS boys' and girls' rowing injuries during the 2011–2012 through 2013–2014 academic years.Objective:

Descriptive epidemiology study.Design:

Injury and exposure data from 8 and 11 boys' and girls' rowing programs providing 13 and 17 team-seasons of data, respectively.Setting:

High school boys' and girls' varsity rowing student-athletes.Patients or Other Participants:

High school rowing data from the National Athletic Treatment, Injury and Outcomes Network.Intervention(s):

Injury rates and rate ratios were reported with 95% confidence intervals (CIs).Main Outcome Measure(s):

In HS boys' and girls' rowing, 59 and 190 injuries were reported, respectively, for rates of 2.39/1000 athlete-exposures (95% CI = 1.78, 3.00) and 8.60/1000 athlete-exposures (95% CI = 7.38, 9.82). The girls' rowing injury rate was 3.60 times that of boys' (95% CI = 2.69, 4.82).Results:

These findings suggest a higher injury rate among HS female rowers than HS male rowers. Additional research exploring reasons for the sex difference is warranted.Conclusions:
Return to Play After Exertional Rhabdomyolysis
Authors: Schleich Kevin , Slayman Tyler , West Douglas , Smoot Kyle
Published: September 2016

Objective: To outline a 4-phase progressive program that safely and successfully enabled athletes to return to sport without recurrence of exertional rhabdomyolysis symptoms.

Background: In January 2011, a large cluster of National Collegiate Athletic Association Division I football athletes were evaluated and treated for exertional rhabdomyolysis. After the athletes were treated, the athletic trainers and sports medicine providers were challenged to develop a safe return-to-play program because of the lack of specific reports in the medical literature to direct such activities.

Treatment: A progressive 4-phase program based on existing recommendations, including guidelines for continued clinical and laboratory monitoring.

Conclusions: Although the actual process of reintegrating players will differ based on each athlete's unique circumstances, this program provides a safe and effective foundation that can be modified based on the response to activity and sport.
Optimizing Cold-Water Immersion for Exercise-Induced Hyperthermia: An Evidence-Based Paper
Authors: Nye Emma A. , Edler Jessica R. , Eberman Lindsey E. , Games Kenneth E.
Published: September 2016

Reference: Zhang Y, Davis JK, Casa DJ, Bishop PA. Optimizing cold water immersion for exercise-induced hyperthermia: a meta-analysis. Med Sci Sports Exerc. 2015;47(11):2464−2472.

Clinical Questions: Do optimal procedures exist for implementing cold-water immersion (CWI) that yields high cooling rates for hyperthermic individuals?

Data Sources: One reviewer performed a literature search using PubMed and Web of Science. Search phrases were cold water immersion, forearm immersion, ice bath, ice water immersion, immersion, AND cooling.

Study Selection: Studies were included based on the following criteria: (1) English language, (2) full-length articles published in peer-reviewed journals, (3) healthy adults subjected to exercise-induced hyperthermia, and (4) reporting of core temperature as 1 outcome measure. A total of 19 studies were analyzed.

Data Extraction: Pre-immersion core temperature, immersion water temperature, ambient temperature, immersion duration, and immersion level were coded a priori for extraction. Data originally reported in graphical form were digitally converted to numeric values. Mean differences comparing the cooling rates of CWI with passive recovery, standard deviation of change from baseline core temperature, and within-subjects r were extracted. Two independent reviewers used the Physiotherapy Evidence Database (PEDro) scale to assess the risk of bias.

Main Results: Cold-water immersion increased the cooling rate by 0.03°C/min (95% confidence interval [CI] = 0.03, 0.04°C/min) compared with passive recovery. Cooling rates were more effective when the pre-immersion core temperature was ≥38.6°C (P = .023), immersion water temperature was ≤10°C (P = .036), ambient temperature was ≥20°C (P = .013), or immersion duration was ≤10 minutes (P < .001). Cooling rates for torso and limb immersion (mean difference = 0.04°C/min, 95% CI = 0.03, 0.06°C/min) were higher (P = .028) than those for forearm and hand immersion (mean difference = 0.01°C/min, 95% CI = −0.01, 0.04°C/min).

Conclusions: Hyperthermic individuals were cooled twice as fast by CWI as by passive recovery. Therefore, the former method is the preferred choice when treating patients with exertional heat stroke. Water temperature should be <10°C, with the torso and limbs immersed. Insufficient published evidence supports CWI of the forearms and hands.
Using Flipped Classroom Components in Blended Courses to Maximize Student Learning
Authors: Heinerichs Scott , Pazzaglia Gina , Gilboy Mary Beth
Published: September 2016

Context: The flipped classroom is an educational approach that has become popular in higher education because it is student centered.

Objective: To provide a rationale for a specific way of approaching the flipped classroom using a blended course design and resources necessary to help instructors be successful.

Main Outcome Measure(s): Three class components are important to the flipped classroom: before-, during-, and after-classroom sessions. Each is important in helping instructors deliver content in ways that will engage students to use all levels of the Bloom taxonomy on a consistent basis. Implementing each component using a blended course delivery will allow faculty to meet the students where they are in their learning as well as maximize class time.

Conclusions: Athletic training educators can successfully use flipped classroom principles in blended courses to create student-centered classes. Educators should strategically think about the course objectives and activities for each of the 3 components. Being deliberate in this approach will ensure the educator is both an expert and a facilitator helping students achieve all levels of the Bloom taxonomy to maximize student learning.