bluuebunny/crossref_metadata_2025_split huggingface dataset:
Influence of Demographics and Utilization of Physical Therapy Interventions on Clinical Outcomes and Revision Rates Following Anterior Cruciate Ligament Reconstruction
Authors: Miller Caitlin J. , Christensen Jesse C. , Burns Ryan D. 
Published: October 2017

Study Design Retrospective cohort from the Intermountain Healthcare system, January 2007 to December 2014. Background Recent evolutions in health care delivery are putting physical therapists in the forefront to be more responsible for providing high-quality rehabilitation care in a more cost-effective manner. Studies investigating the association between physical therapy visit utilization and outcomes in vulnerable patient populations following anterior cruciate ligament (ACL) reconstruction may provide useful insights. Objectives To examine the relationship between patient age, sex, physical therapy visit utilization, and physical therapy intervention charges with revision rates and patient-reported outcomes in individuals following primary ACL reconstruction. Methods A sample of 660 patients who had an ACL reconstruction was identified through an electronic medical record database. Age and physical therapy visit utilization were categorized to examine effects between groups (20 years of age or younger, 21 to 34 years of age, 35 years of age or older; fewer than 9 visits, 9 to 14 visits, 15 or more visits). Multilevel mixed-effects linear models were conducted to compare differences between revision rates and patient-reported outcomes during the episode of care. Receiver operating characteristic curve analyses were also used to determine visit-number and charge-per-visit cut points to discriminate patients who achieved at least a minimal clinically important difference on the patient-reported outcomes. Results Of 660 patients, 22 (3.3%) had revision surgery. Compared with patients 20 years and younger, the incidence rate ratio of ACL reconstruction revision was lower in patients who were 35 years and older (85%) and 21 to 34 years (59%). Of 470 patients who attended physical therapy for longer than 3 months, change in Knee Outcome Survey activities of daily living subscale score was significantly lower among patients 20 years of age and younger and in the lowest visit category. Conclusion Achievement of favorable outcomes following ACL reconstruction may require categorization of patients beyond surgical diagnosis alone. Younger patients (aged 20 years or less) attending fewer physical therapy visits (fewer than 9) were more likely to have ACL revision surgery and had inferior patient-reported outcomes compared to older patients and those with higher physical therapy visit utilization. The study design of a retrospective cohort limits the ability to identify causal relationships. Additionally, this study was conducted in only 1 geographic region within a single health care delivery system, which may limit the generalizability of the results. Level of Evidence Prognosis, level 2c. J Orthop Sports Phys Ther 2017;47(11):834–844. Epub 9 Oct 2017. doi:10.2519/jospt.2017.7048
Knee Extensor Rate of Torque Development Before and After Arthroscopic Partial Meniscectomy, With Analysis of Neuromuscular Mechanisms
Authors: Cobian Daniel G. , Koch Cameron M. , Amendola Annunziato , Williams Glenn N. 
Published: October 2017

Study Design Descriptive, prospective single-cohort longitudinal study. Background Though rapid torque development is essential in activities of daily living and sports, it hasn't been specifically tested by most physical therapists or incorporated into rehabilitation programs until late in the treatment process. Little evidence is available on quadriceps torque development capacity before and after arthroscopic knee surgery. Objectives To study knee extensor rate of torque development, contributing mechanisms, and associations with strength and patient-reported outcomes before and during the first 6 weeks after arthroscopic partial meniscectomy. Methods Twenty subjects (mean ± SD age, 42.3 ± 13.7 years; body mass index, 26.6 ± 3.1 kg/m2) were tested before surgery, and at 2 and 5 weeks after surgery. Quadriceps muscle volume, strength, activation, rate of torque development, and patient-reported outcomes were evaluated across the study period. Results Significant side-to-side differences in quadriceps strength and voluntary rate of torque development were observed at each time point (P<.05). Changes in muscle activity were associated with changes in rapid torque development capacity. Side-to-side rate of torque development deficits after surgery were associated with lower patient-reported outcomes scores. Conclusion Diminished rapid torque development capacity is common in arthroscopic meniscal debridement patients. This reduced capacity is associated with an inability to quickly recruit and drive the quadriceps muscles (neural mechanisms) and not muscle atrophy or other peripheral factors tested. Patient-reported outcomes are associated with quadriceps rate of torque development, but not strength or muscle size. Rapid torque development warrants greater attention in rehabilitation. J Orthop Sports Phys Ther 2017;47(12):945–956. Epub 9 Oct 2017. doi:10.2519/jospt.2017.7310
Pengukuran Beban Kerja Pada Managerial Level Dan Supervisory Level Dengan Menggunakan Metode Defence Research Agency Workload Scale (DRAWS) (Studi Kasus Di Departemen UHT PT. Ultrajaya Milk Industry & Trading Co, TBk )
Authors: Syafei M. Yani , Primanintyo Burhan , Syaefuddin Syaefuddin 
Published: October 2017

<em>Measurement of workload is a technique to get information about the efficiency and effectiveness of an organizational unit, or office holders through a process of research and assessment. It is conducted by using job analysis, workload analysis or other management techniques. PT. Ultrajaya Milk Industry &amp; Trading Co., Tbk is manufacturer of the food and beverage. The company is always trying to meet the needs of consumers by creating products with high quality and competitive price. The high stress level perceived by Managerial Level and Supervisory Level become an important reason for the Department of Ultra High Temperature (UHT) to conduct workload analysis. By measuring the employees workload, it will be known whether the workload of an employee is optimal load or overload. This situation will affect the human-performance (employee). Based on calculations by the DRAWS method is yielded the average workload score for Managerial Level of 67.37% (in the overload category), while the dominant workload variable in Central Demand (CD) is 41.60%, the distribution of the mental workload is 72.60% and physical workload is 27.40%. While for </em><em>Supervisory Level </em><em>is yielded the average workload score of 64.59% (in the overload category) ), where the dominant workload variable in Central Demand (CD) is 33.63%, the distribution of the mental workload is 55.10% and physical workload is 44.90%. Therefore the perceived mental workload of Supervisory Level is still relatively comparable compared to physical workload, and in contrast to the perceived Managerial Level which is dominated by mental workload.</em>
PEMBELAJARAN GEOMETRI BERBANTUAN SOFTWARE GEOGEBRA TERHADAP KEMAMPUAN KOMUNIKASI MATEMATIK SISWA
Authors: Kustiawati Dedek 
Published: October 2017

Tujuan penelitian ini adalah untuk mengetahui kemampuan komunikasi matematik siswa pada pembelajaran geometri yang menggunakan software geogebra dengan siswa pembelajaran konvensional. Penelitian ini dilakukan di SMAN 7 Bendhil Jakarta Pusat Tahun Ajaran 2016/2017. Metode yang digunakan dalam penelitian ini adalah metode quasi eksperimen. Subyek penelitian ini adalah 68 siswa untuk kelas eksperimen dan kelas kontrol yang diperoleh dengan teknik cluster random sampling pada siswa kelas XII. Pengumpulan data diberikan setelah perlakuan diperoleh dari nilai tes kemampuan komunikasi matematik siswa pada materi geometri bangun datar dan bangun tiga dimensi. Hasil penelitian mengungkapkan bahwa kemampuan komunikasi matematik siswa yang diajarkan dengan berbantuan software geogebra lebih baik dari pada siswa yang diajarkan dengan pembelajaran konvensional. Hal ini dapat dilihat dari nilai rata-rata hasil tes kemampuan kemampuan komunikasi matematik siswa yang diajar pada pembelajaran geometri dengan berbantuan software geogebra adalah sebesar dan 69,74 nilai rata-rata hasil tes kemampuan komunikasi matematik siswa yang diajar dengan media pembelajaran konvensional adalah sebesar 61,91. Hasil perhitungan tersebut menunjukkan bahwa thitung ≥ ttabel (2,46 ≥ 2,00). Kesimpulan hasil penelitian ini adalah bahwa pembelajaran matematika pada geometri bangun datar dan tiga dimensi berbantuan software geogebra berpengaruh secara signifikan terhadap kemampuan kemampuan komunikasi matematik siswa dibandingkan yang menggunakan media pembelajaran konvensional.
ANALISIS KESULITAN SISWA SMP DALAM MENYELESAIKAN MASALAH MATEMATIKA DITINJAU DARI GAYA KOGNITIF
Authors: Rasiman Rasiman , Asmarani Fitri 
Published: October 2017

Penelitian ini bertujuan untuk mengetahui kesulitan yang dialami oleh siswa Field Independent dan siswa Field Dependentsertamemberikan solusi bagi siswa yang mengalami kesulitan dalam menyelesaikan masalah matematika. Pengumpulan data dilakukan dengan metode tes dan wawancara Pada metode tes, subjek penelitian sebanyak 4 orang siswa, yang terdiri atas 2 orang siswa Field Independent, dan 2 orang siswa Field Dependentdiberi 3 masalah matematkadan selanjutnya dilakukan wawancara terkait kesulitan yang dialami dalam menyelesaikan masalah matematika tersebut. Uji keabsahan data dilakukan dengan teknik triangulasi data. Berdasarkan analisis hasil penelitian diketahui bahwa siswa Field Independentcenderung memiliki kesulitan dalam menentukan strategi dan melakukan prosedur matematika. Sedangkan siswa Field Dependent cenderung memiliki kesulitan dalam memahami masalah, menerjemahkan masalah ke dalam model matematika, dan menentukan strategi, serta melakukan prosedur matematika.Solusi yang ditawarkan oleh peneliti untuk siswa Field Independent adalah perlu diberikan kebebasan dalam menyelesaikan masalah yang dihadapi. Sedangkan siswa Field Dependentyaitu perlu diberikan petunjuk atau bimbingan dalam menyelesaikan masalah yang dihadapi.
A cross-sectional study of fall injuries in senior people attending emergency ward in BPKIHS, a tertiary level hospital, Dharan, eastern region of Nepal
Authors: Rai Bijendra Kumar , Chaudhari R , Yadav A , Rai B 
Published: October 2017

Background: The Senior or elderly population is rapidly growing in Nepal. They sustain injuries fall frequently which is mostly unintentional and occurs either inside or outside of house. The cost of treatment is high. The most effective fall prevention strategies are multifactorial interventions targeting identified risk factors, exercises for muscle strengthening combined with balance training and withdrawal of psychotropic medication. Objective: To study the pattern and associated rule factors of fall injuries among elderly patients from frequenting in the emergency.Method: It is an observational cross sectional study of fall in senior people presenting in emergency ward using a semi-structured questionnaire.Result: Male and female subjects were 76 (54.3%) and 64 (45.7%) respectively. Among 140 patients, 115 (82.1%) were living with families and 25 (17.9%) were living alone. Fifty six (40%) patients sustained injuries in early morning, fifty-two (37.1%) in late evening and thirty two (22.9%) in the afternoon. Seventy-three percent subjects fell outside and 26.40% fell inside house. Sixty-five (53.6%) patients were suffering from chronic diseases. Fifty-seven (40.7%) patients were suffering from visual impairment. Fourty-seven (33.6%) patients had multiple joints problem, 20% subjects were anaemic. Hypoglyceaemia was present in fifteen (10.7%) subject. Eighteen (12.9%) subjects had a history of fall in past. Eighteen (12.9%) subject had head injury. Twelve (8.6%) subjects had chest injury. Three (2.1%) subjects had abdominal injury and 24 (17.1%) spinal injury. Seventy-three (52.1%) subjects had fracture, 30 (21.4%) had soft tissue injury, 48 (34.3%) external injury and 11 (7.9%) eye most common injury found in elderly patients in this set up. Mosy of the fall injury injuries. Of all 82 (30.7%) patients were admitted in hospital.Conclusion: Fracture of bone was the occurred outside home. Most of the patients required admission in the hospital for treatment.Health Renaissance 2015;13 (1):
Measurement of compartmental pressure in a leg by Whitesides method in a Nepalese patients attending a tertiary care hospital in eastern region of Nepal
Authors: Chaudhary Pashupati , Shrestha BP , Yadav DK , Khanal GP , Rijal R 
Published: October 2017

Background: Compartment syndrome can be a life or limb-threatening emergency. Early diagnosis is important for the prevention of disability. The clinical features are subjective in nature. Intra compartmental pressure measurement is a reliable objective method for early and accurate diagnosis of compartment syndrome.Objective: To measure the compartmental pressure in a leg by Whitesides method in Nepalese patient attending a tertiary care hospital in eastern region of Nepal.Methods: This is a cross-sectional study done over the period of three years on adult patients aged 16 years and above presenting to the Emergency Department of BPKIHS with unilateral closed tibial fracture. Total of 60 patients aged 16 years and above with closed fracture tibia were enrolled in the study.Results: Out of total study population, 40 were males and 20 females. The anterior compartmental pressure in the uninjured legs ranged between 3 mmHg and 20 mmHg. Patients from hilly areas had more compartmental pressure (range 8 to 20 mmHg) as compared to patients of plain land (range 3 to 15 mmHg). People of hilly areas have more girth of thigh and calf muscles. Conclusion: The compartmental pressure in the uninjured legs ranged between 3 mmHg and 20 mmHg with variations in different geographic location. Whitesides injection technique of compartmental pressure measurement can be useful in the promptly defect compartmental syndrome in emergency and outpatient set-ups. Health Renaissance 2015;13 (1):health.renaissance@bpkihs.edu
Reversible intraventricular conduction defect in aconite poisoning: A Case report
Authors: Yadav Ajay Kumar , Chaudhuri S , Gupta PP , Chaudhary R , Aryal BD , Sah B , Malla G 
Published: October 2017

Aconitine and related alkaloids found in the Aconitum species are highly cardiotoxic and neurotoxic. The wild plant (especially the roots and root tubers) is extremely toxic. Severe aconite poisoning can occur after accidental ingestion of the wild plant or consumption of an herbal made from aconite roots. In traditional Chinese medicine, aconite roots are used only after processing to reduce the toxic alkaloid content. Soaking and boiling during processing will hydrolyze aconite alkaloids into less toxic and non-toxic derivatives. However, the use of a larger than recommended dose and inadequate processing increases the risk of poisoning. The aconite herb is one of the commonly-prescribed ingredients for various clinical problems. However, due to its narrow therapeutic index, toxicities are not uncommonly encountered, including life-threatening cardiac arrhythmias like ventricular arrhythmias Health Renaissance 2015; 13 (1): 108-111
An isolated capitellum fracture of the humerus in adult: A rare case report
Authors: Shah Kalawar Rosan Prasad , Chaudhary P , Maharjan R , Afaque SF 
Published: October 2017

Introduction: Isolated capitellum fractures are rare and represent only 1% of all elbow fractures and 6% of distal humeral fractures.Case description: A 45-year-old right hand dominant female presented to us with pain and stiffness in her left elbow following a fall onto the outstretched hand that occurred 6 months prior. She had capitellum fracture with avascular changes and excision of the fractured fragment was done. Physiotherapy was initiated with outcome of nearly normal elbow function. At the time of injury, she was unable to move her elbow actively due to pain and she was misdiagnosed as soft tissue injury earlier in a local hospital.Conclusion: Possibility of rare diagnosis such as capitellum fracture should also be kept in mind while treating elbow injuries. Health Renaissance 2015; 13 (1): 112-116
Barriers and facilitators to integration of physician associates into the general practice workforce: a grounded theory approach
Authors: Jackson Ben , Marshall Michelle , Schofield Susie 
Published: October 2017

BackgroundPhysician associates (PAs) are described as one solution to workforce capacity in primary care in the UK. Despite new investment in the role, how effective this will be in addressing unmet primary care needs is unclear.AimTo investigate the barriers and facilitators to the integration of PAs into the general practice workforce.Design and settingA modified grounded theory study in a region unfamiliar with the PA role.MethodNo a priori themes were assumed. Themes generated from stakeholder interviews informed a literature review and theoretical framework, and were then tested in focus groups with GPs, advanced nurse practitioners (ANPs), and patients. Recorded data were transcribed verbatim, and organised using NVivo version 10.2.2, with iterative analysis of emergent themes. A reflexive diary and independent verification of coding and analysis were included.ResultsThere were 51 participants (30 GPs, 11 ANPs, and 10 patients) in eight focus groups. GPs, ANPs, and patients recognised that support for general practice was needed to improve access. GPs expressed concerns regarding PAs around managing medical complexity and supervision burden, non-prescriber status, and medicolegal implications in routine practice. Patients were less concerned about specific competencies as long as there was effective supervision, and were accepting of a PA role. ANPs highlighted their own negative experiences entering advanced clinical practice, and the need for support to counteract stereotypical and prejudicial attitudesConclusionThis study highlights the complex factors that may impede the introduction of PAs into UK primary care. A conceptual model is proposed to help regulators and educationalists support this integration, which has relevance to other proposed new roles in primary care.
Improving access to allied health professionals through the Champlain BASE™eConsult service: a cross-sectional study in Canada
Authors: McKellips Fanny , Keely Erin , Afkham Amir , Liddy Clare 
Published: October 2017

BackgroundAllied health services are an important part of providing effective team-based care. The Champlain BASE™ (Building Access to Specialists through eConsultation) eConsult service facilitates quick and secure communication between primary care providers (PCPs) and allied health professionals (AHPs).AimTo assess the eConsult service’s ability to improve access to advice from AHPs.Design and settingA cross-sectional study was carried out on all cases submitted to AHPs through the eConsult service between April 2011 and May 2016. The service covers Ottawa, Canada, and its surrounding rural communities.MethodA descriptive overview of all cases submitted to allied health services was conducted. Utilisation and survey metrics for AHP eConsults were compared with those sent to medical specialties, in order to understand the potential differences and generalisability of eConsult access beyond the traditional medical specialty referral.ResultsPCPs submitted 127 cases to nine allied health specialties during the study period. The most popular specialty was clinical pharmacist, which received an average of 1.5 cases per month. The median specialist response time was 2.1 days (interquartile range [IQR] 0.7–5.3 days, range 0.01–14.2 days) versus 0.9 days (IQR 0.2–3.4 days, range 0–49.5 days) for medical specialties. PCPs received advice for a new or additional course of action in 70% (versus 58% for medical specialties) of cases. They rated the service as being of high or very high value for their patients in 88% of cases (versus 93% for medical specialties), and for themselves in 89% (94% for medical specialties) of cases.ConclusionThe eConsult service has demonstrated the ability to support prompt communication between PCPs and AHPs, improving patients’ access to AHP care. Given the importance of AHPs in providing primary care, allied health services should be offered in the menu of specialties available through electronic consultation services.
Experiences with online consultation systems in primary care: case study of one early adopter site
Authors: Casey Michael , Shaw Sara , Swinglehurst Deborah 
Published: October 2017

BackgroundThere is a strong policy drive towards implementing alternatives to face-to-face consultations in general practice to improve access, efficiency, and cost-effectiveness. These alternatives embrace novel technologies that are assumed to offer potential to improve care.AimTo explore the introduction of one online consultation system (Tele-Doc) and how it shapes working practices.Design and settingMixed methods case study in an inner-city general practice.MethodThe study was conducted through interviews with IT developers, clinicians, and administrative staff, and scrutiny of documents, websites, and demonstrator versions of Tele-Doc, followed by thematic analysis and discourse analysis.ResultsThree interrelated themes were identified: online consultation systems as innovation, managing the ‘messiness’ of general practice consultations, and redistribution of the work of general practice. These themes raise timely questions about what it means to consult in contemporary general practice. Uptake of Tele-Doc by patients was low. Much of the work of the consultation was redistributed to patients and administrators, sometimes causing misunderstandings. The ‘messiness’ of consultations was hard to eliminate. In-house training focused on the technical application rather than associated transformations to practice work that were not anticipated. GPs welcomed varied modes of consulting, but the aspiration of improved efficiency was not realised in practice.ConclusionTele-Doc offers a new kind of consultation that is still being worked out in practice. It may offer convenience for patients with discrete, single problems, and a welcome variation to GPs’ workload. Tele-Doc’s potential for addressing more complex problems and achieving efficiency is less clear, and its adoption may involve unforeseeable consequences.