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Sample records for pediatric fitness test

  1. Cardiopulmonary Exercise Testing in Pediatrics

    NARCIS (Netherlands)

    Takken, Tim; Bongers, Bart C; van Brussel, Marco; Haapala, Eero A; Hulzebos, Erik Hj

    2017-01-01

    Aerobic fitness is an important determinant of overall health. Higher aerobic fitness has been associated with many health benefits. Because myocardial ischemia is rare in children, indications for exercise testing differ in children compared to adults. Pediatric exercise testing is imperative to

  2. PEDIATRIC FITNESS: SECULAR TRENDS AND GEOGRAPHIC VARIABILITY

    Directory of Open Access Journals (Sweden)

    Grant R. Tomkinson

    2007-06-01

    Full Text Available DESCRIPTION This book describes and discusses children's physical capacity in terms of aerobic and anaerobic power generation according to secular trends and geographic variability. PURPOSE To discuss the controversial issue of whether present day's children and adolescents are fitter than their equals of the past and whether they are fitter if they live in the more prosperous countries. AUDIENCE Pediatricians, medical practitioners, physical educators, exercise and/or sport scientists, exercise physiologists, personal trainers and graduate students in relevant fields will find this book helpful when dealing with contemporary trends and geographic variability in pediatric fitness. FEATURES The volume starts by examining the general picture on children fitness by the editors. The individual chapter's authors discuses the data gathered since the late 1950s on secular trends and geographic changeability in aerobic and anaerobic pediatric fitness performances of children and adolescents from 23 countries in Africa, Asia, Australasia, Europe, the Middle East and North America. There are chapters proposing that there is proof that there has been a world-wide decline in pediatric aerobic performance in recent decades, relative stability in anaerobic performance, and that the best performing children come from northern and central Europe. In final chapters possible causes to that end are considered, including whether weakening in aerobic performance are the result of distributional or widespread declines, and whether increases in obesity alone can explain the failure in aerobic performance. ASSESSMENT The editors have assembled a volume of Medicine and Sports Science that is necessary and essential reading for all who are interested in understanding and improving the fitness of children. The readers will find useful information in this book on secular trends and geographic variability in pediatric fitness. I believe, the book will serve as a first

  3. FitKids360: Design, Conduct, and Outcomes of a Stage 2 Pediatric Obesity Program

    Directory of Open Access Journals (Sweden)

    Jared M. Tucker

    2014-01-01

    Full Text Available This paper describes FitKids360, a stage 2 pediatric weight management program. FitKids360 is a physician-referred, multicomponent, low-cost healthy lifestyle program for overweight and obese youth 5–16 years of age and their families. FitKids360 provides an evidence-based approach to the treatment of pediatric overweight by targeting patients’ physical activity, screen time, and dietary behaviors using a family-centered approach. The intervention begins with a two-hour orientation and assessment period followed by six weekly sessions. Assessments include lifestyle behaviors, anthropometry, and the Family Nutrition and Physical Activity (FNPA survey, which screens for obesogenic risk factors in the home environment. Outcomes are presented from 258 patients who completed one of 33 FitKids360 classes. After completing FitKids360, patients increased moderate to vigorous physical activity by 14 minutes (P=0.019, reduced screen time by 44 minutes (P<0.001, and improved key dietary behaviors. Overall, FNPA scores increased by 9% (P<0.001 and 69% of patients with “high risk” FNPA scores at baseline dropped below the “high risk” range by followup. Patients also lowered BMIs (P=0.011 and age- and sex-adjusted BMI z-scores (P<0.001 after completing the 7-week program. We hope this report will be useful to medical and public health professionals seeking to develop stage 2 pediatric obesity programs.

  4. Pediatric Exercise Testing: Value and Implications of Peak Oxygen Uptake

    Directory of Open Access Journals (Sweden)

    Paolo T. Pianosi

    2017-01-01

    Full Text Available Peak oxygen uptake (peak V ˙ O 2 measured by clinical exercise testing is the benchmark for aerobic fitness. Aerobic fitness, estimated from maximal treadmill exercise, is a predictor of mortality in adults. Peak V ˙ O 2 was shown to predict longevity in patients aged 7–35 years with cystic fibrosis over 25 years ago. A surge of exercise studies in young adults with congenital heart disease over the past decade has revealed significant prognostic information. Three years ago, the first clinical trial in children with pulmonary arterial hypertension used peak V ˙ O 2 as an endpoint that likewise delivered clinically relevant data. Cardiopulmonary exercise testing provides clinicians with biomarkers and clinical outcomes, and researchers with novel insights into fundamental biological mechanisms reflecting an integrated physiological response hidden at rest. Momentum from these pioneering observations in multiple disease states should impel clinicians to employ similar methods in other patient populations; e.g., sickle cell disease. Advances in pediatric exercise science will elucidate new pathways that may identify novel biomarkers. Our initial aim of this essay is to highlight the clinical relevance of exercise testing to determine peak V ˙ O 2 , and thereby convince clinicians of its merit, stimulating future clinical investigators to broaden the application of exercise testing in pediatrics.

  5. Commentary on the Assessment and Interpretation of Pediatric Aerobic Fitness-The Year That Was 2017.

    Science.gov (United States)

    Armstrong, Neil

    2018-02-01

    Three papers, which between them contribute to the current debate on the assessment and interpretation of pediatric aerobic fitness, were selected for commentary. The first paper (Children. 2017; 4:6; doi: 10.3390/children4010006 ) highlights the merits of clinical exercise testing and advocates the advancement of pediatric exercise testing through a rationale founded on demonstrated prognostic value of data obtained. It notes the lack of well-accepted definitions of exercise outcome variables in children and promotes the case for data harmonization across laboratories. The second paper (J Appl Physiol. 2017; 122: 997-1002) argues persuasively that the acceptance of peak oxygen uptake (peak [Formula: see text]) at the termination of an exercise test to voluntary exhaustion as a surrogate for a "true" maximal value (ie, [Formula: see text]) is no longer tolerable. The authors present a compelling case for the adoption of a follow-up verification test to unambiguously validate the achievement of [Formula: see text]. The third paper (Br J Sports Med. 2017; 1-10, doi: 10.1136/bjsports-2017-097982 ) compiles large, previously published datasets to provide a review of temporal trends in 20-m shuttle run test scores. The authors assert that temporal trends in 20-m shuttle run test performance provide meaningful insight into trends in population health. The commentary stresses the importance of scientific rigor in pediatric exercise testing, emphasizes the use of precise definitions when describing health-related variables, and cautions against the misuse of exercise outcome measures in recommendations relating to or impacting on young people's health and well-being.

  6. NCI Pediatric Preclinical Testing Consortium

    Science.gov (United States)

    NCI has awarded grants to five research teams to participate in its Pediatric Preclinical Testing Consortium, which is intended to help to prioritize which agents to pursue in pediatric clinical trials.

  7. Commentary: Pediatric Epilepsy: A Good Fit for Pediatric Psychologists

    Science.gov (United States)

    Modi, Avani; Smith, Gigi

    2011-01-01

    While there are an abundance of pediatric neuropsychologists working with youth with epilepsy (YWE), other subspecialty psychologists have played minimal roles in clinical and research endeavors in pediatric epilepsy. Thus, the purpose of this commentary was to describe (a) the needs of YWE due to the intermittent nature of seizures and difficulties with disease management, (b) increased risk for psychosocial comorbidities, (c) limited access to care, and (d) provide recommendations for how pediatric psychologists can become involved in the clinical care and research activities for YWE. PMID:21148174

  8. Pediatric art preferences: countering the "one-size-fits-all" approach.

    Science.gov (United States)

    Nanda, Upali; Chanaud, Cheryl M; Brown, Linda; Hart, Robyn; Hathorn, Kathy

    2009-01-01

    three operational stages, so one should be careful before using the "one-size-fits-all" approach. Child art, typically used in pediatric wards, is better suited for younger children than for older children.

  9. The Andersen aerobic fitness test

    DEFF Research Database (Denmark)

    Aadland, Eivind; Terum, Torkil; Mamen, Asgeir

    2014-01-01

    BACKGROUND: High aerobic fitness is consistently associated with a favorable metabolic risk profile in children. Direct measurement of peak oxygen consumption (VO2peak) is often not feasible, thus indirect tests such as the Andersen test are required in many settings. The present study seeks...... of agreement) were 26.7±125.2 m for test 2 vs. test 1 (pfit in the present sample; thus, we suggest a new equation: VO2peak = 23....... Researchers should be aware of the amount of noise in indirect tests that estimate aerobic fitness....

  10. Goodness-of-fit tests for the Gompertz distribution

    DEFF Research Database (Denmark)

    Lenart, Adam; Missov, Trifon

    The Gompertz distribution is often fitted to lifespan data, however testing whether the fit satisfies theoretical criteria was neglected. Here five goodness-of-fit measures, the Anderson-Darling statistic, the Kullback-Leibler discrimination information, the correlation coefficient test, testing ...... for the mean of the sample hazard and a nested test against the generalized extreme value distributions are discussed. Along with an application to laboratory rat data, critical values calculated by the empirical distribution of the test statistics are also presented.......The Gompertz distribution is often fitted to lifespan data, however testing whether the fit satisfies theoretical criteria was neglected. Here five goodness-of-fit measures, the Anderson-Darling statistic, the Kullback-Leibler discrimination information, the correlation coefficient test, testing...

  11. Decision-Making in Pediatric Transport Team Dispatch Using Script Concordance Testing.

    Science.gov (United States)

    Rajapreyar, Prakadeshwari; Marcdante, Karen; Zhang, Liyun; Simpson, Pippa; Meyer, Michael T

    2017-11-01

    Our objective was to compare decision-making in dispatching pediatric transport teams by Medical Directors of pediatric transport teams (serving as experts) to that of Pediatric Intensivists and Critical Care fellows who often serve as Medical Control physicians. Understanding decision-making around team composition and dispatch could impact clinical management, cost effectiveness, and educational needs. Survey was developed using Script Concordance Testing guidelines. The survey contained 15 transport case vignettes covering 20 scenarios (45 questions). Eleven scenarios assessed impact of intrinsic patient factors (e.g., procedural needs), whereas nine assessed extrinsic factors (e.g., weather). Pediatric Critical Care programs accredited by the Accreditation Council for Graduate Medical Education (the United States). Pediatric Intensivists and senior Critical Care fellows at Pediatric Critical Care programs were the target population with Transport Medical Directors serving as the expert panel. None. Survey results were scored per Script Concordance Testing guidelines. Concordance within groups was assessed using simple percentage agreement. There was little concordance in decision-making by Transport Medical Directors (median Script Concordance Testing percentage score [interquartile range] of 33.9 [30.4-37.3]). In addition, there was no statistically significant difference between the median Script Concordance Testing scores among the senior fellows and Pediatric Intensivists (31.1 [29.6-33.2] vs 29.7 [28.3-32.3], respectively; p = 0.12). Transport Medical Directors were more concordant on reasoning involving intrinsic patient factors rather than extrinsic factors (10/21 vs 4/24). Our study demonstrates pediatric transport team dispatch decision-making discordance by pediatric critical care physicians of varying levels of expertise and experience. Script Concordance Testing at a local level may better elucidate standards in medical decision-making within

  12. Effect of test exercises and mask donning on measured respirator fit.

    Science.gov (United States)

    Crutchfield, C D; Fairbank, E O; Greenstein, S L

    1999-12-01

    Quantitative respirator fit test protocols are typically defined by a series of fit test exercises. A rationale for the protocols that have been developed is generally not available. There also is little information available that describes the effect or effectiveness of the fit test exercises currently specified in respiratory protection standards. This study was designed to assess the relative impact of fit test exercises and mask donning on respirator fit as measured by a controlled negative pressure and an ambient aerosol fit test system. Multiple donnings of two different sizes of identical respirator models by each of 14 test subjects showed that donning affects respirator fit to a greater degree than fit test exercises. Currently specified fit test protocols emphasize test exercises, and the determination of fit is based on a single mask donning. A rationale for a modified fit test protocol based on fewer, more targeted test exercises and multiple mask donnings is presented. The modified protocol identified inadequately fitting respirators as effectively as the currently specified Occupational Safety and Health Administration (OSHA) quantitative fit test protocol. The controlled negative pressure system measured significantly (p < 0.0001) more respirator leakage than the ambient aerosol fit test system. The bend over fit test exercise was found to be predictive of poor respirator fit by both fit test systems. For the better fitting respirators, only the talking exercise generated aerosol fit factors that were significantly lower (p < 0.0001) than corresponding donning fit factors.

  13. Goodness of Fit Test and Test of Independence by Entropy

    OpenAIRE

    M. Sharifdoost; N. Nematollahi; E. Pasha

    2009-01-01

    To test whether a set of data has a specific distribution or not, we can use the goodness of fit test. This test can be done by one of Pearson X 2 -statistic or the likelihood ratio statistic G 2 , which are asymptotically equal, and also by using the Kolmogorov-Smirnov statistic in continuous distributions. In this paper, we introduce a new test statistic for goodness of fit test which is based on entropy distance, and which can be applied for large sample sizes...

  14. Comparison of different tests to determine difficult intubation in pediatric patients

    Directory of Open Access Journals (Sweden)

    Mehmet Turan Inal

    2014-12-01

    Full Text Available Background: The difficulties with airway management is the main reason for pediatric anesthesia-related morbidity and mortality. Objective: To assess the value of modified Mallampati test, Upper-Lip-Bite test, thyromental distance and the ratio of height to thyromental distance to predict difficult intubation in pediatric patients. Design: Prospective analysis. Measurements and results: Data were collected from 5 to 11 years old 250 pediatric patients requiring tracheal intubation. The Cormack and Lehane classification was used to evaluate difficult laryngoscopy. Sensitivity, specificity, positive predictive value and AUC values for each test were measured. Results: The sensitivity and specificity of modified Mallampati test were 76.92% and 95.54%, while those for ULBT were 69.23% and 97.32%. The optimal cutoff point for the ratio of height to thyromental distance and thyromental distance for predicting difficult laryngoscopy was 23.5 (sensitivity, 57.69%; specificity, 86.61% and 5.5 cm (sensitivity, 61.54%; specificity, 99.11%. The modified Mallampati was the most sensitive of the tests. The ratio of height to thyromental distance was the least sensitive test. Conclusion: These results suggested that the modified Mallampati and Upper-Lip-Bite tests may be useful in pediatric patients for predicting difficult intubation.

  15. Elective penicillin skin testing in a pediatric outpatient setting.

    Science.gov (United States)

    Jost, Barbara Capes; Wedner, H James; Bloomberg, Gordon R

    2006-12-01

    Adverse reactions associated with penicillin-type antibiotics are common in pediatric practice, leading to the subsequent unnecessary use of alternative antibiotics. IgE-mediated penicillin allergy represents only a fraction of these adverse reactions. To examine (1) the trend of penicillin skin test reactivity during a recent 10-year interval, (2) the relative distribution of specific reagents related to a positive skin test result, and (3) skin test reactivity as a function of reaction history. Penicillin testing using 3 reagents--benzylpenicilloyl polylysine, penicillin G, and sodium penicilloate (penicillin A)--was conducted in a prospective study of 359 consecutive patients referred to an outpatient pediatric allergy clinic between January 1, 1993, and May 31, 2003. We also retrospectively reviewed penicillin skin test results for 562 children previously tested between January 1, 1979, and December 31, 1992. Between 1993 and 2003, the prevalence of penicillin skin test sensitivity markedly declined. Of all the positive skin test results between 1979 and 2002, either penicillin G or sodium penicilloate or both identified 34%, with sodium penicilloate alone responsible for 8.5%. The rate of positive skin test reactions was not significantly different between patients with vs without a history of suggestive IgE-mediated reactions. A marked decline in penicillin skin test sensitivity in the pediatric age group is identified. The minor determinant reagents penicillin G and sodium penicilloate are both necessary for determining potential penicillin allergy. Relating history alone to potential penicillin sensitivity is unreliable in predicting the presence or absence of a positive skin test result.

  16. Simplified pressure method for respirator fit testing.

    Science.gov (United States)

    Han, D; Xu, M; Foo, S; Pilacinski, W; Willeke, K

    1991-08-01

    A simplified pressure method has been developed for fit testing air-purifying respirators. In this method, the air-purifying cartridges are replaced by a pressure-sensing attachment and a valve. While wearers hold their breath, a small pump extracts air from the respirator cavity until a steady-state pressure is reached in 1 to 2 sec. The flow rate through the face seal leak is a unique function of this pressure, which is determined once for all respirators, regardless of the respirator's cavity volume or deformation because of pliability. The contaminant concentration inside the respirator depends on the degree of dilution by the flow through the cartridges. The cartridge flow varies among different brands and is measured once for each brand. The ratio of cartridge to leakflow is a measure of fit. This flow ratio has been measured on human subjects and has been compared to fit factors determined on the same subjects by means of photometric and particle count tests. The aerosol tests gave higher values of fit.

  17. Inappropriate Practices in Fitness Testing and Reporting: Alternative Strategies

    Science.gov (United States)

    Zhu, Xihe; Davis, Summer; Kirk, T. Nicole; Haegele, Justin A.; Knott, Stephen E.

    2018-01-01

    Fitness education is becoming an integrated component for many physical education programs. As such, many physical educators conduct health-related fitness tests on a regular basis. Some states even mandate certain types of physical fitness tests to be administered and reported annually or by semester. Yet, inappropriate practices have been…

  18. CUSUM-based person-fit statistics for adaptive testing

    NARCIS (Netherlands)

    van Krimpen-Stoop, Edith; Meijer, R.R.

    2001-01-01

    Item scores that do not fit an assumed item response theory model may cause the latent trait value to be inaccurately estimated. Several person-fit statistics for detecting nonfitting score patterns for paper-and-pencil tests have been proposed. In the context of computerized adaptive tests (CAT),

  19. CUSUM-based person-fit statistics for adaptive testing

    NARCIS (Netherlands)

    van Krimpen-Stoop, Edith; Meijer, R.R.

    1999-01-01

    Item scores that do not fit an assumed item response theory model may cause the latent trait value to be estimated inaccurately. Several person-fit statistics for detecting nonfitting score patterns for paper-and-pencil tests have been proposed. In the context of computerized adaptive tests (CAT),

  20. Goodness of Fit Test and Test of Independence by Entropy

    Directory of Open Access Journals (Sweden)

    M. Sharifdoost

    2009-06-01

    Full Text Available To test whether a set of data has a specific distribution or not, we can use the goodness of fit test. This test can be done by one of Pearson X 2 -statistic or the likelihood ratio statistic G 2 , which are asymptotically equal, and also by using the Kolmogorov-Smirnov statistic in continuous distributions. In this paper, we introduce a new test statistic for goodness of fit test which is based on entropy distance, and which can be applied for large sample sizes. We compare this new statistic with the classical test statistics X 2 , G 2 , and Tn by some simulation studies. We conclude that the new statistic is more sensitive than the usual statistics to the rejection of distributions which are almost closed to the desired distribution. Also for testing independence, a new test statistic based on mutual information is introduced

  1. High School Physical Education Teachers' Attitudes and Use of Fitness Tests

    Science.gov (United States)

    Mercier, Kevin; Phillips, Sharon; Silverman, Stephen

    2016-01-01

    Recommendations for using and implementing fitness tests have been extensively researched and teachers' attitudes toward fitness tests are beginning to be studied. Less understood is how high school teachers use fitness tests and the role their attitudes toward fitness tests affect students' attitudes toward physical activity. The purpose of this…

  2. Effects of Nintendo Wii-Fit® video games on balance in children with mild cerebral palsy.

    Science.gov (United States)

    Tarakci, Devrim; Ersoz Huseyinsinoglu, Burcu; Tarakci, Ela; Razak Ozdincler, Arzu

    2016-10-01

    This study compared the effects of Nintendo Wii-Fit ® balance-based video games and conventional balance training in children with mild cerebral palsy (CP). This randomized controlled trial involved 30 ambulatory pediatric patients (aged 5-18 years) with CP. Participants were randomized to either conventional balance training (control group) or to Wii-Fit balance-based video games training (Wii group). Both group received neuro-developmental treatment (NDT) during 24 sessions. In addition, while the control group received conventional balance training in each session, the Wii group played Nintendo Wii Fit games such as ski slalom, tightrope walk and soccer heading on balance board. Primary outcomes were Functional Reach Test (forward and sideways), Sit-to-Stand Test and Timed Get up and Go Test. Nintendo Wii Fit balance, age and game scores, 10 m walk test, 10-step climbing test and Wee-Functional Independence Measure (Wee FIM) were secondary outcomes. After the treatment, changes in balance scores and independence level in activities of daily living were significant (P Wii-based game group compared with the control group in all balance tests and total Wee FIM score (P Wii-fit balance-based video games are better at improving both static and performance-related balance parameters when combined with NDT treatment in children with mild CP. © 2016 Japan Pediatric Society.

  3. A Comparison of the US Air Force Fitness Test and Sister Services’ Combat-Oriented Fitness Tests

    Science.gov (United States)

    2009-03-01

    their status quo. These changes included changing their road runs into 400- to 800- meter (m) interval training, reducing their test run distance from 5...sleep were recorded throughout the operation. Measures of fitness were the isokinetic strength of the arms and legs, isometric handgrip strength...JIT = Just-In-Time (training) km = kilometer MANUF = Maneuver-Under-Fire (drill within the CFT) MFTC = Master Fitness Trainer Course m = meter

  4. Fitness Testing: How Do Students Make Sense of the Gender Disparities?

    Science.gov (United States)

    Domangue, Elizabeth A.; Solmon, Melinda A.

    2012-01-01

    The ways in which students make sense of the gendered fitness expectations found in a norm-referenced fitness testing program (i.e. President's challenge physical fitness test) were the focus of this study. Participants were 18 fifth grade students who completed fitness tests in their physical education classes. They were interviewed using a…

  5. The efficacy of the PACER versus the modified PACER test for assessing aerobic fitness in overweight children

    Science.gov (United States)

    Overweight status is negatively related to health in children. Achieving adequate cardiorespiratory fitness (CRF) may reduce the health problems associated with pediatric overweight. It is important to accurately measure CRF. There is limited research concerning the validity of existing CRF field te...

  6. Quantum chi-squared and goodness of fit testing

    Energy Technology Data Exchange (ETDEWEB)

    Temme, Kristan [IQIM, California Institute of Technology, Pasadena, California 91125 (United States); Verstraete, Frank [Fakultät für Physik, Universität Wien, Boltzmanngasse 5, 1090 Wien, Austria and Faculty of Science, Ghent University, B-9000 Ghent (Belgium)

    2015-01-15

    A quantum mechanical hypothesis test is presented for the hypothesis that a certain setup produces a given quantum state. Although the classical and the quantum problems are very much related to each other, the quantum problem is much richer due to the additional optimization over the measurement basis. A goodness of fit test for i.i.d quantum states is developed and a max-min characterization for the optimal measurement is introduced. We find the quantum measurement which leads both to the maximal Pitman and Bahadur efficiencies, and determine the associated divergence rates. We discuss the relationship of the quantum goodness of fit test to the problem of estimating multiple parameters from a density matrix. These problems are found to be closely related and we show that the largest error of an optimal strategy, determined by the smallest eigenvalue of the Fisher information matrix, is given by the divergence rate of the goodness of fit test.

  7. Comparison of physical fitness tests in swimming

    OpenAIRE

    Dostálová, Sabina

    2015-01-01

    Title: Comparison of physical fitness tests in swimming. Objective: The aim of this thesis is to evaluate specific tests, used while testing selected physical abilities in swimming. By specific tests we mean tests realized in the water. Selected tests are intended for swim coaches, who train junior to senior age groups. Methods: The chosen method was a comparison of studies, that pursue selected specific tests. We created partial conclusions for every test by summing up the results of differe...

  8. Testing and Treatment After Adolescent Sexual Assault in Pediatric Emergency Departments.

    Science.gov (United States)

    Schilling, Samantha; Samuels-Kalow, Margaret; Gerber, Jeffrey S; Scribano, Philip V; French, Benjamin; Wood, Joanne N

    2015-12-01

    To examine rates of recommended of testing and prophylaxis for chlamydia, gonorrhea, and pregnancy in adolescents diagnosed with sexual assault across pediatric emergency departments (EDs) and to determine whether specialized sexual assault pathways and teams are associated with performance of recommended testing and prophylaxis. In this retrospective study of 12- to 18-year-old adolescents diagnosed with sexual assault at 38 EDs in the Pediatric Hospital Information System database from 2004 to 2013, information regarding routine practice for sexual assault evaluations and presence and year of initiation of specialized ED sexual assault pathways and teams was collected via survey. We examined across-hospital variation and identified patient- and hospital-level factors associated with testing and prophylaxis using logistic regression models, accounting for clustering by hospital. Among 12,687 included cases, 93% were female, 79% were <16 years old, 34% were non-Hispanic white, 38% were non-Hispanic black, 21% were Hispanic, and 52% had public insurance. Overall, 44% of adolescents received recommended testing (chlamydia, gonorrhea, pregnancy) and 35% received recommended prophylaxis (chlamydia, gonorrhea, emergency contraception). Across EDs, unadjusted rates of testing ranged from 6% to 89%, and prophylaxis ranged from 0% to 57%. Presence of a specialized sexual assault pathway was associated with increased rates of prophylaxis even after adjusting for case-mix and temporal trends (odds ratio 1.46, 95% confidence interval 1.15 to 1.86). Evaluation and treatment of adolescent sexual assault victims varied widely across pediatric EDs. Adolescents cared for in EDs with specialized sexual assault pathways were more likely to receive recommended prophylaxis. Copyright © 2015 by the American Academy of Pediatrics.

  9. Test of Seal System for Flexible Pipe End Fitting

    DEFF Research Database (Denmark)

    Banke, Lars; Jensen, Thomas Gregers

    1999-01-01

    The purpose of the end fitting seal system is to ensure leak proof termination of flexible pipes. The seal system of an NKT end fitting normally consists of a number of ring joint gaskets mounted in a steel sleeve on the outside of the polymeric inner liner of the pipe. The seal system is activated...... by compression of the gaskets, thus using the geometry to establish a seal towards the inner liner of the pipe and the steel sleeve of the end fitting. This paper describes how the seal system of an end fitting can be tested using an autoclave. By regulating temperature and pressure, the seal system can...... be tested up to 130oC and 51.7 MPa. Pressure, temperature and the mechanical behaviours of the pipe are measured for use in further research. The set-up is used to test the efficiency of the seal system as function of parameters such as cross sectional shapes of the gaskets, tolerances between gaskets...

  10. A note on goodness of fit test using moments

    Directory of Open Access Journals (Sweden)

    Alex Papadopoulos

    2007-10-01

    Full Text Available The purpose of this article is to introduce a general moment-based approach to derive formal goodness of fit tests of a parametric family. We show that, in general, an approximate normal test or a chi-squared test can be derived by exploring the moment structure of a parametric family, when moments up to certain order exist. The idea is simple and the resulting tests are easy to implement. To illustrate the use of this approach, we derive moment-based goodness of fit tests for some common discrete and continuous parametric families. We also compare the proposed tests with the well known Pearson-Fisher chi-square test and some distance tests in a simulation study.

  11. Chi-squared goodness of fit tests with applications

    CERN Document Server

    Balakrishnan, N; Nikulin, MS

    2013-01-01

    Chi-Squared Goodness of Fit Tests with Applications provides a thorough and complete context for the theoretical basis and implementation of Pearson's monumental contribution and its wide applicability for chi-squared goodness of fit tests. The book is ideal for researchers and scientists conducting statistical analysis in processing of experimental data as well as to students and practitioners with a good mathematical background who use statistical methods. The historical context, especially Chapter 7, provides great insight into importance of this subject with an authoritative author team

  12. Design and interpretation of anthropometric and fitness testing of basketball players.

    Science.gov (United States)

    Drinkwater, Eric J; Pyne, David B; McKenna, Michael J

    2008-01-01

    The volume of literature on fitness testing in court sports such as basketball is considerably less than for field sports or individual sports such as running and cycling. Team sport performance is dependent upon a diverse range of qualities including size, fitness, sport-specific skills, team tactics, and psychological attributes. The game of basketball has evolved to have a high priority on body size and physical fitness by coaches and players. A player's size has a large influence on the position in the team, while the high-intensity, intermittent nature of the physical demands requires players to have a high level of fitness. Basketball coaches and sport scientists often use a battery of sport-specific physical tests to evaluate body size and composition, and aerobic fitness and power. This testing may be used to track changes within athletes over time to evaluate the effectiveness of training programmes or screen players for selection. Sports science research is establishing typical (or 'reference') values for both within-athlete changes and between-athlete differences. Newer statistical approaches such as magnitude-based inferences have emerged that are providing more meaningful interpretation of fitness testing results in the field for coaches and athletes. Careful selection and implementation of tests, and more pertinent interpretation of data, will enhance the value of fitness testing in high-level basketball programmes. This article presents reference values of fitness and body size in basketball players, and identifies practical methods of interpreting changes within players and differences between players beyond the null-hypothesis.

  13. Permutation tests for goodness-of-fit testing of mathematical models to experimental data.

    Science.gov (United States)

    Fişek, M Hamit; Barlas, Zeynep

    2013-03-01

    This paper presents statistical procedures for improving the goodness-of-fit testing of theoretical models to data obtained from laboratory experiments. We use an experimental study in the expectation states research tradition which has been carried out in the "standardized experimental situation" associated with the program to illustrate the application of our procedures. We briefly review the expectation states research program and the fundamentals of resampling statistics as we develop our procedures in the resampling context. The first procedure we develop is a modification of the chi-square test which has been the primary statistical tool for assessing goodness of fit in the EST research program, but has problems associated with its use. We discuss these problems and suggest a procedure to overcome them. The second procedure we present, the "Average Absolute Deviation" test, is a new test and is proposed as an alternative to the chi square test, as being simpler and more informative. The third and fourth procedures are permutation versions of Jonckheere's test for ordered alternatives, and Kendall's tau(b), a rank order correlation coefficient. The fifth procedure is a new rank order goodness-of-fit test, which we call the "Deviation from Ideal Ranking" index, which we believe may be more useful than other rank order tests for assessing goodness-of-fit of models to experimental data. The application of these procedures to the sample data is illustrated in detail. We then present another laboratory study from an experimental paradigm different from the expectation states paradigm - the "network exchange" paradigm, and describe how our procedures may be applied to this data set. Copyright © 2012 Elsevier Inc. All rights reserved.

  14. Construct Validity of Physical Fitness Tests

    Science.gov (United States)

    2011-02-03

    Powers, S. K., Lawler, J., Ayers, D., & Stuart, M. K. (1991). Physiological correlates to 800 meter running performance. Journal of Sports Medicine and... isokinetic tests. Journal of Sports Medicine and Physical Fitness, 36, 169-177. *Myers, D. C., Gebhardt, D. L., Crump, C.E., & Fleishman, E. A. (1984

  15. Exact goodness-of-fit tests for Markov chains.

    Science.gov (United States)

    Besag, J; Mondal, D

    2013-06-01

    Goodness-of-fit tests are useful in assessing whether a statistical model is consistent with available data. However, the usual χ² asymptotics often fail, either because of the paucity of the data or because a nonstandard test statistic is of interest. In this article, we describe exact goodness-of-fit tests for first- and higher order Markov chains, with particular attention given to time-reversible ones. The tests are obtained by conditioning on the sufficient statistics for the transition probabilities and are implemented by simple Monte Carlo sampling or by Markov chain Monte Carlo. They apply both to single and to multiple sequences and allow a free choice of test statistic. Three examples are given. The first concerns multiple sequences of dry and wet January days for the years 1948-1983 at Snoqualmie Falls, Washington State, and suggests that standard analysis may be misleading. The second one is for a four-state DNA sequence and lends support to the original conclusion that a second-order Markov chain provides an adequate fit to the data. The last one is six-state atomistic data arising in molecular conformational dynamics simulation of solvated alanine dipeptide and points to strong evidence against a first-order reversible Markov chain at 6 picosecond time steps. © 2013, The International Biometric Society.

  16. Measurement precision and efficiency of multidimensional computer adaptive testing of physical functioning using the pediatric evaluation of disability inventory.

    Science.gov (United States)

    Haley, Stephen M; Ni, Pengsheng; Ludlow, Larry H; Fragala-Pinkham, Maria A

    2006-09-01

    To compare the measurement efficiency and precision of a multidimensional computer adaptive testing (M-CAT) application to a unidimensional CAT (U-CAT) comparison using item bank data from 2 of the functional skills scales of the Pediatric Evaluation of Disability Inventory (PEDI). Using existing PEDI mobility and self-care item banks, we compared the stability of item calibrations and model fit between unidimensional and multidimensional Rasch models and compared the efficiency and precision of the U-CAT- and M-CAT-simulated assessments to a random draw of items. Pediatric rehabilitation hospital and clinics. Clinical and normative samples. Not applicable. Not applicable. The M-CAT had greater levels of precision and efficiency than the separate mobility and self-care U-CAT versions when using a similar number of items for each PEDI subdomain. Equivalent estimation of mobility and self-care scores can be achieved with a 25% to 40% item reduction with the M-CAT compared with the U-CAT. M-CAT applications appear to have both precision and efficiency advantages compared with separate U-CAT assessments when content subdomains have a high correlation. Practitioners may also realize interpretive advantages of reporting test score information for each subdomain when separate clinical inferences are desired.

  17. Universal Physical Fitness Testing for United States Guardians Afloat

    Science.gov (United States)

    2016-06-10

    fitness tests assist with establishing a high retention rate and reducing absenteeism .”58 Robert Behn talks about measurements as an “overall...https://www.policeone.com/police- products /fitness-health-wellness/articles/ 1641504-Final-Word-Mandatory-Fitness-Standards-for-In-Service-Officers...30, 2016, http://static.e-publishing.af.mil/ production /1/af_a1/ publication/afi36-2905/afi36-2905.pdf. 95 Major Richard T. Gindhard Jr., “The Air

  18. Pediatric health-related quality of life: a structural equation modeling approach.

    Directory of Open Access Journals (Sweden)

    Ester Villalonga-Olives

    Full Text Available OBJECTIVES: One of the most referenced theoretical frameworks to measure Health Related Quality of Life (HRQoL is the Wilson and Cleary framework. With some adaptions this framework has been validated in the adult population, but has not been tested in pediatric populations. Our goal was to empirically investigate it in children. METHODS: The contributory factors to Health Related Quality of Life that we included were symptom status (presence of chronic disease or hospitalizations, functional status (developmental status, developmental aspects of the individual (social-emotional behavior, and characteristics of the social environment (socioeconomic status and area of education. Structural equation modeling was used to assess the measurement structure of the model in 214 German children (3-5 years old participating in a follow-up study that investigates pediatric health outcomes. RESULTS: Model fit was χ2 = 5.5; df = 6; p = 0.48; SRMR  = 0.01. The variance explained of Health Related Quality of Life was 15%. Health Related Quality of Life was affected by the area education (i.e. where kindergartens were located and development status. Developmental status was affected by the area of education, socioeconomic status and individual behavior. Symptoms did not affect the model. CONCLUSIONS: The goodness of fit and the overall variance explained were good. However, the results between children' and adults' tests differed and denote a conceptual gap between adult and children measures. Indeed, there is a lot of variety in pediatric Health Related Quality of Life measures, which represents a lack of a common definition of pediatric Health Related Quality of Life. We recommend that researchers invest time in the development of pediatric Health Related Quality of Life theory and theory based evaluations.

  19. Developing Effective Physical Fitness Testing Standards for Pre Service Physical Educators

    Science.gov (United States)

    Hill, Kory; Thornburg, Roland

    2016-01-01

    Physical educators are often held to a higher standard of physical fitness. The ability to effectively convey the importance of physical fitness may depend upon the ability to appear physically fit. The ability to perform at a minimal level of proficiency on fitness tests was deemed important by the faculty of one physical education teacher…

  20. Goodness-of-fit test for copulas

    Science.gov (United States)

    Panchenko, Valentyn

    2005-09-01

    Copulas are often used in finance to characterize the dependence between assets. However, a choice of the functional form for the copula is an open question in the literature. This paper develops a goodness-of-fit test for copulas based on positive definite bilinear forms. The suggested test avoids the use of plug-in estimators that is the common practice in the literature. The test statistics can be consistently computed on the basis of V-estimators even in the case of large dimensions. The test is applied to a dataset of US large cap stocks to assess the performance of the Gaussian copula for the portfolios of assets of various dimension. The Gaussian copula appears to be inadequate to characterize the dependence between assets.

  1. Sport specific fitness testing of elite badminton players.

    Science.gov (United States)

    Chin, M K; Wong, A S; So, R C; Siu, O T; Steininger, K; Lo, D T

    1995-01-01

    There is a scarcity of descriptive data on the performance capacity of elite badminton players, whose fitness requirements are quite specific. The purpose of this paper is to investigate the physiological response of elite badminton players in a sport-specific fitness test. Twelve Hong Kong national badminton team players performed a field test on a badminton court. Six light bulbs were connected to a programming device causing individual bulbs to light up in a given sequence. The players were instructed to react to the flashes by running towards them, and striking shuttles mounted in the vicinity of the bulbs. Exercise intensity was controlled by altering the interval between successive lightings. A low correlation (r = 0.65) was found between the results of the field test and the rank-order list of subjects, based on an objective on-field physiological assessment and subjective ranking. This may be explained by the requirements of other factors besides physical fitness which contribute to success in elite level badminton competition. These factors may include, for example, technical skill, mental power, and aesthetic judgements on the court. Maximum mean (s.d.) heart rate data (187(8) beats.min-1) and blood lactate values (10.4(2.9) mmol.l-1) in this study showed that players were under maximal load during the field test. From the testing data, it seems reasonable to speculate that the intensity of level 3 (20 light pulses.min-1; 3.0 s.pulse-1) and level 4 (22 light pulses.min-1; 2.7 s.pulse-1) simulates the requirement of actual games energy expenditure of the Hong Kong badminton players exercising at close to their anaerobic threshold. The results also show that an estimate of fitness can be derived from measurements involving exercise closely resembling that which is specific for the sports activity in question. Improved training advice and guidance may result from such studies. PMID:8800846

  2. Student Motivation Associated with Fitness Testing in the Physical Education Context

    Science.gov (United States)

    Jaakkola, Timo Tapio; Sääkslahti, Arja; Yli-Piipari, Sami; Manninen, Mika; Watt, Anthony; Liukkonen, Jarmo

    2013-01-01

    The purpose of the study was to analyze students' motivation in relation to their participation in fitness testing classes. Participants were 134 Finnish Grade 5 and 8 students. Students completed the contextual motivation and perceived physical competence scales before the fitness testing class and the situational motivation questionnaire…

  3. A simple non-parametric goodness-of-fit test for elliptical copulas

    Directory of Open Access Journals (Sweden)

    Jaser Miriam

    2017-12-01

    Full Text Available In this paper, we propose a simple non-parametric goodness-of-fit test for elliptical copulas of any dimension. It is based on the equality of Kendall’s tau and Blomqvist’s beta for all bivariate margins. Nominal level and power of the proposed test are investigated in a Monte Carlo study. An empirical application illustrates our goodness-of-fit test at work.

  4. Developing Guidelines for HIV Antibody Testing among Victims of Pediatric Sexual Abuse.

    Science.gov (United States)

    Gellert, George A.; And Others

    1990-01-01

    An interim set of human immunodeficiency virus (HIV) testing guidelines for victims of pediatric sexual abuse (PSA) is proposed. Guidelines are based on responses of 63 practitioners of PSA assessment to 7 hypothetical clinical profiles with 12 testing criteria. (Author/DB)

  5. Pediatric residents' learning styles and temperaments and their relationships to standardized test scores.

    Science.gov (United States)

    Tuli, Sanjeev Y; Thompson, Lindsay A; Saliba, Heidi; Black, Erik W; Ryan, Kathleen A; Kelly, Maria N; Novak, Maureen; Mellott, Jane; Tuli, Sonal S

    2011-12-01

    Board certification is an important professional qualification and a prerequisite for credentialing, and the Accreditation Council for Graduate Medical Education (ACGME) assesses board certification rates as a component of residency program effectiveness. To date, research has shown that preresidency measures, including National Board of Medical Examiners scores, Alpha Omega Alpha Honor Medical Society membership, or medical school grades poorly predict postresidency board examination scores. However, learning styles and temperament have been identified as factors that 5 affect test-taking performance. The purpose of this study is to characterize the learning styles and temperaments of pediatric residents and to evaluate their relationships to yearly in-service and postresidency board examination scores. This cross-sectional study analyzed the learning styles and temperaments of current and past pediatric residents by administration of 3 validated tools: the Kolb Learning Style Inventory, the Keirsey Temperament Sorter, and the Felder-Silverman Learning Style test. These results were compared with known, normative, general and medical population data and evaluated for correlation to in-service examination and postresidency board examination scores. The predominant learning style for pediatric residents was converging 44% (33 of 75 residents) and the predominant temperament was guardian 61% (34 of 56 residents). The learning style and temperament distribution of the residents was significantly different from published population data (P  =  .002 and .04, respectively). Learning styles, with one exception, were found to be unrelated to standardized test scores. The predominant learning style and temperament of pediatric residents is significantly different than that of the populations of general and medical trainees. However, learning styles and temperament do not predict outcomes on standardized in-service and board examinations in pediatric residents.

  6. Hearing protector fit testing with off-shore oil-rig inspectors in Louisiana and Texas.

    Science.gov (United States)

    Murphy, William J; Themann, Christa L; Murata, Taichi K

    2016-11-01

    This field study aimed to assess the noise reduction of hearing protection for individual workers, demonstrate the effectiveness of training on the level of protection achieved, and measure the time required to implement hearing protector fit testing in the workplace. The National Institute for Occupational Safety and Health (NIOSH) conducted field studies in Louisiana and Texas to test the performance of HPD Well-Fit. Fit tests were performed on 126 inspectors and engineers working in the offshore oil industry. Workers were fit tested with the goal of achieving a 25-dB PAR. Less than half of the workers were achieving sufficient protection from their hearing protectors prior to NIOSH intervention and training; following re-fitting and re-training, over 85% of the workers achieved sufficient protection. Typical test times were 6-12 minutes. Fit testing of the workers' earplugs identified those workers who were and were not achieving the desired level of protection. Recommendations for other hearing protection solutions were made for workers who could not achieve the target PAR. The study demonstrates the need for individual hearing protector fit testing and addresses some of the barriers to implementation.

  7. Testing the validity of stock-recruitment curve fits

    International Nuclear Information System (INIS)

    Christensen, S.W.; Goodyear, C.P.

    1988-01-01

    The utilities relied heavily on the Ricker stock-recruitment model as the basis for quantifying biological compensation in the Hudson River power case. They presented many fits of the Ricker model to data derived from striped bass catch and effort records compiled by the National Marine Fisheries Service. Based on this curve-fitting exercise, a value of 4 was chosen for the parameter alpha in the Ricker model, and this value was used to derive the utilities' estimates of the long-term impact of power plants on striped bass populations. A technique was developed and applied to address a single fundamental question: if the Ricker model were applicable to the Hudson River striped bass population, could the estimates of alpha from the curve-fitting exercise be considered reliable. The technique involved constructing a simulation model that incorporated the essential biological features of the population and simulated the characteristics of the available actual catch-per-unit-effort data through time. The ability or failure to retrieve the known parameter values underlying the simulation model via the curve-fitting exercise was a direct test of the reliability of the results of fitting stock-recruitment curves to the real data. The results demonstrated that estimates of alpha from the curve-fitting exercise were not reliable. The simulation-modeling technique provides an effective way to identify whether or not particular data are appropriate for use in fitting such models. 39 refs., 2 figs., 3 tabs

  8. Pediatric oncologist willingness to offer germline TP53 testing in osteosarcoma.

    Science.gov (United States)

    Shaul, Eliana; Roth, Michael; Lo, Yungtai; Geller, David S; Hoang, Bang; Yang, Rui; Malkin, David; Gorlick, Richard; Gill, Jonathan

    2018-03-15

    Li-Fraumeni syndrome (LFS) is a cancer predisposition syndrome caused by mutations in the tumor-suppressor gene TP53. Osteosarcoma is a sentinel cancer in LFS. Prior studies using Sanger sequencing platforms have demonstrated that 3% of individuals with osteosarcoma harbor a mutation in TP53. New data from next-generation sequencing have demonstrated that 3.8% of patients with osteosarcoma have a known pathogenic variant, and an additional 5.7% carry exonic variants of unknown significance in TP53. Pediatric oncologists were e-mailed an anonymous 18-question survey assessing their willingness to offer TP53 germline testing to a child with osteosarcoma with or without a family history, and they were evaluated for changes in their choices with the prior data and the new data. One hundred seventy-seven pediatric oncologists (22%) responded to the survey. Respondents were more likely to offer TP53 testing to a patient with a positive family history (77.4% vs 12.4%; P offer TP53 testing once they were provided with the new data (25.4% vs 12.4%; P = .0038). The proportion of providers who responded that they were unsure increased significantly when they were presented with the new data (25.4% vs 10.2%; P = .0002). Potential implications for other family members and the possibility that surveillance imaging would detect new malignancies at an earlier stage were important factors influencing a provider's decision to offer TP53 testing. Recent data increase the proportion of providers willing to offer testing, and this suggests concern on the part of pediatric oncologists that variants of unknown significance may be disease-defining in rare cancers. Cancer 2018;124:1242-50. © 2018 American Cancer Society. © 2018 American Cancer Society.

  9. Physical Fitness in Young Adults Born Preterm.

    Science.gov (United States)

    Tikanmäki, Marjaana; Tammelin, Tuija; Sipola-Leppänen, Marika; Kaseva, Nina; Matinolli, Hanna-Maria; Miettola, Satu; Eriksson, Johan G; Järvelin, Marjo-Riitta; Vääräsmäki, Marja; Kajantie, Eero

    2016-01-01

    Young adults born preterm have higher levels of cardiometabolic risk factors than their term-born peers. Muscular and cardiorespiratory fitness have important cardiometabolic and other health benefits. We assessed muscular, cardiorespiratory, and self-rated fitness in preterm-born young adults. We studied unimpaired participants of the ESTER (Ennenaikainen syntymä ja aikuisiän terveys [Preterm Birth and Early-Life Programming of Adult Health and Disease]) birth cohort study at age 23.3 (SD: 1.2) years: 139 born early preterm (EPT; Young adults born EPT (-0.8; 95% confidence interval: -1.5 to -0.1; adjusted for gender, age, and source cohort) and LPT (-0.8; -1.4 to -0.3) performed fewer modified push-ups than controls. Handgrip strength was 23.8 (0.9-46.8) N lower in EPT participants. Cardiorespiratory fitness, measured by submaximal step test, was similar. On a self-rated fitness scale (1-5), the EPT adults reported 0.2 (0.0-0.4) lower scores than controls. After adjustment for early-life confounders, the results remained. They attenuated after further adjustment for mediating factors. Young adults born EPT and LPT had lower muscular fitness than controls, which may predispose them to cardiometabolic and other chronic diseases. Adults born EPT also perceived themselves as less fit than controls. Copyright © 2016 by the American Academy of Pediatrics.

  10. Full-scale tank car rollover tests - survivability of top fittings and top fittings protective structures : final report.

    Science.gov (United States)

    2016-05-01

    Full-scale rollover crash tests were performed on three non-pressure tank carbodies to validate previous analytical work and : determine the effectiveness of two different types of protective structures in protecting the top fittings. The tests were ...

  11. Graded Exercise Testing in a Pediatric Weight Management Center: The DeVos Protocol.

    Science.gov (United States)

    Eisenmann, Joey C; Guseman, Emily Hill; Morrison, Kyle; Tucker, Jared; Smith, Lucie; Stratbucker, William

    2015-12-01

    In this article, we describe a protocol used to test the functional capacity of the obese pediatric patient and describe the peak oxygen consumption (VO2peak) of patients seeking treatment at a pediatric weight management center. One hundred eleven (mean age, 12.5 ± 3.0 years) patients performed a multistage exercise test on a treadmill, of which 90 (81%) met end-test criteria and provided valid VO2peak data. Peak VO2 was expressed: (1) in absolute terms (L·min(-1)); (2) as the ratio of the volume of oxygen consumed per minute relative to total body mass (mL·kg(-1)·min(-1)); and (3) as the ratio of the volume of oxygen consumed per minute relative to fat-free mass (mL·FFM·kg(-1)·min(-1)). Mean BMI z-score was 2.4 ± 0.3 and the mean percent body fat was 36.5 ± 9.7%. Absolute VO2peak (L·min(-1)) was significantly different between sexes; however, relative values were similar between sexes. Mean VO2peak was 25.7 ± 4.8 mL·kg(-1)·min(-1) with a range of 13.5-36.7 mL·kg(-1)·min(-1). Obese youth seeking treatment at a stage 3 pediatric weight management center exhibit low VO2peak. The protocol outlined here should serve as a model for similar programs interested in the submaximal and peak responses to exercise in obese pediatric patients.

  12. A review of targeted therapies evaluated by the Pediatric Preclinical Testing Program for osteosarcoma

    Directory of Open Access Journals (Sweden)

    Valerie eSampson

    2013-05-01

    Full Text Available Osteosarcoma, the most common malignant bone tumor of childhood, is a high grade primary bone sarcoma that occurs mostly in adolescence. Standard treatment consists of surgery in combination with multi-agent chemotherapy regimens. The development and approval of imatinib for Philadelphia chromosome-positive acute lymphoblastic leukemia (ALL in children and the fully human monoclonal antibody, anti-GD2, as part of an immune therapy for high-risk neuroblastoma patients have established the precedent for use of targeted inhibitors along with standard chemotherapy backbones. However, few targeted agents tested have achieved traditional clinical end points for osteosarcoma. Many biological agents demonstrating anti-tumor responses in preclinical and early phase clinical testing have failed to reach response thresholds to justify randomized trials with large numbers of patients. The development of targeted therapies for pediatric cancer remains a significant challenge. To aid in the prioritization of new agents for clinical testing, the Pediatric Preclinical Testing Program (PPTP has developed reliable and robust preclinical pediatric cancer models to rapidly screen agents for activity in multiple childhood cancers and establish pharmacological parameters and effective drug concentrations for clinical trials. In this article, we examine a range of standard and novel agents that have been evaluated by the PPTP, and we discuss the preclinical and clinical development of these for the treatment of osteosarcoma. We further demonstrate that committed resources for hypothesis-driven drug discovery and development are needed to yield clinical successes in the search for new therapies for this pediatric disease.

  13. A Study of the Physical Fitness Test in Relation to Demographics, Academic Achievement, and Students' Physical Fitness Perceptions

    Science.gov (United States)

    Mobilia-Jones, Karen

    2010-01-01

    This study examines the overall results of the Physical Fitness Test (PFT) and the six fitness areas of the PFT, academic achievement, demographics and self perceptions and the potential impact on students' performance on the PFT. While academic expectations are increasing, the adolescent obesity rate is also increasing, producing a decline in the…

  14. Prevalence and Correlates of Physical Fitness Testing in U.S. Schools--2000

    Science.gov (United States)

    Morrow, James R., Jr.; Fulton, Janet E.; Brener, Nancy D.; Kohl, Harold W., III

    2008-01-01

    Because of the perceived lack of youth physical fitness and/or concerns for increased obesity, physical education teachers are interested in youth fitness and physical activity levels. Statewide mandates are being developed that require school-based teachers to complete physical fitness testing. Data from the nationally representative School…

  15. Pediatric anthropometrics are inconsistent with current guidelines for assessing rider fit on all-terrain vehicles.

    Science.gov (United States)

    Bernard, Andrew C; Mullineaux, David R; Auxier, James T; Forman, Jennifer L; Shapiro, Robert; Pienkowski, David

    2010-07-01

    This study sought to establish objective anthropometric measures of fit or misfit for young riders on adult and youth-sized all-terrain vehicles and use these metrics to test the unproved historical reasoning that age alone is a sufficient measure of rider-ATV fit. Male children (6-11 years, n=8; and 12-15 years, n=11) were selected by convenience sampling. Rider-ATV fit was quantified by five measures adapted from published recommendations: (1) standing-seat clearance, (2) hand size, (3) foot vs. foot-brake position, (4) elbow angle, and (5) handlebar-to-knee distance. Youths aged 12-15 years fit the adult-sized ATV better than the ATV Safety Institute recommended age-appropriate youth model (63% of subjects fit all 5 measures on adult-sized ATV vs. 20% on youth-sized ATV). Youths aged 6-11 years fit poorly on ATVs of both sizes (0% fit all 5 parameters on the adult-sized ATV vs 12% on the youth-sized ATV). The ATV Safety Institute recommends rider-ATV fit according to age and engine displacement, but no objective data linking age or anthropometrics with ATV engine or frame size has been previously published. Age alone is a poor predictor of rider-ATV fit; the five metrics used offer an improvement compared to current recommendations. Copyright 2010 Elsevier Ltd. All rights reserved.

  16. A person fit test for IRT models for polytomous items

    NARCIS (Netherlands)

    Glas, Cornelis A.W.; Dagohoy, A.V.

    2007-01-01

    A person fit test based on the Lagrange multiplier test is presented for three item response theory models for polytomous items: the generalized partial credit model, the sequential model, and the graded response model. The test can also be used in the framework of multidimensional ability

  17. Reference Curves for Field Tests of Musculoskeletal Fitness in U.S. Children and Adolescents: The 2012 NHANES National Youth Fitness Survey.

    Science.gov (United States)

    Laurson, Kelly R; Saint-Maurice, Pedro F; Welk, Gregory J; Eisenmann, Joey C

    2017-08-01

    Laurson, KR, Saint-Maurice, PF, Welk, GJ, and Eisenmann, JC. Reference curves for field tests of musculoskeletal fitness in U.S. children and adolescents: The 2012 NHANES National Youth Fitness Survey. J Strength Cond Res 31(8): 2075-2082, 2017-The purpose of the study was to describe current levels of musculoskeletal fitness (MSF) in U.S. youth by creating nationally representative age-specific and sex-specific growth curves for handgrip strength (including relative and allometrically scaled handgrip), modified pull-ups, and the plank test. Participants in the National Youth Fitness Survey (n = 1,453) were tested on MSF, aerobic capacity (via submaximal treadmill test), and body composition (body mass index [BMI], waist circumference, and skinfolds). Using LMS regression, age-specific and sex-specific smoothed percentile curves of MSF were created and existing percentiles were used to assign age-specific and sex-specific z-scores for aerobic capacity and body composition. Correlation matrices were created to assess the relationships between z-scores on MSF, aerobic capacity, and body composition. At younger ages (3-10 years), boys scored higher than girls for handgrip strength and modified pull-ups, but not for the plank. By ages 13-15, differences between the boys and girls curves were more pronounced, with boys scoring higher on all tests. Correlations between tests of MSF and aerobic capacity were positive and low-to-moderate in strength. Correlations between tests of MSF and body composition were negative, excluding absolute handgrip strength, which was inversely related to other MSF tests and aerobic capacity but positively associated with body composition. The growth curves herein can be used as normative reference values or a starting point for creating health-related criterion reference standards for these tests. Comparisons with prior national surveys of physical fitness indicate that some components of MSF have likely decreased in the United States over

  18. Finite impulse testing (FIT) system for Emergency Cooling System (ECS) in Dhruva

    International Nuclear Information System (INIS)

    Punekar, Parag; Ramkumar, N.; Kulkarni, U.S.; Darbhea, M.D.; Bharadhwaj, G; Jangra, L.R.; Geetha, Patil; Das, Shantanu; Sonnis, S.T.; Trevedi, P.; Patil, M.B.; Biswas, B.B.

    2006-01-01

    Finite Impulse Testing (FIT) system for Emergency Cooling System (ECS) is used to check healthiness of ECS logic circuits in an online mode. The ECS is an important safety system that ensures the cooling of reactor core during shutdown state of Main Coolant Pumps (MCPs), and hence FIT-ECS that monitors the health of ECS logic circuits in an online (real time) mode is an important part of it. Based on a Safety Related Unusual Occurrence in ECS system due to the malfunction of its earlier single channel FIT system, the new FIT-ECS system has been designed with new features and is commissioned. The FIT-ECS system feeds the simulated input signals (fine impulses of nominal width 575 μS) to the ECS logic circuits and read the outputs. These output (predicted) signals from ECS logic circuit are processed in the FIT-ECS system and in event of any discrepancy, the FIT-ECS system displays fault signature on local panel, detailed information of the fault on Operator Console (OC), and generates an alarm 'ECS logic Fail' in the control room. FIT-ECS also monitors the inputs and outputs of ECS logic circuit. All the information required is stored as a database that can be subsequently displayed in various formats. ECS system is designated as Category I-A system and is a hardwired system and FIT-ECS monitors the healthiness of the logics of the ECS System is a computerized system. As per IEC 1226, FIT-ECS is categorized as Category I-B system. This paper provides technical information on FIT-ECS system design, its important features, the testing carried on the FIT-ECS system, interconnections of FIT-ECS and ECS and the commissioning experience of FIT-ECS system. (author)

  19. Effectiveness of three just-in-time training modalities for N-95 mask fit testing.

    Science.gov (United States)

    Jones, David; Stoler, Genevieve; Suyama, Joe

    2013-01-01

    To compare and contrast three different training modalities for fit testing N-95 respirator face masks. Block randomized interventional study. Urban university. Two hundred eighty-nine medical students. Students were randomly assigned to video, lecture, or slide show to evaluate the effectiveness of the methods for fit testing large groups of people. Ease of fit and success of fit for each instructional technique. Mask 1 was a Kimberly-Clark duckbill N-95 respirator mask, and mask 2 was a 3M™ carpenters N-95 respirator mask. "Ease of fit" was defined as the ability to successfully don a mask in less than 30 seconds. "Success of fit" was defined as the ability to correctly don a mask in one try. There were no statistical differences by training modality for either mask regarding ease of fit or success of fit. There were no differences among video presentation, small group demonstration, and self-directed slide show just-in-time training modalities for ease of fit or success of fit N-95 respirator mask fitting. Further study is needed to explore more effective fit training modalities.

  20. Push-off tests and strength evaluation of joints combining shrink fitting with bonding

    Science.gov (United States)

    Yoneno, Masahiro; Sawa, Toshiyuki; Shimotakahara, Ken; Motegi, Yoichi

    1997-03-01

    Shrink fitted joints have been used in mechanical structures. Recently, joints combining shrink fitting with anaerobic adhesives bonded between the shrink fitted surfaces have been appeared in order to increase the joint strength. In this paper, push-off test was carried out on strength of joints combining shrink fitting with bonding by material testing machine. In addition, the push-off strength of shrink fitting joints without an anaerobic adhesive was also measured. In the experiments, the effects of the shrinking allowance and the outer diameter of the rings on the joint strength are examined. The interface stress distribution in bonded shrink fitted joints subjected to a push-off load is analyzed using axisymmetrical theory of elasticity as a four-body contact problem. Using the interface stress distribution, a method for estimating joint strength is proposed. The experimental results are in a fairly good agreement with the numerical results. It is found that the strength of combination joints is greater than that of shrink fitted joints.

  1. Cardiovascular Fitness of a Pediatric Population in Central Kampala ...

    African Journals Online (AJOL)

    There was significant gender difference in cardiovascular fitness endurance with boys recording higher mean score (1591±356.76) than girls (1440.64±236.72). Majority (71%) of pupils met acceptable cardiovascular fitness endurance according to percentile norms set by American Association of Health, Physical Education ...

  2. Use of Ancillary Tests When Determining Brain Death in Pediatric Patients in the United States.

    Science.gov (United States)

    Lewis, Ariane; Adams, Nellie; Chopra, Arun; Kirschen, Matthew P

    2017-10-01

    Although pediatric brain death guidelines stipulate when ancillary testing should be used during brain death determination, little is known about the way these recommendations are implemented in clinical practice. We conducted a survey of pediatric intensivists and neurologists in the United States on the use of ancillary testing. Although most respondents noted they only performed an ancillary test if the clinical examination and apnea test could not be completed, 20% of 195 respondents performed an ancillary test for other reasons, including (1) to convince a family that objected to the brain death determination that a patient is truly dead (n = 21), (2) personal preference (n = 14), and (3) institutional requirement (n = 5). Our findings suggest that pediatricians use ancillary tests for a variety of reasons during brain death determination. Medical societies and governmental regulatory bodies must reinforce the need for homogeneity in practice.

  3. Maximal cardiorespiratory fitness testing in individuals with chronic stroke with cognitive impairment: practice test effects and test-retest reliability.

    Science.gov (United States)

    Olivier, Charles; Doré, Jean; Blanchet, Sophie; Brooks, Dina; Richards, Carol L; Martel, Guy; Robitaille, Nancy-Michelle; Maltais, Désirée B

    2013-11-01

    To evaluate, for individuals with chronic stroke with cognitive impairment, (1) the effects of a practice test on peak cardiorespiratory fitness test results; (2) cardiorespiratory fitness test-retest reliability; and (3) the relationship between individual practice test effects and cognitive impairment. Cross-sectional. Rehabilitation center. A convenience sample of 21 persons (men [n=12] and women [n=9]; age range, 48-81y; 44.9±36.2mo poststroke) with cognitive impairments who had sufficient lower limb function to perform the test. Not applicable. Peak oxygen consumption (Vo(2)peak, ml·kg(-1)·min(-1)). Test-retest reliability of Vo(2)peak was excellent (intraclass correlation coefficient model 2,1 [ICC2,1]=.94; 95% confidence interval [CI], .86-.98). A paired t test showed that there was no significant difference for the group for Vo(2)peak obtained from 2 symptom-limited cardiorespiratory fitness tests performed 1 week apart on a semirecumbent cycle ergometer (test 2-test 1 difference, -.32ml·kg(-1)·min(-1); 95% CI, -.69 to 1.33ml·kg(-1)·min(-1); P=.512). Individual test-retest differences in Vo(2)peak were, however, positively related to general cognitive function as measured by the Mini-Mental State Examination (ρ=.485; Preliably measured in this group without a practice test. General cognitive function, however, may influence the effect of a practice test in that those with lower general cognitive function appear to respond differently to a practice test than those with higher cognitive function. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  4. Feasibility and Reliability of Physical Fitness Tests in Older Adults with Intellectual Disability: A Pilot Study

    Science.gov (United States)

    Hilgenkamp, Thessa I. M.; van Wijck, Ruud; Evenhuis, Heleen M.

    2012-01-01

    Background: Physical fitness is relevant for wellbeing and health, but knowledge on the feasibility and reliability of instruments to measure physical fitness for older adults with intellectual disability is lacking. Methods: Feasibility and test-retest reliability of a physical fitness test battery (Box and Block Test, Response Time Test, walking…

  5. Pediatric portal hypertension

    Science.gov (United States)

    Vogel, Clarissa Barbon

    2017-01-01

    Abstract: Pediatric portal hypertension management is a team approach between the patient, the patient's family, the primary caregiver, and specialty providers. Evidence-based practice guidelines have not been established in pediatrics. This article serves as a review for the primary care NP in the management of pediatric portal hypertension, discussing the etiology, pathophysiology, and clinical presentation of pediatric portal hypertension, diagnostic tests, and treatment and management options. PMID:28406835

  6. Test-retest reliability of Eurofit Physical Fitness items for children with visual impairments

    NARCIS (Netherlands)

    Houwen, Suzanne; Visscher, Chris; Hartman, Esther; Lemmink, Koen A. P. M.

    The purpose of this study was to examine the test-retest reliability of physical fitness items from the European Test of Physical Fitness (Eurofit) for children with visual impairments. A sample of 21 children, ages 6-12 years, that were recruited from a special school for children with visual

  7. Stroop Color-Word Interference Test: Normative data for Spanish-speaking pediatric population.

    Science.gov (United States)

    Rivera, D; Morlett-Paredes, A; Peñalver Guia, A I; Irías Escher, M J; Soto-Añari, M; Aguayo Arelis, A; Rute-Pérez, S; Rodríguez-Lorenzana, A; Rodríguez-Agudelo, Y; Albaladejo-Blázquez, N; García de la Cadena, C; Ibáñez-Alfonso, J A; Rodriguez-Irizarry, W; García-Guerrero, C E; Delgado-Mejía, I D; Padilla-López, A; Vergara-Moragues, E; Barrios Nevado, M D; Saracostti Schwartzman, M; Arango-Lasprilla, J C

    2017-01-01

    To generate normative data for the Stroop Word-Color Interference test in Spanish-speaking pediatric populations. The sample consisted of 4,373 healthy children from nine countries in Latin America (Chile, Cuba, Ecuador, Guatemala, Honduras, Mexico, Paraguay, Peru, and Puerto Rico) and Spain. Each participant was administered the Stroop Word-Color Interference test as part of a larger neuropsychological battery. The Stroop Word, Stroop Color, Stroop Word-Color, and Stroop Interference scores were normed using multiple linear regressions and standard deviations of residual values. Age, age2, sex, and mean level of parental education (MLPE) were included as predictors in the analyses. The final multiple linear regression models showed main effects for age on all scores, except on Stroop Interference for Guatemala, such that scores increased linearly as a function of age. Age2 affected Stroop Word scores for all countries, Stroop Color scores for Ecuador, Mexico, Peru, and Spain; Stroop Word-Color scores for Ecuador, Mexico, and Paraguay; and Stroop Interference scores for Cuba, Guatemala, and Spain. MLPE affected Stroop Word scores for Chile, Mexico, and Puerto Rico; Stroop Color scores for Mexico, Puerto Rico, and Spain; Stroop Word-Color scores for Ecuador, Guatemala, Mexico, Puerto Rico and Spain; and Stroop-Interference scores for Ecuador, Mexico, and Spain. Sex affected Stroop Word scores for Spain, Stroop Color scores for Mexico, and Stroop Interference for Honduras. This is the largest Spanish-speaking pediatric normative study in the world, and it will allow neuropsychologists from these countries to have a more accurate approach to interpret the Stroop Word-Color Interference test in pediatric populations.

  8. Goodness-of-fit tests for multi-dimensional copulas: Expanding application to historical drought data

    Directory of Open Access Journals (Sweden)

    Ming-wei Ma

    2013-01-01

    Full Text Available The question of how to choose a copula model that best fits a given dataset is a predominant limitation of the copula approach, and the present study aims to investigate the techniques of goodness-of-fit tests for multi-dimensional copulas. A goodness-of-fit test based on Rosenblatt's transformation was mathematically expanded from two dimensions to three dimensions and procedures of a bootstrap version of the test were provided. Through stochastic copula simulation, an empirical application of historical drought data at the Lintong Gauge Station shows that the goodness-of-fit tests perform well, revealing that both trivariate Gaussian and Student t copulas are acceptable for modeling the dependence structures of the observed drought duration, severity, and peak. The goodness-of-fit tests for multi-dimensional copulas can provide further support and help a lot in the potential applications of a wider range of copulas to describe the associations of correlated hydrological variables. However, for the application of copulas with the number of dimensions larger than three, more complicated computational efforts as well as exploration and parameterization of corresponding copulas are required.

  9. Unilateral Arm Crank Exercise Test for Assessing Cardiorespiratory Fitness in Individuals with Hemiparetic Stroke

    DEFF Research Database (Denmark)

    Oyake, Kazuaki; Yamaguchi, Tomofumi; Oda, Chihiro

    2017-01-01

    Cardiorespiratory fitness assessment with leg cycle exercise testing may be influenced by motor impairments in the paretic lower extremity. Hence, this study examined the usefulness of a unilateral arm crank exercise test to assess cardiorespiratory fitness in individuals with stroke, including s...

  10. Pediatric MATCH Infographic

    Science.gov (United States)

    Infographic explaining NCI-COG Pediatric MATCH, a cancer treatment clinical trial for children and adolescents, from 1 to 21 years of age, that is testing the use of precision medicine for pediatric cancers.

  11. Reliability of Health-Related Physical Fitness Tests among Colombian Children and Adolescents: The FUPRECOL Study.

    Directory of Open Access Journals (Sweden)

    Robinson Ramírez-Vélez

    Full Text Available Substantial evidence indicates that youth physical fitness levels are an important marker of lifestyle and cardio-metabolic health profiles and predict future risk of chronic diseases. The reliability physical fitness tests have not been explored in Latino-American youth population. This study's aim was to examine the reliability of health-related physical fitness tests that were used in the Colombian health promotion "Fuprecol study". Participants were 229 Colombian youth (boys n = 124 and girls n = 105 aged 9 to 17.9 years old. Five components of health-related physical fitness were measured: 1 morphological component: height, weight, body mass index (BMI, waist circumference, triceps skinfold, subscapular skinfold, and body fat (% via impedance; 2 musculoskeletal component: handgrip and standing long jump test; 3 motor component: speed/agility test (4x10 m shuttle run; 4 flexibility component (hamstring and lumbar extensibility, sit-and-reach test; 5 cardiorespiratory component: 20-meter shuttle-run test (SRT to estimate maximal oxygen consumption. The tests were performed two times, 1 week apart on the same day of the week, except for the SRT which was performed only once. Intra-observer technical errors of measurement (TEMs and inter-rater (reliability were assessed in the morphological component. Reliability for the Musculoskeletal, motor and cardiorespiratory fitness components was examined using Bland-Altman tests. For the morphological component, TEMs were small and reliability was greater than 95% of all cases. For the musculoskeletal, motor, flexibility and cardiorespiratory components, we found adequate reliability patterns in terms of systematic errors (bias and random error (95% limits of agreement. When the fitness assessments were performed twice, the systematic error was nearly 0 for all tests, except for the sit and reach (mean difference: -1.03% [95% CI = -4.35% to -2.28%]. The results from this study indicate that the

  12. Feasibility and reliability of physical fitness tests in older adults with intellectual disability : A pilot study

    NARCIS (Netherlands)

    Hilgenkamp, Thessa I. M.; van Wijck, Ruud; Evenhuis, Heleen M.

    Background Physical fitness is relevant for wellbeing and health, but knowledge on the feasibility and reliability of instruments to measure physical fitness for older adults with intellectual disability is lacking. Methods Feasibility and test-retest reliability of a physical fitness test battery

  13. Vestibular evoked myogenic potential testing for the diagnosis of conductive hearing loss: survey of pediatric otolaryngologists' knowledge and beliefs.

    Science.gov (United States)

    Dargie, Jenna M; Zhou, Guangwei; Dornan, Briana K; Whittemore, Kenneth R

    2014-11-01

    To assess physicians' knowledge and beliefs regarding vestibular evoked myogenic potential (VEMP) testing in children. A survey was delivered via email in html format to 1069 members of the American Academy of Otolaryngology--Head and Neck Surgery who identified as pediatric otolaryngologists. Study data were collected and managed using the Research Electronic Data Capture (REDCap) tools. 443 (41.4%) physicians opened the email. 190 (42.9% of opens) initiated the survey, of which 117 (61.9%) fully completed the survey of the physicians who responded to a question regarding knowledge of VEMP, 16% of respondents had never heard of the test. 16% of participants would use it in the setting of diagnosing pediatric conductive hearing loss. Responses regarding the youngest age at which VEMP is possible ranged from younger than 6 months through greater than 13 years of age. Beliefs regarding utility and reliability of VEMP varied, with 'unsure' as the most frequent response. Additionally, only 26% of pediatric otolaryngologists indicated some access to the test. The knowledge and availability of VEMP testing in the pediatric otolaryngology community varies widely. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  14. Characteristics of the technical parameters in the realization of computed tomography studies in pediatric patients in Bogota

    International Nuclear Information System (INIS)

    Triana, Gustavo; Romero, Javier; Rivero, Oscar; Sosa, Daniel; Patarroyo, Edith

    2005-01-01

    The use of Computed Tomography (CT) examinations for the diagnosis of common pathologies in pediatric patients has increase. This implies an increase in the radiation doses that pediatric patients received, therefore increasing the risk of secondary mortality due to cancer throughout life. In recent papers, the recommended radiation doses for pediatric patients in agreement with the concept ALARA (As Low As Reasonably Achievable) has settled down. This study evaluates the CT technical parameters of pediatric examinations in Bogota city, and review if they have been fitted with parameters recommended according to age and body weight. Materials and methods: A non-probabilistic sampling of 46 scanning tests were applied to children in six different institutions in Bogota; the technical parameters of kv and second mAs were checked of studies in abdomen, thorax and skeletal muscle system. Results: It was found that the technical parameters used in TC in children are higher of the recommended; the group of 4-year-old is the most affected by dos e of unnecessary radiation. Discussion and conclusions: The information from the protection of the radiation must be spread to the whole radiology personnel of the institutions that fulfill scanning tests of pediatric patients. ar zones that influences the wetland

  15. Symbol Digit Modalities Test: Normative data for Spanish-speaking pediatric population.

    Science.gov (United States)

    Arango-Lasprilla, J C; Rivera, D; Trapp, S; Jiménez-Pérez, C; Hernández Carrillo, C L; Pohlenz Amador, S; Vergara-Moragues, E; Rodríguez-Agudelo, Y; Rodriguez-Irizarry, W; García de la Cadena, C; Galvao-Carmona, A; Galarza-Del-Angel, J; Llerena Espezúa, X; Torales Cabrera, N; Flor-Caravia, P; Aguayo Arelis, A; Saracostti Schwartzman, M; Barranco Casimiro, R; Albaladejo-Blázquez, N

    2017-01-01

    To generate normative data for the Symbol Digit Modalities Test (SDMT) in Spanish-speaking pediatric populations. The sample consisted of 4,373 healthy children from nine countries in Latin America (Chile, Cuba, Ecuador, Guatemala, Honduras, Mexico, Paraguay, Peru, and Puerto Rico) and Spain. Each participant was administered the SDMT as part of a larger neuropsychological battery. SDMT scores were normed using multiple linear regressions and standard deviations of residual values. Age, age2, sex, and mean level of parental education (MLPE) were included as predictors in the analyses. The final multiple linear regression models showed main effects for age in all countries, such that score increased linearly as a function of age. In addition, age2 had a significant effect in all countries, except in Honduras and Puerto Rico. Models indicated that children whose parent(s) had a MLPE >12 years of education obtained higher score compared to children whose parent(s) had a MLPE ≤12 years for Chile, Guatemala, Mexico, and Spain. Sex affected SDMT score for Paraguay and Spain. This is the largest Spanish-speaking pediatric normative study in the world, and it will allow neuropsychologists from these countries to have a more accurate interpretation of the SDMT with pediatric populations.

  16. Characterization of small-to-medium head-and-face dimensions for developing respirator fit test panels and evaluating fit of filtering facepiece respirators with different faceseal design

    Science.gov (United States)

    Lin, Yi-Chun

    2017-01-01

    A respirator fit test panel (RFTP) with facial size distribution representative of intended users is essential to the evaluation of respirator fit for new models of respirators. In this study an anthropometric survey was conducted among youths representing respirator users in mid-Taiwan to characterize head-and-face dimensions key to RFTPs for application to small-to-medium facial features. The participants were fit-tested for three N95 masks of different facepiece design and the results compared to facial size distribution specified in the RFTPs of bivariate and principal component analysis design developed in this study to realize the influence of facial characteristics to respirator fit in relation to facepiece design. Nineteen dimensions were measured for 206 participants. In fit testing the qualitative fit test (QLFT) procedures prescribed by the U.S. Occupational Safety and Health Administration were adopted. As the results show, the bizygomatic breadth of the male and female participants were 90.1 and 90.8% of their counterparts reported for the U.S. youths (P < 0.001), respectively. Compared to the bivariate distribution, the PCA design better accommodated variation in facial contours among different respirator user groups or populations, with the RFTPs reported in this study and from literature consistently covering over 92% of the participants. Overall, the facial fit of filtering facepieces increased with increasing facial dimensions. The total percentages of the tests wherein the final maneuver being completed was “Moving head up-and-down”, “Talking” or “Bending over” in bivariate and PCA RFTPs were 13.3–61.9% and 22.9–52.8%, respectively. The respirators with a three-panel flat fold structured in the facepiece provided greater fit, particularly when the users moved heads. When the facial size distribution in a bivariate RFTP did not sufficiently represent petite facial size, the fit testing was inclined to overestimate the general fit

  17. Children's (Pediatric) Abdominal Ultrasound Imaging

    Science.gov (United States)

    ... Physician Resources Professions Site Index A-Z Children's (Pediatric) Ultrasound - Abdomen Children’s (pediatric) ultrasound imaging of the ... abdomen using ultrasound. View full size with caption Pediatric Content Some imaging tests and treatments have special ...

  18. Development of a Postacute Hospital Item Bank for the New Pediatric Evaluation of Disability Inventory-Computer Adaptive Test

    Science.gov (United States)

    Dumas, Helene M.

    2010-01-01

    The PEDI-CAT is a new computer adaptive test (CAT) version of the Pediatric Evaluation of Disability Inventory (PEDI). Additional PEDI-CAT items specific to postacute pediatric hospital care were recently developed using expert reviews and cognitive interviewing techniques. Expert reviews established face and construct validity, providing positive…

  19. Fitness Testing in Physical Education--A Misdirected Effort in Promoting Healthy Lifestyles and Physical Activity?

    Science.gov (United States)

    Cale, Lorraine; Harris, Jo

    2009-01-01

    Background: Physical fitness testing is commonplace within schools and the physical education (PE) curriculum, with advocates claiming one of the key purposes of testing to be the promotion of healthy lifestyles and physical activity. Despite this, much controversy has surrounded the fitness testing of young people. Purpose: This paper draws on…

  20. Goodness-of-fit tests with dependent observations

    International Nuclear Information System (INIS)

    Chicheportiche, Rémy; Bouchaud, Jean-Philippe

    2011-01-01

    We revisit the Kolmogorov–Smirnov and Cramér–von Mises goodness-of-fit (GoF) tests and propose a generalization to identically distributed, but dependent univariate random variables. We show that the dependence leads to a reduction of the 'effective' number of independent observations. The generalized GoF tests are not distribution-free but rather depend on all the lagged bivariate copulas. These objects, that we call 'self-copulas', encode all the non-linear temporal dependences. We introduce a specific, log-normal model for these self-copulas, for which a number of analytical results are derived. An application to financial time series is provided. As is well known, the dependence is to be long-ranged in this case, a finding that we confirm using self-copulas. As a consequence, the acceptance rates for GoF tests are substantially higher than if the returns were iid random variables

  1. Local and omnibus goodness-of-fit tests in classical measurement error models

    KAUST Repository

    Ma, Yanyuan

    2010-09-14

    We consider functional measurement error models, i.e. models where covariates are measured with error and yet no distributional assumptions are made about the mismeasured variable. We propose and study a score-type local test and an orthogonal series-based, omnibus goodness-of-fit test in this context, where no likelihood function is available or calculated-i.e. all the tests are proposed in the semiparametric model framework. We demonstrate that our tests have optimality properties and computational advantages that are similar to those of the classical score tests in the parametric model framework. The test procedures are applicable to several semiparametric extensions of measurement error models, including when the measurement error distribution is estimated non-parametrically as well as for generalized partially linear models. The performance of the local score-type and omnibus goodness-of-fit tests is demonstrated through simulation studies and analysis of a nutrition data set.

  2. Fitness, Sleep-Disordered Breathing, Symptoms of Depression, and Cognition in Inactive Overweight Children: Mediation Models.

    Science.gov (United States)

    Stojek, Monika M K; Montoya, Amanda K; Drescher, Christopher F; Newberry, Andrew; Sultan, Zain; Williams, Celestine F; Pollock, Norman K; Davis, Catherine L

    We used mediation models to examine the mechanisms underlying the relationships among physical fitness, sleep-disordered breathing (SDB), symptoms of depression, and cognitive functioning. We conducted a cross-sectional secondary analysis of the cohorts involved in the 2003-2006 project PLAY (a trial of the effects of aerobic exercise on health and cognition) and the 2008-2011 SMART study (a trial of the effects of exercise on cognition). A total of 397 inactive overweight children aged 7-11 received a fitness test, standardized cognitive test (Cognitive Assessment System, yielding Planning, Attention, Simultaneous, Successive, and Full Scale scores), and depression questionnaire. Parents completed a Pediatric Sleep Questionnaire. We used bootstrapped mediation analyses to test whether SDB mediated the relationship between fitness and depression and whether SDB and depression mediated the relationship between fitness and cognition. Fitness was negatively associated with depression ( B = -0.041; 95% CI, -0.06 to -0.02) and SDB ( B = -0.005; 95% CI, -0.01 to -0.001). SDB was positively associated with depression ( B = 0.99; 95% CI, 0.32 to 1.67) after controlling for fitness. The relationship between fitness and depression was mediated by SDB (indirect effect = -0.005; 95% CI, -0.01 to -0.0004). The relationship between fitness and the attention component of cognition was independently mediated by SDB (indirect effect = 0.058; 95% CI, 0.004 to 0.13) and depression (indirect effect = -0.071; 95% CI, -0.01 to -0.17). SDB mediates the relationship between fitness and depression, and SDB and depression separately mediate the relationship between fitness and the attention component of cognition.

  3. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... Physician Resources Professions Site Index A-Z Children's (Pediatric) CT (Computed Tomography) Pediatric computed tomography (CT) is ... a CT scan. View full size with caption Pediatric Content Some imaging tests and treatments have special ...

  4. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... Physician Resources Professions Site Index A-Z Children's (Pediatric) Ultrasound - Abdomen Children’s (pediatric) ultrasound imaging of the ... abdomen using ultrasound. View full size with caption Pediatric Content Some imaging tests and treatments have special ...

  5. The Six-Minute Walk Test in Chronic Pediatric Conditions: A Systematic Review of Measurement Properties

    NARCIS (Netherlands)

    Bart Bartels; Janke de Groot; Caroline Terwee

    2013-01-01

    Background The Six-Minute Walk Test (6MWT) is increasingly being used as a functional outcome measure for chronic pediatric conditions. Knowledge about its measurement properties is needed to determine whether it is an appropriate test to use. Purpose The purpose of this study was to systematically

  6. The six-minute walk test in chronic pediatric conditions: a systematic review of measurement properties.

    NARCIS (Netherlands)

    Bartels, B.; Groot, J.F. de; Terwee, C.B.

    2013-01-01

    Background: The Six-Minute Walk Test (6MWT) is increasingly being used as a functional outcome measure for chronic pediatric conditions. Knowledge about its measurement properties is needed to determine whether it is an appropriate test to use. Purpose: The purpose of this study was to

  7. Fitness testing as a discriminative tool for the diagnosis and monitoring of fibromyalgia.

    Science.gov (United States)

    Aparicio, V A; Carbonell-Baeza, A; Ruiz, J R; Aranda, P; Tercedor, P; Delgado-Fernández, M; Ortega, F B

    2013-08-01

    We aimed to determine the ability of a set of physical fitness tests to discriminate between presence/absence of fibromyalgia (FM) and moderate/severe FM. The sample comprised 94 female FM patients (52 ± 8 years) and 66 healthy women (54 ± 6 years). We assessed physical fitness by means of the 30-s chair stand, handgrip strength, chair sit and reach, back scratch, blind flamingo, 8-feet up and go, and 6-min walking tests. Patients were classified as having moderate FM if the score in the Fibromyalgia Impact Questionnaire (FIQ) was FIQ was ≥70. FM patients and patients with severe FM performed worse in most of the fitness tests studied (P < 0.001). Except the back scratch test, all the tests were able to discriminate between presence and absence of FM [area under the curve (AUC) = 0.66 to 0.92; P ≤ 0.001], and four tests also discriminated FM severity (AUC = 0.62 to 0.66; P ≤ 0.05). The 30-s chair stand test showed the highest ability to discriminate FM presence and severity (AUC = 0.92, P < 0.001; and AUC = 0.66, P = 0.008, respectively), being the corresponding discriminating cutoffs 9 and 6 repetitions, respectively. Physical fitness in general, and particularly the 30-s chair stand test, is able to discriminate between women with FM from those without FM, as well as between those with moderate FM from their peers with severe FM. © 2011 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  8. Person Fit Based on Statistical Process Control in an Adaptive Testing Environment. Research Report 98-13.

    Science.gov (United States)

    van Krimpen-Stoop, Edith M. L. A.; Meijer, Rob R.

    Person-fit research in the context of paper-and-pencil tests is reviewed, and some specific problems regarding person fit in the context of computerized adaptive testing (CAT) are discussed. Some new methods are proposed to investigate person fit in a CAT environment. These statistics are based on Statistical Process Control (SPC) theory. A…

  9. Development of 1-Mile Walk Tests to Estimate Aerobic Fitness in Children

    Science.gov (United States)

    Sung, Hoyong; Collier, David N.; DuBose, Katrina D.; Kemble, C. David; Mahar, Matthew T.

    2018-01-01

    To examine the reliability and validity of 1-mile walk tests for estimation of aerobic fitness (VO[subscript 2max]) in 10- to 13-year-old children and to cross-validate previously published equations. Participants (n = 61) walked 1-mile on two different days. Self-reported physical activity, demographic variables, and aerobic fitness were used in…

  10. Development and design of a late-model fitness test instrument based on LabView

    Science.gov (United States)

    Xie, Ying; Wu, Feiqing

    2010-12-01

    Undergraduates are pioneers of China's modernization program and undertake the historic mission of rejuvenating our nation in the 21st century, whose physical fitness is vital. A smart fitness test system can well help them understand their fitness and health conditions, thus they can choose more suitable approaches and make practical plans for exercising according to their own situation. following the future trends, a Late-model fitness test Instrument based on LabView has been designed to remedy defects of today's instruments. The system hardware consists of fives types of sensors with their peripheral circuits, an acquisition card of NI USB-6251 and a computer, while the system software, on the basis of LabView, includes modules of user register, data acquisition, data process and display, and data storage. The system, featured by modularization and an open structure, is able to be revised according to actual needs. Tests results have verified the system's stability and reliability.

  11. Fit-for-purpose wastewater treatment: Testing to implementation of decision support tool (II).

    Science.gov (United States)

    Chhipi-Shrestha, Gyan; Hewage, Kasun; Sadiq, Rehan

    2017-12-31

    This paper is the second in a series of two papers. In Paper I, a decision support tool (DST), FitWater, was developed for evaluating the potential of wastewater treatment (WWT) trains for various water reuse applications. In the present paper, the proposed DST has been tested and implemented. FitWater has been tested with several existing WWT plants in Canada and the USA, demonstrating FitWater's effectiveness in estimating life cycle cost (LCC), health risk, and energy use. FitWater has also been implemented in a newly planned neighbourhood in the Okanagan Valley (BC, Canada) by developing 12 alternative WWT trains for water reuse in lawn and public parks irrigation. The results show that FitWater can effectively rank WWT train alternatives based on LCC, health risk, amount of reclaimed water, energy use, and carbon emissions. Moreover, functions have been developed for the variation of unit annualized LCC and energy intensity per unit log removal of microorganisms in different treatment technologies with varying plant capacities. The functions have power relations, showing the economies of scale. FitWater can be applied to identify a cost-effective, risk-acceptable, and energy efficient wastewater treatment train with a plant capacity of 500m 3 /day or more. Furthermore, FitWater can be used to assess potential economic impacts of developing microbiologically stringent effluent standards. The capability of FitWater can be enhanced by including physio-chemical quality of wastewater, additional treatment technologies, and carbon emissions from wastewater decomposition processes. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Systematic review and proposal of a field-based physical fitness-test battery in preschool children: the PREFIT battery.

    Science.gov (United States)

    Ortega, Francisco B; Cadenas-Sánchez, Cristina; Sánchez-Delgado, Guillermo; Mora-González, José; Martínez-Téllez, Borja; Artero, Enrique G; Castro-Piñero, Jose; Labayen, Idoia; Chillón, Palma; Löf, Marie; Ruiz, Jonatan R

    2015-04-01

    Physical fitness is a powerful health marker in childhood and adolescence, and it is reasonable to think that it might be just as important in younger children, i.e. preschoolers. At the moment, researchers, clinicians and sport practitioners do not have enough information about which fitness tests are more reliable, valid and informative from the health point of view to be implemented in preschool children. Our aim was to systematically review the studies conducted in preschool children using field-based fitness tests, and examine their (1) reliability, (2) validity, and (3) relationship with health outcomes. Our ultimate goal was to propose a field-based physical fitness-test battery to be used in preschool children. PubMed and Web of Science. Studies conducted in healthy preschool children that included field-based fitness tests. When using PubMed, we included Medical Subject Heading (MeSH) terms to enhance the power of the search. A set of fitness-related terms were combined with 'child, preschool' [MeSH]. The same strategy and terms were used for Web of Science (except for the MeSH option). Since no previous reviews with a similar aim were identified, we searched for all articles published up to 1 April 2014 (no starting date). A total of 2,109 articles were identified, of which 22 articles were finally selected for this review. Most studies focused on reliability of the fitness tests (n = 21, 96%), while very few focused on validity (0 criterion-related validity and 4 (18%) convergent validity) or relationship with health outcomes (0 longitudinal and 1 (5%) cross-sectional study). Motor fitness, particularly balance, was the most studied fitness component, while cardiorespiratory fitness was the least studied. After analyzing the information retrieved in the current systematic review about fitness testing in preschool children, we propose the PREFIT battery, field-based FITness testing in PREschool children. The PREFIT battery is composed of the following

  13. The Symbol Digit Modalities Test is an effective cognitive screen in pediatric onset multiple sclerosis (MS).

    Science.gov (United States)

    Charvet, Leigh E; Beekman, Rachel; Amadiume, Nneka; Belman, Anita L; Krupp, Lauren B

    2014-06-15

    To evaluate the Symbol Digit Modalities Test (SDMT) as a tool for identifying pediatric-onset MS patients at risk for cognitive impairment. The SDMT is a brief measure of cognitive processing speed that is often used in adult MS patients. Approximately one-third of pediatric-onset MS patients have cognitive impairment and there is a need for an effective screening instrument. Seventy (70) consecutive outpatients with pediatric-onset MS underwent clinical evaluations including the SDMT and were compared to those with other pediatric neurological diagnoses (OND, n=40) and healthy controls (HC, n=32). A subset of the MS group and all healthy controls completed neuropsychological evaluation within one year of SDMT administration. The MS group performed worse on the SDMT compared to the HC group (p=0.02). Thirty-seven percent (37%) of the MS, 20% of the OND, and 9% of HC groups scored in the impaired range. For MS participants who underwent neuropsychological testing (n=31), the SDMT showed 77% sensitivity and 81% specificity for detecting neuropsychological impairment when administered within one year and reached 100% sensitivity when the interval was under two months (n=17). Overall, older age and increased disability predicted poorer SDMT performance (age r=-0.26, p=0.03) and the Expanded Disability Status Scale score or EDSS (r=-0.47, pMS. Copyright © 2014 Elsevier B.V. All rights reserved.

  14. Detection of colorectal serrated polyps by stool DNA testing: comparison with fecal immunochemical testing for occult blood (FIT.

    Directory of Open Access Journals (Sweden)

    Russell I Heigh

    Full Text Available Precursors to 1/3 of colorectal cancer (CRC, serrated polyps have been under-detected by screening due to their inconspicuous, non-hemorrhagic, and proximal nature. A new multi-target stool DNA test (multi-target sDNA shows high sensitivity for both CRC and advanced adenomas. Screen detection of serrated polyps by this approach requires further validation. We sought to assess and compare noninvasive detection of sessile serrated polyps (SSP ≥ 1 cm by sDNA and an occult blood fecal immunochemical test (FIT.In a blinded prospective study, a single stool sample used for both tests was collected from 456 asymptomatic adults prior to screening or surveillance colonoscopy (criterion standard. All 29 patients with SSP ≥ 1 cm were included as cases and all 232 with no neoplastic findings as controls. Buffered stool samples were processed and frozen on receipt; Exact Sciences performed sDNA in batches using optimized analytical methods. The sDNA multi-marker panel targets methylated BMP3 (mBMP3 and NDRG4, mutant KRAS, β-actin, and hemoglobin. FIT (Polymedco OC-FIT Check was performed in separate lab ≤ 2 days post defecation and evaluated at cutoffs of 50 (FIT-50 and 100 ng/ml (FIT-100.MEDIAN AGES: cases 61 (range 57-77, controls 62 (52-70, p = NS. Women comprised 59% and 51%, p = NS, respectively. SSP median size was 1.2 cm (1-3 cm, 93% were proximal, and 64% had synchronous diminutive polyps. Among multi-target sDNA markers, mBMP3 proved highly discriminant for detection of SSP ≥ 1 cm (AUC = 0.87, p<0.00001; other DNA markers provided no incremental sensitivity. Hemoglobin alone showed no discrimination (AUC = 0.50, p = NS. At matched specificities, detection of SSP ≥ 1 cm by stool mBMP3 was significantly greater than by FIT-50 (66% vs 10%, p = 0.0003 or FIT-100 (63% vs 0%, p<0.0001.In a screening and surveillance setting, SSP ≥ 1 cm can be detected noninvasively by stool assay of exfoliated DNA markers, especially mBMP3. FIT appears to

  15. Engaging Overweight Adolescents in a Health and Fitness Program Using Wearable Activity Trackers.

    Science.gov (United States)

    Wilson, Marian; Ramsay, Samantha; Young, Kimberly J

    Our objectives were to (a) examine feasibility and receptivity of overweight adolescents joining a community-based group fitness program and (b) test preliminary efficacy of a 12-week pilot intervention designed to promote health, fitness, and self-efficacy for the identified teens. The 12-week fitness program for overweight adolescents was developed and included planned physical activities, nutrition classes, and goal-setting sessions. A one-group pre-/posttest study design evaluated 20 participants from grades 10 through 12 who enrolled in the program pilot study. Participants were given a wearable activity tracker that captured data using an Internet-based platform. Outcome measures included body mass index, screen time, fitness, and cardiovascular measures. A community fitness program for overweight adolescents was successfully implemented. High school students were receptive to the intervention and reported high program satisfaction. Positive effects included measurements of strength, systolic blood pressure, weight, and screen time behaviors. This study provides evidence to support the feasibility, acceptance, and preliminary effects of the pilot program with overweight adolescents. Copyright © 2017 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

  16. Home urine C-peptide creatinine ratio (UCPCR) testing can identify type 2 and MODY in pediatric diabetes.

    Science.gov (United States)

    Besser, Rachel E J; Shields, Beverley M; Hammersley, Suzanne E; Colclough, Kevin; McDonald, Timothy J; Gray, Zoe; Heywood, James J N; Barrett, Timothy G; Hattersley, Andrew T

    2013-05-01

    Making the correct diabetes diagnosis in children is crucial for lifelong management. Type 2 diabetes and maturity onset diabetes of the young (MODY) are seen in the pediatric setting, and can be difficult to discriminate from type 1 diabetes. Postprandial urinary C-peptide creatinine ratio (UCPCR) is a non-invasive measure of endogenous insulin secretion that has not been tested as a diagnostic tool in children or in patients with diabetes duration MODY and type 2 in pediatric diabetes. Two-hour postprandial UCPCR was measured in 264 patients aged MODY, n = 63). Receiver operating characteristic curves were used to identify the optimal UCPCR cutoff for discriminating diabetes subtypes. UCPCR was lower in type 1 diabetes [0.05 (MODY [3.51 (2.37-5.32) nmol/mmol, p MODY (p = 0.25), so patients were combined for subsequent analyses. After 2-yr duration, UCPCR ≥ 0.7 nmol/mmol has 100% sensitivity [95% confidence interval (CI): 92-100] and 97% specificity (95% CI: 91-99) for identifying non-type 1 (MODY + type 2 diabetes) from type 1 diabetes [area under the curve (AUC) 0.997]. UCPCR was poor at discriminating MODY from type 2 diabetes (AUC 0.57). UCPCR testing can be used in diabetes duration greater than 2 yr to identify pediatric patients with non-type 1 diabetes. UCPCR testing is a practical non-invasive method for use in the pediatric outpatient setting. © 2013 John Wiley & Sons A/S.

  17. A goodness-of-fit test for occupancy models with correlated within-season revisits

    Science.gov (United States)

    Wright, Wilson; Irvine, Kathryn M.; Rodhouse, Thomas J.

    2016-01-01

    Occupancy modeling is important for exploring species distribution patterns and for conservation monitoring. Within this framework, explicit attention is given to species detection probabilities estimated from replicate surveys to sample units. A central assumption is that replicate surveys are independent Bernoulli trials, but this assumption becomes untenable when ecologists serially deploy remote cameras and acoustic recording devices over days and weeks to survey rare and elusive animals. Proposed solutions involve modifying the detection-level component of the model (e.g., first-order Markov covariate). Evaluating whether a model sufficiently accounts for correlation is imperative, but clear guidance for practitioners is lacking. Currently, an omnibus goodnessof- fit test using a chi-square discrepancy measure on unique detection histories is available for occupancy models (MacKenzie and Bailey, Journal of Agricultural, Biological, and Environmental Statistics, 9, 2004, 300; hereafter, MacKenzie– Bailey test). We propose a join count summary measure adapted from spatial statistics to directly assess correlation after fitting a model. We motivate our work with a dataset of multinight bat call recordings from a pilot study for the North American Bat Monitoring Program. We found in simulations that our join count test was more reliable than the MacKenzie–Bailey test for detecting inadequacy of a model that assumed independence, particularly when serial correlation was low to moderate. A model that included a Markov-structured detection-level covariate produced unbiased occupancy estimates except in the presence of strong serial correlation and a revisit design consisting only of temporal replicates. When applied to two common bat species, our approach illustrates that sophisticated models do not guarantee adequate fit to real data, underscoring the importance of model assessment. Our join count test provides a widely applicable goodness-of-fit test and

  18. Reliability, validity and usefulness of 30-15 Intermittent Fitness Test in Female Soccer Players

    Directory of Open Access Journals (Sweden)

    Nedim Čović

    2016-11-01

    Full Text Available PURPOSE: The aim of this study was to examine the reliability, validity and usefulness of the 30-15IFT in competitive female soccer players. METHODS: Seventeen elite female soccer players participated in the study. A within subject test-retest study design was utilized to assess the reliability of the 30-15 intermittent fitness test (IFT. Seven days prior to 30-15IFT, subjects performed a continuous aerobic running test (CT under laboratory conditions to assess the criterion validity of the 30-15IFT. End running velocity (VCT and VIFT, peak heart rate (HRpeak and maximal oxygen consumption (VO2max were collected and/or estimated for both tests. RESULTS: VIFT (ICC = 0.91; CV = 1.8%, HRpeak (ICC = 0.94; CV = 1.2%, and VO2max (ICC = 0.94; CV = 1.6% obtained from the 30-15IFT were all deemed highly reliable (p>0.05. Pearson product moment correlations between the CT and 30-15IFT for VO2max, HRpeak and end running velocity were large (r = 0.67, p=0.013, very large (r = 0.77, p=0.02 and large (r = 0.57, p=0.042, respectively. CONCLUSION: Current findings suggest that the 30 -15IFT is a valid and reliable intermittent aerobic fitness test of elite female soccer players. The findings have also provided practitioners with evidence to support the accurate detection of meaningful individual changes in VIFT of 0.5 km/h (1 stage and HRpeak of 2 bpm. This information may assist coaches in monitoring ‘real’ aerobic fitness changes to better inform training of female intermittent team sport athletes. Lastly, coaches could use the 30-15IFT as a practical alternative to laboratory based assessments to assess and monitor intermittent aerobic fitness changes in their athletes. Keywords: 30-15 intermittent fitness test, aerobic, cardiorespiratory fitness, intermittent activity, soccer, high intensity interval training.

  19. A note on Poisson goodness-of-fit tests for ionizing radiation induced chromosomal aberration samples.

    Science.gov (United States)

    Higueras, Manuel; González, J E; Di Giorgio, Marina; Barquinero, J F

    2018-05-18

    To present Poisson exact goodness-of-fit tests as alternatives and complements to the asymptotic u-test, which is the most widely used in cytogenetic biodosimetry, to decide whether a sample of chromosomal aberrations in blood cells comes from an homogeneous or inhomogeneous exposure. Three Poisson exact goodness-of-fit test from the literature are introduced and implemented in the R environment. A Shiny R Studio application, named GOF Poisson, has been updated for the purpose of giving support to this work. The three exact tests and the u-test are applied in chromosomal aberration data from clinical and accidental radiation exposure patients. It is observed how the u-test is not an appropriate approximation in small samples with small yield of chromosomal aberrations. Tools are provided to compute the three exact tests, which is not as trivial as the implementation of the u-test. Poisson exact goodness-of-fit tests should be considered jointly to the u-test for detecting inhomogeneous exposures in the cytogenetic biodosimetry practice.

  20. Tests and standards for express-control of physical fitness and health of middle school age pupils

    Directory of Open Access Journals (Sweden)

    I.R. Bodnar

    2016-08-01

    Full Text Available Introduction: to day, physical fitness testing often causes negative emotions in pupils. It results in sharp loss of pupils’ wish to fulfill physical exercises in free time and worsens their health. Possibility to assess health level is an important motivation factor for pupils’ passing physical tests. Objective testing system will form positive motivation for physical exercises’ practicing and will facilitate increase of pupils’ motor functioning. It will also facilitate optimization of their physical condition, improvement of physical fitness and strengthening of health. Material: we tested physical fitness level and made diagnosis of pupils’ functional state (10-15 years’ age; n=85 with the help of tool methodic. We also used regressive analysis. Results: the system of tests and standards for express-control over physical fitness and health of middle school age pupils has been worked out and substantiated. The system of tests envisages fulfillment of 4 exercises: back pressing ups on bench during 20 seconds; throwing and catching of ball with two hands from wall during 30 seconds; side bending; torso rising from lying position into sitting during 30 seconds. Integral indicator of pupils’ physical fitness and health correlates with functional state of organism’s leading systems. We worked out 5 levels’ scale for express-control over physical fitness and health of middle school age pupils. The system stipulates calculation of integrative indicator with the help of regression equation by results of 4 test exercises and calculation of one index. Conclusions: The system of tests and standards permits the following: to divide pupils into relatively uniform groups even at the beginning of academic year for successful reasonable physical load. The system also permits to determine standard and find what shall be strived for by a pupil in order to achieve optimal physical fitness and somatic state; to motivate relatively weakly

  1. Validity of the Pediatric Running-Based Anaerobic Sprint Test to Determine Anaerobic Performance in Healthy Children

    NARCIS (Netherlands)

    Bongers, Bart C.; Werkman, Maarten S.; Blokland, Donna; Eijsermans, Maria J. C.; van der Torre, Patrick; Bartels, Bart; Verschuren, Olaf; Takken, Tim

    Purpose: To determine criterion validity of the pediatric running-based anaerobic sprint test (RAST) as a nonsophisticated field test for evaluating anaerobic performance in healthy children and adolescents. Methods: Data from 65. healthy children (28 boys and 37 girls between 6 and 18 years of age,

  2. Children with Auditory Neuropathy Spectrum Disorder Fitted with Hearing Aids Applying the American Academy of Audiology Pediatric Amplification Guideline: Current Practice and Outcomes.

    Science.gov (United States)

    Walker, Elizabeth; McCreery, Ryan; Spratford, Meredith; Roush, Patricia

    2016-03-01

    Up to 15% of children with permanent hearing loss (HL) have auditory neuropathy spectrum disorder (ANSD), which involves normal outer hair cell function and disordered afferent neural activity in the auditory nerve or brainstem. Given the varying presentations of ANSD in children, there is a need for more evidence-based research on appropriate clinical interventions for this population. This study compared the speech production, speech perception, and language outcomes of children with ANSD, who are hard of hearing, to children with similar degrees of mild-to-moderately severe sensorineural hearing loss (SNHL), all of whom were fitted with bilateral hearing aids (HAs) based on the American Academy of Audiology pediatric amplification guidelines. Speech perception and communication outcomes data were gathered in a prospective accelerated longitudinal design, with entry into the study between six mo and seven yr of age. Three sites were involved in participant recruitment: Boys Town National Research Hospital, the University of North Carolina at Chapel Hill, and the University of Iowa. The sample consisted of 12 children with ANSD and 22 children with SNHL. The groups were matched based on better-ear pure-tone average, better-ear aided speech intelligibility index, gender, maternal education level, and newborn hearing screening result (i.e., pass or refer). Children and their families participated in an initial baseline visit, followed by visits twice a year for children 2 yr of age. Paired-sample t-tests were used to compare children with ANSD to children with SNHL. Paired t-tests indicated no significant differences between the ANSD and SNHL groups on language and articulation measures. Children with ANSD displayed functional speech perception skills in quiet. Although the number of participants was too small to conduct statistical analyses for speech perception testing, there appeared to be a trend in which the ANSD group performed more poorly in background noise

  3. Speech Perception in Noise in Normally Hearing Children: Does Binaural Frequency Modulated Fitting Provide More Benefit than Monaural Frequency Modulated Fitting?

    Science.gov (United States)

    Mukari, Siti Zamratol-Mai Sarah; Umat, Cila; Razak, Ummu Athiyah Abdul

    2011-07-01

    The aim of the present study was to compare the benefit of monaural versus binaural ear-level frequency modulated (FM) fitting on speech perception in noise in children with normal hearing. Reception threshold for sentences (RTS) was measured in no-FM, monaural FM, and binaural FM conditions in 22 normally developing children with bilateral normal hearing, aged 8 to 9 years old. Data were gathered using the Pediatric Malay Hearing in Noise Test (P-MyHINT) with speech presented from front and multi-talker babble presented from 90°, 180°, 270° azimuths in a sound treated booth. The results revealed that the use of either monaural or binaural ear level FM receivers provided significantly better mean RTSs than the no-FM condition (Pbinaural FM did not produce a significantly greater benefit in mean RTS than monaural fitting. The benefit of binaural over monaural FM varies across individuals; while binaural fitting provided better RTSs in about 50% of study subjects, there were those in whom binaural fitting resulted in either deterioration or no additional improvement compared to monaural FM fitting. The present study suggests that the use of monaural ear-level FM receivers in children with normal hearing might provide similar benefit as binaural use. Individual subjects' variations of binaural FM benefit over monaural FM suggests that the decision to employ monaural or binaural fitting should be individualized. It should be noted however, that the current study recruits typically developing normal hearing children. Future studies involving normal hearing children with high risk of having difficulty listening in noise is indicated to see if similar findings are obtained.

  4. The Marine Corps Physical Fitness Test: The Need to Replace it with a Combat Fitness Test

    Science.gov (United States)

    2008-02-19

    unforeseen emergencies.”1 Crossfit , a website-based workout program, has popularized the en vogue, yet relatively old concept of “functional fitness...Sports; 1996. <http://www.cdc.gov/nccdphp/sgr/sgr.htm> 2 Greg Glassman, “What is Fitness?” Crossfit Journal, October 2002, 1-2. 3 human...short, intense workouts aimed at increasing power, speed, and strength. Additionally, Crossfit explains the crossover between the three pathways

  5. Examine the Relationship between Dynamic Balance and Physical Fitness Tests in Preschool Children

    OpenAIRE

    杉浦, 宏季; Sugiura, Hiroki; 杉本, 寛恵; Sugimoto, Hiroe

    2016-01-01

    This study examined the relationship between dynamic balance tests and various physical fitness tests in preschool children. The subjects were 22 preschool children (age, 5.0+0.4years; height, 107.3+5.7cm; weight, 17.9+3.4 kg). Dynamic balance was assessed by walking the length of a balance beam several times (beam height, 30cm; width, 10cm; length, 200cm) and walking a pathway (width, 10cm; length, 200cm). Physical fitness was assessed with activities such as a 25-meter run, continuous bilat...

  6. Construction and psychometric testing of the EMPATHIC questionnaire measuring parent satisfaction in the pediatric intensive care unit

    NARCIS (Netherlands)

    Latour, Jos M.; van Goudoever, Johannes B.; Duivenvoorden, Hugo J.; Albers, Marcel J. I. J.; van Dam, Nicolette A. M.; Dullaart, Eugenie; van Heerde, Marc; de Neef, Marjorie; Verlaat, Carin W. M.; van Vught, Elise M.; Hazelzet, Jan A.

    To construct and test the reliability and validity of the EMpowerment of PArents in THe Intensive Care (EMPATHIC) questionnaire measuring parent satisfaction in the pediatric intensive care unit (PICU). Structured development and psychometric testing of a parent satisfaction-with-care instrument

  7. Construction and psychometric testing of the EMPATHIC questionnaire measuring parent satisfaction in the pediatric intensive care unit

    NARCIS (Netherlands)

    Latour, J.M.; van Goudoever, J.B.; Duivenvoorden, H.J.; Albers, M.J.I.J.; van Dam, N.A.M.; Dullaart, E.; van Heerde, M.; de Neef, M.; Verlaat, C.W.M.; van Vught, E.M.; Hazelzet, J.A.

    2011-01-01

    To construct and test the reliability and validity of the EMpowerment of PArents in THe Intensive Care (EMPATHIC) questionnaire measuring parent satisfaction in the pediatric intensive care unit (PICU). Structured development and psychometric testing of a parent satisfaction-with-care instrument

  8. 557 Test and Manage Protocol for 841 Patients Requiring Iodinated Contrast Media (Icm) in Pediatrics

    Science.gov (United States)

    Diaz, Maria Cristina; Lavrut, Alberto Jorge; Spinelli, Silvia Susana

    2012-01-01

    Background ICM's adverse effects are quite frequent and potentially serious. The use of protocols to test and manage patients receiving ICM could help to decrease the adverse effects because they advise against the studies or prescribe the administration of premedication; however, its use in pediatrics is still limited. We describe the results of the use of a test and management protocol for pediatric patients requiring ICM. Methods All the patients of a pediatric hospital prescribed with ICM between 31st January 2008 and 5th March 2011 were included. The following variables have been analyzed: age, sex, type of study to be performed, diagnoses and hospitalized or outpatient, risk (regular, increased or non-advised) and the presence of adverse reactions. We also analyzed the relation between risk and age, sex and condition (chi cuadrado o t test). Significance level P < 0.05. Results We included 841 patients (56.9% male, age = 92.7 ± 24.5 months, 60% hospitalized). The most frequent test was chest Tc (36%) and the most frequent diagnosis was solid tumors (25%). Patients with increased risk were significantly lower than those with regular risk (75.7 ± 69.7 months vs 109.7 ± 61.6, P < 0.001). During the research period there were no adverse effects. Conclusions The classification of risk groups by this Goverment Buenos Aires City protocols allows a rational management of the patients requiring ICM and minimize the adverse effects.

  9. Respiratory fit testing for farmworkers in the Black Dirt region of Hudson Valley, New York.

    Science.gov (United States)

    Earle-Richardson, Giulia; Fiske, Todd; Wyckoff, Sherry; Shuford, James; May, John

    2014-01-01

    Respiratory protection in agriculture has lagged behind other industries. Migrant farmworkers often work in dusty environments yet do not receive appropriate, fitted respiratory protection. During May and June of 2013, researchers pilot-tested a respiratory protection program adapted to fit the unique needs of migrant and seasonal farmworkers. It was implemented in Spanish, with literacy support, at convenient times and locations. Additionally, staff was known to workers, and a farmworker medical center provided medical follow-up. Fifty-six farmworkers participated (68%; 82 invited). Of the participants, 88% were male; 20% reported using respiratory protection. One worker had been fit tested previously; 57% reported being exposed to pesticides. All but six farmworkers passed the medical clearance (91%). The mask most commonly fit to the American-born population was a good fit for only 41% of Latino farmworkers. The fact that two thirds of invited farmworkers participated in the clearance and over half completed mask fitting indicates that the modified protocol meets farmworker needs. A wide range of mask types should be made available for Latino farmworkers.

  10. Unilateral Arm Crank Exercise Test for Assessing Cardiorespiratory Fitness in Individuals with Hemiparetic Stroke

    Directory of Open Access Journals (Sweden)

    Kazuaki Oyake

    2017-01-01

    Full Text Available Cardiorespiratory fitness assessment with leg cycle exercise testing may be influenced by motor impairments in the paretic lower extremity. Hence, this study examined the usefulness of a unilateral arm crank exercise test to assess cardiorespiratory fitness in individuals with stroke, including sixteen individuals with hemiparetic stroke (mean ± SD age, 56.4±7.5 years and 12 age- and sex-matched healthy controls. Participants performed the unilateral arm crank and leg cycle exercise tests to measure oxygen consumption (V˙O2 and heart rate at peak exercise. The V˙O2 at peak exercise during the unilateral arm crank exercise test was significantly lower in the stroke group than in the control group (p<0.001. In the stroke group, the heart rate at peak exercise during the unilateral arm crank exercise test did not significantly correlate with the Brunnstrom recovery stages of the lower extremity (p=0.137, whereas there was a significant correlation during the leg cycle exercise test (rho = 0.775, p<0.001. The unilateral arm crank exercise test can detect the deterioration of cardiorespiratory fitness independently of lower extremity motor impairment severity in individuals with hemiparetic stroke. This study is registered with UMIN000014733.

  11. Preliminary tests in skull pediatric phantom for dosimetry in computerized tomography

    International Nuclear Information System (INIS)

    Martins, Elaine Wirney; Potiens, Maria da Penha de A.

    2014-01-01

    Computed tomography (CT) is one of the techniques in the field of radiology with striking technological advance in recent years. One reason for this was the increased number of channels associated with the increased power of the X-ray tube. These conditions allowed the equipment high speed in the acquisition of the cuts, reducing the patient exposure time essential characteristic for the increase of its use in pediatric patients. In this context, were developed a new pediatric skull simulator to analyze the results of measurements performed in laboratory and clinic beams with the objective of creation and use of diagnostic reference levels observing risks stochastic effects and assessing the reduction of absorbed doses in patients undergoing growing. Preliminary tests performed in clinical beams showed C w values: 2.525 ± 0.212 mGy for the developed simulator quoted and 3.362 ± 0.282 mGy for a simulator developed by IPEN called standard, both being between uncertainty values of 8.4% and 14.4% suggested by TRS number 457

  12. Development and feasibility testing of the Pediatric Emergency Discharge Interaction Coding Scheme.

    Science.gov (United States)

    Curran, Janet A; Taylor, Alexandra; Chorney, Jill; Porter, Stephen; Murphy, Andrea; MacPhee, Shannon; Bishop, Andrea; Haworth, Rebecca

    2017-08-01

    Discharge communication is an important aspect of high-quality emergency care. This study addresses the gap in knowledge on how to describe discharge communication in a paediatric emergency department (ED). The objective of this feasibility study was to develop and test a coding scheme to characterize discharge communication between health-care providers (HCPs) and caregivers who visit the ED with their children. The Pediatric Emergency Discharge Interaction Coding Scheme (PEDICS) and coding manual were developed following a review of the literature and an iterative refinement process involving HCP observations, inter-rater assessments and team consensus. The coding scheme was pilot-tested through observations of HCPs across a range of shifts in one urban paediatric ED. Overall, 329 patient observations were carried out across 50 observational shifts. Inter-rater reliability was evaluated in 16% of the observations. The final version of the PEDICS contained 41 communication elements. Kappa scores were greater than .60 for the majority of communication elements. The most frequently observed communication elements were under the Introduction node and the least frequently observed were under the Social Concerns node. HCPs initiated the majority of the communication. Pediatric Emergency Discharge Interaction Coding Scheme addresses an important gap in the discharge communication literature. The tool is useful for mapping patterns of discharge communication between HCPs and caregivers. Results from our pilot test identified deficits in specific areas of discharge communication that could impact adherence to discharge instructions. The PEDICS would benefit from further testing with a different sample of HCPs. © 2017 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

  13. A clinical utility study of exome sequencing versus conventional genetic testing in pediatric neurology.

    Science.gov (United States)

    Vissers, Lisenka E L M; van Nimwegen, Kirsten J M; Schieving, Jolanda H; Kamsteeg, Erik-Jan; Kleefstra, Tjitske; Yntema, Helger G; Pfundt, Rolph; van der Wilt, Gert Jan; Krabbenborg, Lotte; Brunner, Han G; van der Burg, Simone; Grutters, Janneke; Veltman, Joris A; Willemsen, Michèl A A P

    2017-09-01

    Implementation of novel genetic diagnostic tests is generally driven by technological advances because they promise shorter turnaround times and/or higher diagnostic yields. Other aspects, including impact on clinical management or cost-effectiveness, are often not assessed in detail prior to implementation. We studied the clinical utility of whole-exome sequencing (WES) in complex pediatric neurology in terms of diagnostic yield and costs. We analyzed 150 patients (and their parents) presenting with complex neurological disorders of suspected genetic origin. In a parallel study, all patients received both the standard diagnostic workup (e.g., cerebral imaging, muscle biopsies or lumbar punctures, and sequential gene-by-gene-based testing) and WES simultaneously. Our unique study design allowed direct comparison of diagnostic yield of both trajectories and provided insight into the economic implications of implementing WES in this diagnostic trajectory. We showed that WES identified significantly more conclusive diagnoses (29.3%) than the standard care pathway (7.3%) without incurring higher costs. Exploratory analysis of WES as a first-tier diagnostic test indicates that WES may even be cost-saving, depending on the extent of other tests being omitted. Our data support such a use of WES in pediatric neurology for disorders of presumed genetic origin.Genet Med advance online publication 23 March 2017.

  14. Assessment of fitness to drive after acquired brain injury: The role of neuropsychological tests

    DEFF Research Database (Denmark)

    Meng, Annette

    It is a well established fact that Acquired Brain Injury (ABI) can affect fitness to drive. Some cognitive functions have been emphasized as particular important when driving e.g. attention, reaction time, visual perception, and executive functioning. Research attempts have been made in order...... to identify a neuropsychological test battery to predict driving ability. However, there is no consensus as to which test such a test battery should consist of. The aim of this study was to explore the relationship between some neuropsychological test results and the results of an on-road test.......g. WCST will not predict the driving ability of this group. This illustrates that many things can affect the predictive value a neuropsychological test and the belief that neuropsychological testing on its own cannot predict fitness to drive. As findings in the field of driving assessment of older people...

  15. Modified Distribution-Free Goodness-of-Fit Test Statistic.

    Science.gov (United States)

    Chun, So Yeon; Browne, Michael W; Shapiro, Alexander

    2018-03-01

    Covariance structure analysis and its structural equation modeling extensions have become one of the most widely used methodologies in social sciences such as psychology, education, and economics. An important issue in such analysis is to assess the goodness of fit of a model under analysis. One of the most popular test statistics used in covariance structure analysis is the asymptotically distribution-free (ADF) test statistic introduced by Browne (Br J Math Stat Psychol 37:62-83, 1984). The ADF statistic can be used to test models without any specific distribution assumption (e.g., multivariate normal distribution) of the observed data. Despite its advantage, it has been shown in various empirical studies that unless sample sizes are extremely large, this ADF statistic could perform very poorly in practice. In this paper, we provide a theoretical explanation for this phenomenon and further propose a modified test statistic that improves the performance in samples of realistic size. The proposed statistic deals with the possible ill-conditioning of the involved large-scale covariance matrices.

  16. Different goodness of fit tests for Rayleigh distribution in ranked set sampling

    Directory of Open Access Journals (Sweden)

    Amer Al-Omari

    2016-03-01

    Full Text Available In this paper, different goodness of fit tests for the Rayleigh distribution are considered based on simple random sampling (SRS and ranked set sampling (RSS techniques. The performance of the suggested estimators is evaluated in terms of the power of the tests by using Monte Carlo simulation. It is found that the suggested RSS tests perform better than their counterparts  in SRS.

  17. Youth fitness testing: the effect of percentile-based evaluative feedback on intrinsic motivation.

    Science.gov (United States)

    Whitehead, J R; Corbin, C B

    1991-06-01

    This study was a test of Deci and Ryan's (1985) cognitive evaluation theory in a fitness testing situation. More specifically, it was a test of Proposition 2 of that theory, which posits that external events that increase or decrease perceived competence will increase or decrease intrinsic motivation. Seventh and eighth grade schoolchildren (N = 105) volunteered for an experiment that was ostensibly to collect data on a new youth fitness test (the Illinois Agility Run). After two untimed practice runs, a specially adapted version of the Intrinsic Motivation Inventory (IMI) was administered as a pretest of intrinsic motivation. Two weeks later when subjects ran again, they were apparently electronically timed. In reality, the subjects were given bogus feedback. Subjects in a positive feedback condition were told their scores were above the 80th percentile, while those in a negative feedback condition were told their scores were below the 20th percentile. Those in a control condition received no feedback. The IMI was again administered to the subjects after their runs. Multivariate and subsequent univariate tests were significant for all four subscale dependent variables (perceived interest-enjoyment, competence, effort, and pressure-tension). Positive feedback enhanced all aspects of intrinsic motivation, whereas negative feedback decreased them. In a further test of cognitive evaluation theory, path analysis results supported the prediction that perceived competence would mediate changes in the other IMI subscales. Taken together, these results clearly support cognitive evaluation theory and also may have important implications regarding motivation for those who administer youth fitness tests.

  18. Children's (Pediatric) Magnetic Resonance Imaging

    Medline Plus

    Full Text Available ... MRI) exam. View full size with caption Pediatric Content Some imaging tests and treatments have special pediatric considerations. The teddy bear denotes child-specific content. Related Articles and Media Catheter Angiography Magnetic Resonance, ...

  19. Children's (Pediatric) Magnetic Resonance Imaging

    Medline Plus

    Full Text Available ... the exam. MRI scanners are air-conditioned and well-lit. Music may be played through the headphones ... full size with caption Pediatric Content Some imaging tests and treatments have special pediatric considerations. The teddy ...

  20. Children's (Pediatric) Magnetic Resonance Imaging

    Medline Plus

    Full Text Available ... a risk, depending on their nature and the strength of the MRI magnet. Many implanted devices will ... full size with caption Pediatric Content Some imaging tests and treatments have special pediatric considerations. The teddy ...

  1. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... need to be returned to the transducer for analysis. top of page This page was reviewed on ... using ultrasound. View full size with caption Pediatric Content Some imaging tests and treatments have special pediatric ...

  2. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... in CT scans should have no immediate side effects. Risks The risk of serious allergic reaction to ... Pediatric Content Some imaging tests and treatments have special pediatric considerations. The teddy bear denotes child-specific ...

  3. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... scans, your doctor may ask you to withhold food and drink for several hours before your child's ... full size with caption Pediatric Content Some imaging tests and treatments have special pediatric considerations. The teddy ...

  4. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... Imaging? Ultrasound waves are disrupted by air or gas; therefore ultrasound is not an ideal imaging technique ... with caption Pediatric Content Some imaging tests and treatments have special pediatric considerations. The teddy bear denotes ...

  5. When symptoms don't fit: a case series of conversion disorder in the pediatric otolaryngology practice.

    Science.gov (United States)

    Caulley, Lisa; Kohlert, Scott; Gandy, Hazen; Olds, Janet; Bromwich, Matthew

    2018-05-29

    Conversion disorder refers to functional bodily impairments that can be precipitated by high stress situations including trauma and surgery. Symptoms of conversion disorder may mimic or complicate otolaryngology diseases in the pediatric population. In this report, the authors describe 3 cases of conversion disorder that presented to a pediatric otolaryngology-head and neck surgery practice. This report highlights a unique population of patients who have not previously been investigated. The clinical presentation and management of these cases are discussed in detail. Non-organic otolaryngology symptoms of conversion disorder in the pediatric population are reviewed. In addition, we discuss the challenges faced by clinicians in appropriately identifying and treating these patients and present an approach to management of their care. In this report, the authors highlight the importance of considering psychogenic illnesses in patients with atypical clinical presentations of otolaryngology disorders.

  6. Approaching a diagnostic point-of-care test for pediatric tuberculosis through evaluation of immune biomarkers across the clinical disease spectrum

    DEFF Research Database (Denmark)

    Jenum, Synne; Dhanasekaran, S; Lodha, Rakesh

    2016-01-01

    The World Health Organization (WHO) calls for an accurate, rapid, and simple point-of-care (POC) test for the diagnosis of pediatric tuberculosis (TB) in order to make progress "Towards Zero Deaths". Whereas the sensitivity of a POC test based on detection of Mycobacterium tuberculosis (MTB...... (CD14, FCGR1A, FPR1, MMP9, RAB24, SEC14L1, and TIMP2) or "downstream" towards a decreased likelihood of TB disease (BLR1, CD3E, CD8A, IL7R, and TGFBR2), suggesting a correlation with MTB-related pathology and high relevance to a future POC test for pediatric TB. A biomarker signature consisting of BPI...

  7. Physiological testing of basketball players: toward a standard evaluation of anaerobic fitness.

    Science.gov (United States)

    Delextrat, Anne; Cohen, Daniel

    2008-07-01

    The aim of this study was to examine whether the changes in the rules of the game instituted in 2000 have modified the physiological factors of success in basketball. The performances of 8 elite male players and 8 average-level players were compared in order to identify which components of fitness among agility, speed, anaerobic power, anaerobic capacity, and upper body strength were key determinants of performance in modern basketball. Each subject performed 7 tests, including vertical jump (VJ), 20-m sprint, agility T test, suicide sprint, 30-second Wingate anaerobic test (WAnT), isokinetic testing of the knee extensors, and 1 repetition maximum (1RM) bench press test. The statistical difference in the anaerobic performances was assessed by Student's t test. The main results showed that, compared to average-level players, elite-level players achieved significantly better performances in the agility T test (+6.2%), VJ test (+8.8%), peak torques developed by knee extensors (+20.2%), and 1RM bench press (+18.6%, p 0.05). These results emphasized the importance of anaerobic power in modern basketball, whereas anaerobic capacity does not seem to be a key aspect to consider. In this context, coaches are advised to avoid using exercises lasting >/=30 seconds in their physical fitness programs, but instead to focus on short and intense tests such as VJ, agility T test, and sprints over very short distances (5 or 10 m).

  8. Customization of stock eye prosthesis for a pediatric patient by a simplified technique.

    Science.gov (United States)

    Jurel, Sunit Kumar; Talwar, Naina; Chand, Pooran; Singh, Raghuwar D; Gupta, Durga Shanker

    2012-05-01

    The unfortunate loss or absence of an eye may be caused by congenital defect , irreparable trauma, tumor or blind eye. The role of the maxillofacial prosthodontist in fabricating an ocular prosthesis to restore facial symmetry and normal appearance for the anophthalmic patient becomes essential. A custom-made ocular prosthesis is an excellent alternative for the people who lose their eye especially in young age. It has acceptable fit, retention and esthetics but is technically difficult to fabricate. On the other hand the stock eye has compromised fit and poor esthetics. Our case report presents a simple technique of customization of stock eye prosthesis to provide accurate fit and acceptable esthetics. How to cite this article: Jurel SK, Talwar N, Chand P, Singh RD, Gupta DS. Customization of Stock Eye Prosthesis for a Pediatric Patient by a Simplified Technique. Int J Clin Pediatr Dent 2012;5(2):155-158.

  9. Evaluation of Cooper 12-minute walk/run test as a marker of cardiorespiratory fitness in young urban children with persistent asthma.

    Science.gov (United States)

    Weisgerber, Michael; Danduran, Michael; Meurer, John; Hartmann, Kathryn; Berger, Stuart; Flores, Glenn

    2009-07-01

    To evaluate Cooper 12-minute run/walk test (CT12) as a one-time estimate of cardiorespiratory fitness and marker of fitness change compared with treadmill fitness testing in young children with persistent asthma. A cohort of urban children with asthma participated in the asthma and exercise program and a subset completed pre- and postintervention fitness testing. Treadmill fitness testing was conducted by an exercise physiologist in the fitness laboratory at an academic children's hospital. CT12 was conducted in a college recreation center gymnasium. Forty-five urban children with persistent asthma aged 7 to 14 years participated in exercise interventions. A subset of 19 children completed pre- and postintervention exercise testing. Participants completed a 9-week exercise program where they participated in either swimming or golf 3 days a week for 1 hour. A subset of participants completed fitness testing by 2 methods before and after program completion. CT12 results (meters), maximal oxygen consumption ((.)Vo2max) (mL x kg(-1) x min(-1)), and treadmill exercise time (minutes). CT12 and maximal oxygen consumption were moderately correlated (preintervention: 0.55, P = 0.003; postintervention: 0.48, P = 0.04) as one-time measures of fitness. Correlations of the tests as markers of change over time were poor and nonsignificant. In children with asthma, CT12 is a reasonable one-time estimate of fitness but a poor marker of fitness change over time.

  10. Evaluation of the protection factor of half-masks with respirator fitting test apparatus

    International Nuclear Information System (INIS)

    Murata, M.; Ikezawa, Y.; Yoshida, Y.; Matsui, H.; Kokubu, M.

    1980-01-01

    A respirator fitting test apparatus has been developed to select half-masks of high performance and to estimate their protective ability. With the apparatus, the facepiece leakage was measured for six different half-masks worn by 40 volunteer subjects, under simulated working conditions of normal breathing, smiling, moving head, and talking. A cloud of submicron sodium chloride particles was fed into a test hood in which the subject wore a mask. The air sampled from inside the mask with a miniature pump was assessed by a flame photometer. It is hown that the protection factor (ratio of the concentration of test cloud outside the mask to that inside) for each mask varies widely with the subject and the working conditions, and that the protection factors roughly fit a lognormal distribution. The values characterizing the distributions of respective masks are given. (H.K.)

  11. Musculoskeletal Fitness Measures Are Not Created Equal: An Assessment of School Children in Corpus Christi, Texas.

    Science.gov (United States)

    Ajisafe, Toyin; Garcia, Theresa; Fanchiang, Hsin-Chen

    2018-01-01

    This study investigated current obesity prevalence and associations between musculoskeletal fitness test scores and the odds of being underweight, overweight, or obese compared to having a healthy weight in elementary school children in Corpus Christi, Texas. The sample analyzed consisted of 492 public elementary school children between kindergarten and fifth grade. Their ages ranged from 5 to 11 years. Trunk lift, 90° push-up, curl-up, and back saver sit and reach tests were administered. Weight status was determined using BMI scores and the CDC growth charts. Obesity prevalence remains high among elementary school-aged children in Corpus Christi, Texas. Higher 90° push-up test scores were most consistently associated with decreased odds of being obese as compared to being overweight and having healthy weight except in kindergarten. Conversely, higher trunk lift test scores were associated with increased odds of being obese in second and fourth grades. When children achieved the minimum score to be classified in the Healthy Fitness Zone, those with healthy weight had similarly low musculoskeletal fitness (i.e., abdominal strength and endurance, hamstring flexibility, and trunk extensor strength and flexibility) as peers with overweight and obesity, especially in the lower grades. It was concluded that increased obesity prevalence in higher grades may be precipitated (at least in part) by low musculoskeletal fitness in the lower grades, especially kindergarten. Given previous associations in the literature, low musculoskeletal fitness may be symptomatic of poor motor skill competence in the current sample. These findings suggest a need for early and focused school-based interventions that leverage both known and novel strategies to combat pediatric obesity in Corpus Christi.

  12. Musculoskeletal Fitness Measures Are Not Created Equal: An Assessment of School Children in Corpus Christi, Texas

    Directory of Open Access Journals (Sweden)

    Toyin Ajisafe

    2018-05-01

    Full Text Available This study investigated current obesity prevalence and associations between musculoskeletal fitness test scores and the odds of being underweight, overweight, or obese compared to having a healthy weight in elementary school children in Corpus Christi, Texas. The sample analyzed consisted of 492 public elementary school children between kindergarten and fifth grade. Their ages ranged from 5 to 11 years. Trunk lift, 90° push-up, curl-up, and back saver sit and reach tests were administered. Weight status was determined using BMI scores and the CDC growth charts. Obesity prevalence remains high among elementary school-aged children in Corpus Christi, Texas. Higher 90° push-up test scores were most consistently associated with decreased odds of being obese as compared to being overweight and having healthy weight except in kindergarten. Conversely, higher trunk lift test scores were associated with increased odds of being obese in second and fourth grades. When children achieved the minimum score to be classified in the Healthy Fitness Zone, those with healthy weight had similarly low musculoskeletal fitness (i.e., abdominal strength and endurance, hamstring flexibility, and trunk extensor strength and flexibility as peers with overweight and obesity, especially in the lower grades. It was concluded that increased obesity prevalence in higher grades may be precipitated (at least in part by low musculoskeletal fitness in the lower grades, especially kindergarten. Given previous associations in the literature, low musculoskeletal fitness may be symptomatic of poor motor skill competence in the current sample. These findings suggest a need for early and focused school-based interventions that leverage both known and novel strategies to combat pediatric obesity in Corpus Christi.

  13. Studies and testing in water and steam of valves and fittings, and nuclear components. The result of 25 years of testing using a comprehensive range of test facilities under service conditions

    International Nuclear Information System (INIS)

    Berail, J.F.; Bruneau, S.; Crouzet, D.; Haas, J.L.; Zbinden, M.

    1998-05-01

    Electricite de France operates 58 PWR nuclear power stations, for which the behaviour of valves and fittings is of major importance for safety, for the availability of the plants, and for maintenance costs. Since the early 70's, EDF has developed a comprehensive range of facilities to test valves and fittings in PWR service and accident conditions. It has carried out studies, tests, development work, experimental and numerical research in collaboration with external organisations and manufacturers, to improve the technologies of these equipment as well as maintenance tools and methods. In the present paper, the authors quantify the importance of valves and fittings studies for EDF, which has led to the drawing up of a catalogue of approved equipment. They describe the principle test facilities, and the structure of the EDF 'valves and fittings tests results' data base. They show the importance of twenty-five years of testing experience for both the evolution of equipment and for the increase in French nuclear plants availability. (author)

  14. Reliable Prediction of Insulin Resistance by a School-Based Fitness Test in Middle-School Children

    Directory of Open Access Journals (Sweden)

    Allen DavidB

    2009-09-01

    Full Text Available Objectives. (1 Determine the predictive value of a school-based test of cardiovascular fitness (CVF for insulin resistance (IR; (2 compare a "school-based" prediction of IR to a "laboratory-based" prediction, using various measures of fitness and body composition. Methods. Middle school children ( performed the Progressive Aerobic Cardiovascular Endurance Run (PACER, a school-based CVF test, and underwent evaluation of maximal oxygen consumption treadmill testing ( max, body composition (percent body fat and BMI z score, and IR (derived homeostasis model assessment index []. Results. PACER showed a strong correlation with max/kg ( = 0.83, and with ( = , . Multivariate regression analysis revealed that a school-based model (using PACER and BMI z score predicted IR similar to a laboratory-based model (using max/kg of lean body mass and percent body fat. Conclusions. The PACER is a valid school-based test of CVF, is predictive of IR, and has a similar relationship to IR when compared to complex laboratory-based testing. Simple school-based measures of childhood fitness (PACER and fatness (BMI z score could be used to identify childhood risk for IR and evaluate interventions.

  15. Spontaneous breathing test in the prediction of extubation failure in the pediatric population.

    Science.gov (United States)

    Nascimento, Milena Siciliano; Rebello, Celso Moura; Vale, Luciana Assis Pires Andrade; Santos, Érica; Prado, Cristiane do

    2017-01-01

    To assess whether the spontaneous breathing test can predict the extubation failure in pediatric population. A prospective and observational study that evaluated data of inpatients at the Pediatric Intensive Care Unit between May 2011 and August 2013, receiving mechanical ventilation for at least 24 hours followed by extubation. The patients were classified in two groups: Test Group, with patients extubated after spontaneous breathing test, and Control Group, with patients extubated without spontaneous breathing test. A total of 95 children were enrolled in the study, 71 in the Test Group and 24 in the Control Group. A direct comparison was made between the two groups regarding sex, age, mechanical ventilation time, indication to start mechanical ventilation and respiratory parameters before extubation in the Control Group, and before the spontaneous breathing test in the Test Group. There was no difference between the parameters evaluated. According to the analysis of probability of extubation failure between the two groups, the likelihood of extubation failure in the Control Group was 1,412 higher than in the Test Group, nevertheless, this range did not reach significance (p=0.706). This model was considered well-adjusted according to the Hosmer-Lemeshow test (p=0.758). The spontaneous breathing test was not able to predict the extubation failure in pediatric population. Avaliar se o teste de respiração espontânea pode ser utilizado para predizer falha da extubação na população pediátrica. Estudo prospectivo, observacional, no qual foram avaliados todos os pacientes internados no Centro de Terapia Intensiva Pediátrica, no período de maio de 2011 a agosto de 2013, que utilizaram ventilação mecânica por mais de 24 horas e que foram extubados. Os pacientes foram classificados em dois grupos: Grupo Teste, que incluiu os pacientes extubados depois do teste de respiração espontânea; e Grupo Controle, pacientes foram sem teste de respiração espont

  16. Pediatric Contact Dermatitis Registry Inaugural Case Data.

    Science.gov (United States)

    Goldenberg, Alina; Mousdicas, Nico; Silverberg, Nanette; Powell, Douglas; Pelletier, Janice L; Silverberg, Jonathan I; Zippin, Jonathan; Fonacier, Luz; Tosti, Antonella; Lawley, Leslie; Wu Chang, Mary; Scheman, Andrew; Kleiner, Gary; Williams, Judith; Watsky, Kalman; Dunnick, Cory A; Frederickson, Rachel; Matiz, Catalina; Chaney, Keri; Estes, Tracy S; Botto, Nina; Draper, Michelle; Kircik, Leon; Lugo-Somolinos, Aida; Machler, Brian; Jacob, Sharon E

    2016-01-01

    Little is known about the epidemiology of allergic contact dermatitis (ACD) in US children. More widespread diagnostic confirmation through epicutaneous patch testing is needed. The aim was to quantify patch test results from providers evaluating US children. The study is a retrospective analysis of deidentified patch test results of children aged 18 years or younger, entered by participating providers in the Pediatric Contact Dermatitis Registry, during the first year of data collection (2015-2016). One thousand one hundred forty-two cases from 34 US states, entered by 84 providers, were analyzed. Sixty-five percent of cases had one or more positive patch test (PPT), with 48% of cases having 1 or more relevant positive patch test (RPPT). The most common PPT allergens were nickel (22%), fragrance mix I (11%), cobalt (9.1%), balsam of Peru (8.4%), neomycin (7.2%), propylene glycol (6.8%), cocamidopropyl betaine (6.4%), bacitracin (6.2%), formaldehyde (5.7%), and gold (5.7%). This US database provides multidisciplinary information on pediatric ACD, rates of PPT, and relevant RPPT reactions, validating the high rates of pediatric ACD previously reported in the literature. The registry database is the largest comprehensive collection of US-only pediatric patch test cases on which future research can be built. Continued collaboration between patients, health care providers, manufacturers, and policy makers is needed to decrease the most common allergens in pediatric consumer products.

  17. Penicillin skin testing is a safe and effective tool for evaluating penicillin allergy in the pediatric population.

    Science.gov (United States)

    Fox, Stephanie J; Park, Miguel A

    2014-01-01

    Penicillin skin testing has been validated in the evaluation of adult patients with penicillin allergy. However, the commercially available benzylpenicilloyl polylysine (Pre-Pen) is not indicated in the pediatric population. Moreover, the safety and validity of penicillin skin testing in the pediatric population has not been well studied. We describe the safety and validity of penicillin skin testing in the evaluation of children with a history of penicillin allergy. Children (penicillin allergy were evaluated with penicillin skin tests and were reviewed for basic demographics, penicillin skin test results, adverse drug reaction to penicillin after penicillin skin test, and adverse reaction to penicillin skin test. By using the χ(2) test, we compared the differences in the proportion of children and adults with a positive penicillin skin test. P value (penicillin skin testing; 703 of 778 patients had a negative penicillin skin test (90.4%), 66 had a positive test (8.5%), and 9 had an equivocal test (1.1%). Children were more likely to have a positive penicillin skin test (P penicillin skin test (52%) were challenged with penicillin, and 14 of 369 patients (3.8%) had an adverse drug reaction. No adverse reactions to penicillin skin testing were observed. Penicillin skin testing was safe and effective in the evaluation of children with a history of penicillin allergy. Copyright © 2014 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  18. The 6-min push test is reliable and predicts low fitness in spinal cord injury.

    Science.gov (United States)

    Cowan, Rachel E; Callahan, Morgan K; Nash, Mark S

    2012-10-01

    The objective of this study is to assess 6-min push test (6MPT) reliability, determine whether the 6MPT is sensitive to fitness differences, and assess if 6MPT distance predicts fitness level in persons with spinal cord injury (SCI) or disease. Forty individuals with SCI who could self-propel a manual wheelchair completed an incremental arm crank peak oxygen consumption assessment and two 6MPTs across 3 d (37% tetraplegia (TP), 63% paraplegia (PP), 85% men, 70% white, 63% Hispanic, mean age = 34 ± 10 yr, mean duration of injury = 13 ± 10 yr, and mean body mass index = 24 ± 5 kg.m). Intraclass correlation and Bland-Altman plots assessed 6MPT distance (m) reliability. Mann-Whitney U test compared 6MPT distance (m) of high and low fitness groups for TP and PP. The fitness status prediction was developed using N = 30 and validated in N = 10 (validation group (VG)). A nonstatistical prediction approach, below or above a threshold distance (TP = 445 m and PP = 604 m), was validated statistically by binomial logistic regression. Accuracy, sensitivity, and specificity were computed to evaluate the threshold approach. Intraclass correlation coefficients exceeded 0.90 for the whole sample and the TP/PP subsets. High fitness persons propelled farther than low fitness persons for both TP/PP (both P < 0.05). Binomial logistic regression (P < 0.008) predicted the same fitness levels in the VG as the threshold approach. In the VG, overall accuracy was 70%. Eighty-six percent of low fitness persons were correctly identified (sensitivity), and 33% of high fitness persons were correctly identified (specificity). The 6MPT may be a useful tool for SCI clinicians and researchers. 6MPT distance demonstrates excellent reliability and is sensitive to differences in fitness level. 6MPT distances less than a threshold distance may be an effective approach to identify low fitness in person with SCI.

  19. Improving Healthcare in Pediatric Oncology: Development and Testing of Multiple Indicators to Evaluate a Hub-And-Spoke Model.

    Science.gov (United States)

    Zucchetti, Giulia; Bertorello, Nicoletta; Angelastro, Angela; Gianino, Paola; Bona, Gianni; Barbara, Affif; Besenzon, Luigi; Brach Del Prever, Adalberto; Pesce, Fernando; Nangeroni, Marco; Fagioli, Franca

    2017-06-01

    Purpose The hub-and-spoke is a new innovation model in healthcare that has been adopted in some countries to manage rare pathologies. We developed a set of indicators to assess current quality practices of the hub-and-spoke model adopted in the Interregional Pediatric Oncology Network in Northwest Italy and to promote patient, family, and professional healthcare empowerment. Methods Literature and evidence-based clinical guidelines were reviewed and multiprofessional team workshops were carried out to highlight some important issues on healthcare in pediatric oncology and to translate them into a set of multiple indicators. For each indicator, specific questions were formulated and tested through a series of questionnaires completed by 80 healthcare professionals and 50 pediatric patients and their parents. Results The results highlighted a positive perception of healthcare delivered by the hub-and-spoke model (M HP = 156, M Pat = 93, M Par = 104). Based on the participants' suggestions, some quality improvements have been implemented. Conclusions This study represents the first attempt to examine this new model of pediatric oncology care through the active involvement of patients, families, and healthcare professionals. Suggestions for adopting a hub-and-spoke model in pediatric oncology in other regions and countries are also highlighted.

  20. A Women-Only Comparison of the U.S. Air Force Fitness Test and the Marine Combat Fitness Test

    Science.gov (United States)

    2012-03-01

    Air Force established the Fitness Assessment Cell to conduct fitness assessments for all Air Force members and to encourage standardization in...objective. “The MCFT was specifically designed to evaluate strength, stamina , agility and coordination as well as overall anaerobic capacity” (Department...1308.1, “Service members must possess stamina and strength to perform, successfully, any mission,” and that “…each service develops a quality 78

  1. Poisson goodness-of-fit tests for radiation-induced chromosome aberrations

    International Nuclear Information System (INIS)

    Merkle, W.

    1981-01-01

    Asymptotic and exact Poisson goodness-to-fit tests have been reviewed with regard to their applicability in analysing distributional properties of data on chromosome aberrations. It has been demonstrated that for typical cytogenetic samples, i.e. when the average number of aberrations per cell is smaller than one, results of asymptotic tests, especially of the most commonly used u-test, differ greatly from results of corresponding exact tests. While the u-statistic can serve as a qualitative index to indicate a tendency towards under- or over-dispersion, exact tests should be used if the assumption of a Poisson distribution is crucial, e.g. in investigating induction mechanisms. If the main interest is to detect a difference between the mean and the variance of a sample it is furthermore important to realize that a much larger sample size is required to detect underdispersion than it is to detect overdispersion. (author)

  2. Dehydration treatment practices among pediatrics-trained and non-pediatrics trained emergency physicians.

    Science.gov (United States)

    Nunez, Jeranil; Liu, Deborah R; Nager, Alan L

    2012-04-01

    We sought to survey emergency physicians in the United States regarding the management of pediatric dehydration secondary to acute gastroenteritis. We hypothesized that responses from physicians with dedicated pediatric training (PT), that is, board certification in pediatrics or pediatric emergency medicine, would differ from responses of physicians with no dedicated pediatric training (non-PT). An anonymous survey was mailed to randomly selected members of the American College of Emergency Physicians and sent electronically to enrollees of Brown University pediatric emergency medicine listserv. The survey consisted of 17 multiple-choice questions based on a clinical scenario depicting a 2-year-old with acute gastroenteritis and moderate dehydration. Questions asked related to treatment preferences, practice setting, and training information. One thousand sixty-nine surveys were received: 997 surveys were used for data analysis, including 269 PT physicians and 721 non-PT physicians. Seventy-nine percent of PT physicians correctly classified the scenario patient as moderately dehydrated versus 71% of non-PT physicians (P = 0.063). Among those who correctly classified the patient, 121 PT physicians (58%) and 350 non-PT physicians (68%) would initially hydrate the patient with intravenous fluids. Pediatrics-trained physicians were more likely to initially choose oral or nasogastric hydration compared with non-PT physicians (P = 0.0127). Pediatrics-trained physicians were less likely to perform laboratory testing compared with the non-PT group (n = 92, 45%, vs n = 337, 66%; P dehydrated children, significantly more PT physicians, compared with non-PT physicians, follow established guidelines.

  3. Exploiting the information content of hydrological ''outliers'' for goodness-of-fit testing

    Directory of Open Access Journals (Sweden)

    F. Laio

    2010-10-01

    Full Text Available Validation of probabilistic models based on goodness-of-fit tests is an essential step for the frequency analysis of extreme events. The outcome of standard testing techniques, however, is mainly determined by the behavior of the hypothetical model, FX(x, in the central part of the distribution, while the behavior in the tails of the distribution, which is indeed very relevant in hydrological applications, is relatively unimportant for the results of the tests. The maximum-value test, originally proposed as a technique for outlier detection, is a suitable, but seldom applied, technique that addresses this problem. The test is specifically targeted to verify if the maximum (or minimum values in the sample are consistent with the hypothesis that the distribution FX(x is the real parent distribution. The application of this test is hindered by the fact that the critical values for the test should be numerically obtained when the parameters of FX(x are estimated on the same sample used for verification, which is the standard situation in hydrological applications. We propose here a simple, analytically explicit, technique to suitably account for this effect, based on the application of censored L-moments estimators of the parameters. We demonstrate, with an application that uses artificially generated samples, the superiority of this modified maximum-value test with respect to the standard version of the test. We also show that the test has comparable or larger power with respect to other goodness-of-fit tests (e.g., chi-squared test, Anderson-Darling test, Fung and Paul test, in particular when dealing with small samples (sample size lower than 20–25 and when the parent distribution is similar to the distribution being tested.

  4. Statistical alignment: computational properties, homology testing and goodness-of-fit

    DEFF Research Database (Denmark)

    Hein, J; Wiuf, Carsten; Møller, Martin

    2000-01-01

    The model of insertions and deletions in biological sequences, first formulated by Thorne, Kishino, and Felsenstein in 1991 (the TKF91 model), provides a basis for performing alignment within a statistical framework. Here we investigate this model.Firstly, we show how to accelerate the statistical...... alignment algorithms several orders of magnitude. The main innovations are to confine likelihood calculations to a band close to the similarity based alignment, to get good initial guesses of the evolutionary parameters and to apply an efficient numerical optimisation algorithm for finding the maximum...... analysis.Secondly, we propose a new homology test based on this model, where homology means that an ancestor to a sequence pair can be found finitely far back in time. This test has statistical advantages relative to the traditional shuffle test for proteins.Finally, we describe a goodness-of-fit test...

  5. A Special Pre-Service-Inspection Using Radiographic Testing(RT) for Brazing Fitting used in Aircraft Hydraulic System

    International Nuclear Information System (INIS)

    Kim, Gyu Ho

    2010-01-01

    Brazing fitting which is one of the aircraft hydraulic power system components is widely used for saving weight and achieving higher reliability. Any inherent defects or damage of fitting can cause system failure and/or physical damage of human body due to highly pressurized fluid. Radiographic testing(RT) technique and additional micro-structure investigation on cut-away surfaces have been accomplished to find out some defect-like-inhomogeneity in the fittings. The radiography results showed that some defect-like-inhomogeneity existed inside body. Additional micro-structure investigation on cut-away surface reveals that the inhomogeneity is due to internal voids. In this study, it can be is said that RT technique can be a useful tool for field acceptance test of hydraulic brazing fitting in short time

  6. Reliable Prediction of Insulin Resistance by a School-Based Fitness Test in Middle-School Children

    Directory of Open Access Journals (Sweden)

    Todd Varness

    2009-01-01

    Full Text Available Objectives. (1 Determine the predictive value of a school-based test of cardiovascular fitness (CVF for insulin resistance (IR; (2 compare a “school-based” prediction of IR to a “laboratory-based” prediction, using various measures of fitness and body composition. Methods. Middle school children (n=82 performed the Progressive Aerobic Cardiovascular Endurance Run (PACER, a school-based CVF test, and underwent evaluation of maximal oxygen consumption treadmill testing (VO2 max, body composition (percent body fat and BMI z score, and IR (derived homeostasis model assessment index [HOMAIR]. Results. PACER showed a strong correlation with VO2 max/kg (rs = 0.83, P<.001 and with HOMAIR (rs = −0.60, P<.001. Multivariate regression analysis revealed that a school-based model (using PACER and BMI z score predicted IR similar to a laboratory-based model (using VO2 max/kg of lean body mass and percent body fat. Conclusions. The PACER is a valid school-based test of CVF, is predictive of IR, and has a similar relationship to IR when compared to complex laboratory-based testing. Simple school-based measures of childhood fitness (PACER and fatness (BMI z score could be used to identify childhood risk for IR and evaluate interventions.

  7. Comparison of Physical Fitness Parameters with EUROFIT Test Battery of Male Adolescent Soccer Players and Sedentary Counterparts

    Directory of Open Access Journals (Sweden)

    Özgür ERİKOĞLU

    2015-09-01

    Full Text Available The aim of this study was to compare physical fitness parameters of male adolescent soccer players and sedentary counterparts. A total of 26 male adolescents participated in this study voluntarily: Active soccer players (n: 3, age x : 13,00 ± 0,00 and sedentary counterparts (n: 13, age x :12,92 ± 0,75. The EUROFIT test battery was used to determine physical fitness. The test battery includes body height and weight measurements, touching the discs, flamingo balan ce, throwing health ball, vertical jumping, sit and reach, sit - up for 30 s, 20 meter sprint run, and 20 meter shuttle run tests. Data were analyzed by Mann Whitney U test. Significance was defined as p.05. In conclusion, children who do sports are more successful on most of the fitness parameters than sedentary children.

  8. Physical Fitness Assessment.

    Science.gov (United States)

    Valdes, Alice

    This document presents baseline data on physical fitness that provides an outline for assessing the physical fitness of students. It consists of 4 tasks and a 13-item questionnaire on fitness-related behaviors. The fitness test evaluates cardiorespiratory endurance by a steady state jog; muscular strength and endurance with a two-minute bent-knee…

  9. Pediatric Oculomotor Findings during Monocular Videonystagmography: A Developmental Study.

    Science.gov (United States)

    Doettl, Steven M; Plyler, Patrick N; McCaslin, Devin L; Schay, Nancy L

    2015-09-01

    The differential diagnosis of a dizzy patient >4 yrs old is often aided by videonystagmography (VNG) testing to provide a global assessment of peripheral and central vestibular function. Although the value of a VNG evaluation is well-established, it remains unclear if the VNG test battery is as applicable to the pediatric population as it is for adults. Oculomotor testing specifically, as opposed to spontaneous, positional, and caloric testing, is dependent upon neurologic function. Thus, age and corresponding neuromaturation may have a significant effect on oculomotor findings. The purpose of this investigation was to describe the effect of age on various tests of oculomotor function during a monocular VNG examination. Specifically, this study systematically characterized the impact of age on saccade tracking, smooth pursuit tracking, and optokinetic (OPK) nystagmus. The present study used a prospective, repeated measures design. A total of 62 healthy participants were evaluated. Group 1 consisted of 29 4- to 6-yr-olds. Group 2 consisted of 33 21- to 44-yr-olds. Each participant completed a standard VNG oculomotor test battery including saccades, smooth pursuit, and OPK testing in randomized order using a commercially available system. The response metrics saccade latency, accuracy, and speed, smooth pursuit gain, OPK nystagmus gain, speed and asymmetry ratios were collected and analyzed. Significant differences were noted between groups for saccade latency, smooth pursuit gain, and OPK asymmetry ratios. Saccade latency was significantly longer for the pediatric participants compared to the adult participants. Smooth pursuit gain was significantly less for the pediatric participants compared to the adult participants. The pediatric participants also demonstrated increased OPK asymmetry ratios compared to the adult participants. Significant differences were noted between the pediatric and adult participants for saccade latency, smooth pursuit gain, and OPK

  10. Implementing a pediatric pharmacy educational program for health-system pharmacists.

    Science.gov (United States)

    Meyers, Rachel S; Costello-Curtin, Jennifer

    2011-12-15

    To implement an educational program to improve pediatric content knowledge and confidence in providing pediatric care among health-system pharmacists. Pharmacists were asked to voluntarily participate in this prospective, observational education program. A demographic assessment, pre- and post-intervention confidence assessments, and pre- and post-lecture competency assessments were conducted to evaluate the program. Five of the 6 confidence scores improved from the preintervention to the postintervention stage. Test scores for 2 of the 8 postlecture tests improved significantly, and the average test scores for all postlecture tests combined were significantly higher than those for the prelecture tests. This study demonstrated significant improvements in both confidence and competence in pediatric pharmacotherapy among health-system pharmacists following implementation of a pediatric pharmacy education program.

  11. Reliability of fitness tests using methods and time periods common in sport and occupational management.

    Science.gov (United States)

    Burnstein, Bryan D; Steele, Russell J; Shrier, Ian

    2011-01-01

    Fitness testing is used frequently in many areas of physical activity, but the reliability of these measurements under real-world, practical conditions is unknown. To evaluate the reliability of specific fitness tests using the methods and time periods used in the context of real-world sport and occupational management. Cohort study. Eighteen different Cirque du Soleil shows. Cirque du Soleil physical performers who completed 4 consecutive tests (6-month intervals) and were free of injury or illness at each session (n = 238 of 701 physical performers). Performers completed 6 fitness tests on each assessment date: dynamic balance, Harvard step test, handgrip, vertical jump, pull-ups, and 60-second jump test. We calculated the intraclass coefficient (ICC) and limits of agreement between baseline and each time point and the ICC over all 4 time points combined. Reliability was acceptable (ICC > 0.6) over an 18-month time period for all pairwise comparisons and all time points together for the handgrip, vertical jump, and pull-up assessments. The Harvard step test and 60-second jump test had poor reliability (ICC < 0.6) between baseline and other time points. When we excluded the baseline data and calculated the ICC for 6-month, 12-month, and 18-month time points, both the Harvard step test and 60-second jump test demonstrated acceptable reliability. Dynamic balance was unreliable in all contexts. Limit-of-agreement analysis demonstrated considerable intraindividual variability for some tests and a learning effect by administrators on others. Five of the 6 tests in this battery had acceptable reliability over an 18-month time frame, but the values for certain individuals may vary considerably from time to time for some tests. Specific tests may require a learning period for administrators.

  12. On the optimal number of classes in the Pearson goodness-of-fit tests

    Czech Academy of Sciences Publication Activity Database

    Morales, D.; Pardo, L.; Vajda, Igor

    2005-01-01

    Roč. 41, č. 6 (2005), s. 677-698 ISSN 0023-5954 R&D Projects: GA AV ČR(CZ) IAA1075403 Grant - others:BFM(ES) 2003-00892; GV(ES) 04B-670 Institutional research plan: CEZ:AV0Z10750506 Keywords : pearson-type goodness -of- fit test s * asymptotic local test power * asymptotic equivalence of test s * optimal number of classes Subject RIV: BB - Applied Statistics, Operational Research Impact factor: 0.343, year: 2005

  13. Relationships Among Two Repeated Activity Tests and Aerobic Fitness of Volleyball Players.

    Science.gov (United States)

    Meckel, Yoav; May-Rom, Moran; Ekshtien, Aya; Eisenstein, Tamir; Nemet, Dan; Eliakim, Alon

    2015-08-01

    The purpose of the study was to determine performance indices of a repeated sprint test (RST) and to examine their relationships with performance indices of a repeated jump test (RJT) and with aerobic fitness among trained volleyball players. Sixteen male volleyball players performed RST (6 × 30 m sprints), RJT (6 sets of 6 consecutive jumps), and an aerobic power test (20-m Shuttle Run Test). Performance indices for the RST and the RJT were (a) the ideal 30-m run time (IS), the total run time (TS) of the 6 sprints, and the performance decrement (PD) during the test and (b) the ideal jump height (IJ), the total jump height (TJ) of all the jumps, and the PD during the test, respectively. No significant correlations were found between performance indices of the RST and RJT. Significant correlations were found between PD, IS, and TS in the RST protocol and predicted peak V[Combining Dot Above]O2 (r = -0.60, -0.75, -0.77, respectively). No significant correlations were found between performance indices of the RJT (IJ, TJ, and PD) and peak V[Combining Dot Above]O2. The findings suggest that a selection of repeated activity test protocols should acknowledge the specific technique used in the sport, and that a distinct RJT, rather than the classic RST, is more appropriate for assessing the anaerobic capabilities of volleyball players. The findings also suggest that aerobic fitness plays only a minor role in performance maintenance throughout characteristic repeated jumping activity of a volleyball game.

  14. Tests of α{sub s} running from QCD fits to collider data

    Energy Technology Data Exchange (ETDEWEB)

    Kuprash, Oleg; Geiser, Achim [Deutsches Elektronen-Synchrotron DESY, Hamburg (Germany); Hamburg University, Institute of Experimental Physics, Hamburg (Germany)

    2015-07-01

    The running of the strong coupling constant, α{sub s}(μ), is tested in a QCD analysis using jet measurements at LHC, Tevatron and HERA in combination with inclusive DIS data. Here μ is associated with the energy scale in the process, typically with the jet transverse energy. For the α{sub s} running test, the parameter n{sub f} of the running, which gives the number of active quarks contributing to loop corrections of the jet and DIS cross sections, is replaced by n{sub f} + Δn{sub f} at energy scales greater than μ > μ{sub thresh}. A series of simultaneous α{sub s}(M{sub Z}) + Δn{sub f} + proton PDF fits to world collider cross section data is done at Next-to-Leading Order QCD, for μ{sub thresh} values ranging from 1 GeV to 1 TeV. The fitted Δn{sub f} is consistent with zero at all tested scales, which gives a precise quantitative confirmation of the QCD running of α{sub s} over 3 orders of magnitude in energy scale. The presented study also provides a new way for indirect searches of the physics beyond the Standard Model.

  15. Testing Usability and Acceptability of a Web Application to Promote Physical Activity (iCanFit) Among Older Adults

    Science.gov (United States)

    Goldberg, Daniel; Dahlke, Deborah Vollmer; Ory, Marcia G; Cargill, Jessica S; Coughlin, Rachel; Hernandez, Edgar; Kellstedt, Debra K; Peres, S Camille

    2014-01-01

    Background Most older Americans do not exercise regularly and many have chronic conditions. Among an increasing number of fitness mobile and Web apps, few are designed for older adults with chronic conditions despite high ownership rates of mobile tools and Internet access in this population. We designed a mobile-enabled Web app, iCanFit, to promote physical activity in this population. Objective This study aimed to test the usability and acceptability of iCanFit among older adults in a community setting. Methods A total of 33 older adults (aged 60 to 82 years) were recruited from communities to test iCanFit. Of these 33, 10 participants completed the usability testing in a computer room of a senior community center. A research assistant timed each Web application task and observed user navigation behavior using usability metrics. The other 23 participants used the website on their own devices at home and provided feedback after 2-3 weeks by completing a user-experience survey assessing ease of use, helpfulness, and satisfaction with iCanFit. Results Participants completed all 15 tasks on the iCanFit site in an average of 31 (SD 6.9) minutes; some tasks required more time or needed assistance. Participants’ comments were addressed to improve the site’s senior friendliness and ease of use. In the user-experience survey, participants reported high levels of usefulness and satisfaction. More than 56% (13/23) of participants indicated they would continue using the program and recommend it to their families or friends. Conclusions Testing usability and acceptability is a very important step in developing age-appropriate and user-friendly Web apps, especially for older adults. Testing usability and acceptability in a community setting can help reveal users’ experiences and feedback in a real-life setting. Our study suggested that older adults had a high degree of acceptance of iCanFit and could use it easily. The efficacy trial of iCanFit is currently underway

  16. Pediatric MS

    Science.gov (United States)

    ... Pediatric MS Share this page Facebook Twitter Email Pediatric MS Pediatric MS Pediatric MS Support Pediatric Providers ... system through the Pediatric MS Support Group . Treating pediatric MS In 2018 the U.S. Food and Drug ...

  17. Sport-specific fitness testing and intervention for an adolescent with cerebral palsy: a case report.

    Science.gov (United States)

    Kenyon, Lisa K; Sleeper, Mark D; Tovin, Melissa M

    2010-01-01

    This case report describes the development, implementation, and outcomes of a fitness-related intervention program that addressed the sport-specific goals of an adolescent with cerebral palsy. The participant in this case was a 16-year-old African American male with spastic diplegia. The participant joined his high school wrestling team and asked to focus his physical therapy on interventions that would improve his wrestling performance. An examination was performed using the muscle power sprint test, the 10 x 5-m sprint test, strength tests, the 10-m shuttle run test, and the Gross Motor Function Measure. The intervention consisted of interval training, which focused on the demands of wrestling. Scores on all tests and measures were higher after the intervention. The outcomes of this case report seem to support the use of a fitness-related intervention program for addressing the sport-specific goals of an adolescent with cerebral palsy.

  18. Cochlear implants: 100 pediatric case conversions from the body worn to the nucleus esprit 22 ear level speech processor.

    Science.gov (United States)

    Dodd, M C; Nikolopoulos, T P; Totten, C; Cope, Y; O'Donoghue, G M

    2005-07-01

    To assess performance of Nucleus 22 mini system pediatric users converted from the Spectra 22 body-worn to the ESPrit 22 ear-level speech processor using aided thresholds and speech discrimination measures before and after the conversion. Spectra 22 body-worn speech processor users were chosen using preselection criteria (stable map, ability to report on the quality of the signal, no device problems). The subjects underwent tuning, map conversion, fitting of the ESPrit 22, and aided soundfield threshold and speech discrimination testing. The first 100 consecutive conversions are analyzed in this study. Fifty children (50%) were female, and 50 (50%) were male. The average age at implantation was 4.6 years (median 4.3 years, range 1.7 to 11 years). The average age of fitting the ear level speech processor was 11.1 years (median 11 years, range 6.2 to 18.2 years). Tertiary referral pediatric cochlear implant center in the United Kingdom. Of the 100 fittings attempted, all Spectra 22 maps could to be converted for use in the ESPrit 22. Of these 100 fittings, 44 were straightforward with no adjustment to map parameters being required, and 56 needed rate reductions and other map adjustments to achieve the conversion. The difference of the mean thresholds before and after the conversion did not exceed 2 dB across the frequencies studied (0.5-4 kHz). In 95% of the cases, the differences were less than 9 dB(A). With regard to speech discrimination testing, the mean threshold before the conversion was 53.4 dB and after the conversion 52.7 dB. Of the 100 conversions, only five children stopped using the ESPrit 22 despite fitting being achieved. Conversion from the Spectra 22 body worn to the ESPrit 22 ear level speech processor was found to be feasible in all the 100 cases studied. Only a minority (5%) of children chose not to use the ear level speech processor suggesting that children and parents were satisfied from the conversion.

  19. GOODNESS-OF-FIT TEST FOR THE ACCELERATED FAILURE TIME MODEL BASED ON MARTINGALE RESIDUALS

    Czech Academy of Sciences Publication Activity Database

    Novák, Petr

    2013-01-01

    Roč. 49, č. 1 (2013), s. 40-59 ISSN 0023-5954 R&D Projects: GA MŠk(CZ) 1M06047 Grant - others:GA MŠk(CZ) SVV 261315/2011 Keywords : accelerated failure time model * survival analysis * goodness-of-fit Subject RIV: BB - Applied Statistics, Operational Research Impact factor: 0.563, year: 2013 http://library.utia.cas.cz/separaty/2013/SI/novak-goodness-of-fit test for the aft model based on martingale residuals.pdf

  20. In vivo diagnostic nuclear medicine. Pediatric experience

    International Nuclear Information System (INIS)

    Goetz, W.A.; Hendee, W.R.; Gilday, D.L.

    1983-01-01

    The use of radiopharmaceuticals for diagnostic tests in children is increasing and interest in these is evidenced by the addition of scientific sessions devoted to pediatric medicine at annual meetings of The Society of Nuclear Medicine and by the increase in the literature on pediatric dosimetry. Data presented in this paper describe the actual pediatric nuclear medicine experience from 26 nationally representative U.S. hospitals and provide an overview of the pediatric procedures being performed the types of radiopharmaceuticals being used, and the activity levels being administered

  1. The FORCE Fitness Profile--Adding a Measure of Health-Related Fitness to the Canadian Armed Forces Operational Fitness Evaluation.

    Science.gov (United States)

    Gagnon, Patrick; Spivock, Michael; Reilly, Tara; Mattie, Paige; Stockbrugger, Barry

    2015-11-01

    In 2013, the Canadian Armed Forces (CAF) implemented the Fitness for Operational Requirements of Canadian Armed Forces Employment (FORCE), a field expedient fitness test designed to predict the physical requirements of completing common military tasks. Given that attaining this minimal physical fitness standard may not represent a challenge to some personnel, a fitness incentive program was requested by the chain of command to recognize and reward fitness over and above the minimal standard. At the same time, it was determined that the CAF would benefit from a measure of general health-related fitness, in addition to this measure of operational fitness. The resulting incentive program structure is based on gender and 8 age categories. The results on the 4 elements of the FORCE evaluation were converted to a point scale from which normative scores were derived, where the median score corresponds to the bronze level, and silver, gold, and platinum correspond to a score which is 1, 2, and 3 SDs above this median, respectively. A suite of rewards including merit board point toward promotions and recognition on the uniform and material rewards was developed. A separate group rewards program was also tabled, to recognize achievements in fitness at the unit level. For general fitness, oxygen capacity was derived from FORCE evaluation results and combined with a measure of abdominal circumference. Fitness categories were determined based on relative risks of mortality and morbidity for each age and gender group. Pilot testing of this entire program was performed with 624 participants to assess participants' reactions to the enhanced test, and also to verify logistical aspects of the electronic data capture, calculation, and transfer system. The newly dubbed fitness profile program was subsequently approved by the senior leadership of the CAF and is scheduled to begin a phased implementation in June 2015.

  2. Measuring fitness of Kenyan children with polyparasitic infections using the 20-meter shuttle run test as a morbidity metric.

    Directory of Open Access Journals (Sweden)

    Amaya L Bustinduy

    2011-07-01

    Full Text Available To date, there has been no standardized approach to the assessment of aerobic fitness among children who harbor parasites. In quantifying the disability associated with individual or multiple chronic infections, accurate measures of physical fitness are important metrics. This is because exercise intolerance, as seen with anemia and many other chronic disorders, reflects the body's inability to maintain adequate oxygen supply (VO(2 max to the motor tissues, which is frequently linked to reduced quality-of-life in terms of physical and job performance. The objective of our study was to examine the associations between polyparasitism, anemia, and reduced fitness in a high risk Kenyan population using novel implementation of the 20-meter shuttle run test (20mSRT, a well-standardized, low-technology physical fitness test.Four villages in coastal Kenya were surveyed during 2009-2010. Children 5-18 years were tested for infection with Schistosoma haematobium (Sh, malaria, filaria, and geohelminth infections by standard methods. After anthropometric and hemoglobin testing, fitness was assessed with the 20 mSRT. The 20 mSRT proved easy to perform, requiring only minimal staff training. Parasitology revealed high prevalence of single and multiple parasitic infections in all villages, with Sh being the most common (25-62%. Anemia prevalence was 45-58%. Using multiply-adjusted linear modeling that accounted for household clustering, decreased aerobic capacity was significantly associated with anemia, stunting, and wasting, with some gender differences.The 20 mSRT, which has excellent correlation with VO(2, is a highly feasible fitness test for low-resource settings. Our results indicate impaired fitness is common in areas endemic for parasites, where, at least in part, low fitness scores are likely to result from anemia and stunting associated with chronic infection. The 20 mSRT should be used as a common metric to quantify physical fitness and compare sub

  3. Tests of fit of historically-informed models of African American Admixture.

    Science.gov (United States)

    Gross, Jessica M

    2018-02-01

    African American populations in the U.S. formed primarily by mating between Africans and Europeans over the last 500 years. To date, studies of admixture have focused on either a one-time admixture event or continuous input into the African American population from Europeans only. Our goal is to gain a better understanding of the admixture process by examining models that take into account (a) assortative mating by ancestry in the African American population, (b) continuous input from both Europeans and Africans, and (c) historically informed variation in the rate of African migration over time. We used a model-based clustering method to generate distributions of African ancestry in three samples comprised of 147 African Americans from two published sources. We used a log-likelihood method to examine the fit of four models to these distributions and used a log-likelihood ratio test to compare the relative fit of each model. The mean ancestry estimates for our datasets of 77% African/23% European to 83% African/17% European ancestry are consistent with previous studies. We find admixture models that incorporate continuous gene flow from Europeans fit significantly better than one-time event models, and that a model involving continuous gene flow from Africans and Europeans fits better than one with continuous gene flow from Europeans only for two samples. Importantly, models that involve continuous input from Africans necessitate a higher level of gene flow from Europeans than previously reported. We demonstrate that models that take into account information about the rate of African migration over the past 500 years fit observed patterns of African ancestry better than alternative models. Our approach will enrich our understanding of the admixture process in extant and past populations. © 2017 Wiley Periodicals, Inc.

  4. CLSI-based transference and verification of CALIPER pediatric reference intervals for 29 Ortho VITROS 5600 chemistry assays.

    Science.gov (United States)

    Higgins, Victoria; Truong, Dorothy; Woroch, Amy; Chan, Man Khun; Tahmasebi, Houman; Adeli, Khosrow

    2018-03-01

    Evidence-based reference intervals (RIs) are essential to accurately interpret pediatric laboratory test results. To fill gaps in pediatric RIs, the Canadian Laboratory Initiative on Pediatric Reference Intervals (CALIPER) project developed an age- and sex-specific pediatric RI database based on healthy pediatric subjects. Originally established for Abbott ARCHITECT assays, CALIPER RIs were transferred to assays on Beckman, Roche, Siemens, and Ortho analytical platforms. This study provides transferred reference intervals for 29 biochemical assays for the Ortho VITROS 5600 Chemistry System (Ortho). Based on Clinical Laboratory Standards Institute (CLSI) guidelines, a method comparison analysis was performed by measuring approximately 200 patient serum samples using Abbott and Ortho assays. The equation of the line of best fit was calculated and the appropriateness of the linear model was assessed. This equation was used to transfer RIs from Abbott to Ortho assays. Transferred RIs were verified using 84 healthy pediatric serum samples from the CALIPER cohort. RIs for most chemistry analytes successfully transferred from Abbott to Ortho assays. Calcium and CO 2 did not meet statistical criteria for transference (r 2 reference intervals, 29 successfully verified with approximately 90% of results from reference samples falling within transferred confidence limits. Transferred RIs for total bilirubin, magnesium, and LDH did not meet verification criteria and are not reported. This study broadens the utility of the CALIPER pediatric RI database to laboratories using Ortho VITROS 5600 biochemical assays. Clinical laboratories should verify CALIPER reference intervals for their specific analytical platform and local population as recommended by CLSI. Copyright © 2018 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  5. A 45-second self-test for cardiorespiratory fitness: heart rate-based estimation in healthy individuals

    NARCIS (Netherlands)

    Sartor, F.; Bonato, M.; Papini, G.; Bosio, A.; Mohammed, R.; Bonomi, A.G.; Moore, J.P.; Merati, G.; Della Torre, A.; Kubis, H.P.

    2016-01-01

    Cardio-respiratory fitness (CRF) is a widespread essential indicator in Sports Science as well as in Sports Medicine. This study aimed to develop and validate a prediction model for CRF based on a 45 second self-test, which can be conducted anywhere. Criterion validity, test re-test study was set up

  6. Methodology review: evaluating person fit

    NARCIS (Netherlands)

    Meijer, R.R.; Sijtsma, Klaas

    2001-01-01

    Person-fit methods based on classical test theory-and item response theory (IRT), and methods investigating particular types of response behavior on tests, are examined. Similarities and differences among person-fit methods and their advantages and disadvantages are discussed. Sound person-fit

  7. Upstairs downstairs: vertical integration of a pediatric service.

    Science.gov (United States)

    Racine, A D; Stein, R E; Belamarich, P F; Levine, E; Okun, A; Porder, K; Rosenfeld, J L; Schechter, M

    1998-07-01

    The combined effects of recent changes in health care financing and training priorities have compelled academic medical centers to develop innovative structures to maintain service commitments yet conform to health care marketplace demands. In 1992, a municipal hospital in the Bronx, New York, affiliated with a major academic medical center reorganized its pediatric service into a vertically integrated system of four interdependent practice teams that provided comprehensive care in the ambulatory as well as inpatient settings. One of the goals of the new system was to conserve inpatient resources. To describe the development of a new vertically integrated pediatric service at an inner-city municipal hospital and to test whether its adoption was associated with the use of fewer inpatient resources. A descriptive analysis of the rationale, goals, implementation strategies, and structure of the vertically integrated pediatric service combined with a before-and-after comparison of in-hospital resource consumption. A before-and-after comparison was conducted for two periods: the period before vertical integration, from January 1989 to December 1991, and the period after the adoption of vertical integration, from July 1992 to December 1994. Four measures of inpatient resource use were compared after adjustment for case mix index: mean certified length of stay per case, mean number of radiologic tests per case, mean number of ancillary tests per case, and mean number of laboratory tests per case. Difference-in-differences-in-differences estimators were used to control for institution-wide trends throughout the time period and regional trends in inpatient pediatric practice occurring across institutions. Results. In 1992, the Department of Pediatrics at the Albert Einstein College of Medicine reorganized the pediatric service at Jacobi Medical Center, one of its principal municipal hospital affiliates, into a vertically integrated pediatric service that combines ambulatory

  8. Automated ligand fitting by core-fragment fitting and extension into density

    International Nuclear Information System (INIS)

    Terwilliger, Thomas C.; Klei, Herbert; Adams, Paul D.; Moriarty, Nigel W.; Cohn, Judith D.

    2006-01-01

    An automated ligand-fitting procedure has been developed and tested on 9327 ligands and (F o − F c )exp(iϕ c ) difference density from macromolecular structures in the Protein Data Bank. A procedure for fitting of ligands to electron-density maps by first fitting a core fragment of the ligand to density and then extending the remainder of the ligand into density is presented. The approach was tested by fitting 9327 ligands over a wide range of resolutions (most are in the range 0.8-4.8 Å) from the Protein Data Bank (PDB) into (F o − F c )exp(iϕ c ) difference density calculated using entries from the PDB without these ligands. The procedure was able to place 58% of these 9327 ligands within 2 Å (r.m.s.d.) of the coordinates of the atoms in the original PDB entry for that ligand. The success of the fitting procedure was relatively insensitive to the size of the ligand in the range 10–100 non-H atoms and was only moderately sensitive to resolution, with the percentage of ligands placed near the coordinates of the original PDB entry for fits in the range 58–73% over all resolution ranges tested

  9. Total artificial heart in the pediatric patient with biventricular heart failure.

    Science.gov (United States)

    Park, S S; Sanders, D B; Smith, B P; Ryan, J; Plasencia, J; Osborn, M B; Wellnitz, C M; Southard, R N; Pierce, C N; Arabia, F A; Lane, J; Frakes, D; Velez, D A; Pophal, S G; Nigro, J J

    2014-01-01

    Mechanical circulatory support emerged for the pediatric population in the late 1980s as a bridge to cardiac transplantation. The Total Artificial Heart (TAH-t) (SynCardia Systems Inc., Tuscon, AZ) has been approved for compassionate use by the Food and Drug Administration for patients with end-stage biventricular heart failure as a bridge to heart transplantation since 1985 and has had FDA approval since 2004. However, of the 1,061 patients placed on the TAH-t, only 21 (2%) were under the age 18. SynCardia Systems, Inc. recommends a minimum patient body surface area (BSA) of 1.7 m(2), thus, limiting pediatric application of this device. This unique case report shares this pediatric institution's first experience with the TAH-t. A 14-year-old male was admitted with dilated cardiomyopathy and severe biventricular heart failure. The patient rapidly decompensated, requiring extracorporeal life support. An echocardiogram revealed severe biventricular dysfunction and diffuse clot formation in the left ventricle and outflow tract. The decision was made to transition to biventricular assist device. The biventricular failure and clot formation helped guide the team to the TAH-t, in spite of a BSA (1.5 m(2)) below the recommendation of 1.7 m(2). A computed tomography (CT) scan of the thorax, in conjunction with a novel three-dimensional (3D) modeling system and team, assisted in determining appropriate fit. Chest CT and 3D modeling following implantation were utilized to determine all major vascular structures were unobstructed and the bronchi were open. The virtual 3D model confirmed appropriate device fit with no evidence of compression to the left pulmonary veins. The postoperative course was complicated by a left lung opacification. The left lung anomalies proved to be atelectasis and improved with aggressive recruitment maneuvers. The patient was supported for 11 days prior to transplantation. Chest CT and 3D modeling were crucial in assessing whether the device would

  10. Measuring fit of sequence data to phylogenetic model: gain of power using marginal tests.

    Science.gov (United States)

    Waddell, Peter J; Ota, Rissa; Penny, David

    2009-10-01

    Testing fit of data to model is fundamentally important to any science, but publications in the field of phylogenetics rarely do this. Such analyses discard fundamental aspects of science as prescribed by Karl Popper. Indeed, not without cause, Popper (Unended quest: an intellectual autobiography. Fontana, London, 1976) once argued that evolutionary biology was unscientific as its hypotheses were untestable. Here we trace developments in assessing fit from Penny et al. (Nature 297:197-200, 1982) to the present. We compare the general log-likelihood ratio (the G or G (2) statistic) statistic between the evolutionary tree model and the multinomial model with that of marginalized tests applied to an alignment (using placental mammal coding sequence data). It is seen that the most general test does not reject the fit of data to model (P approximately 0.5), but the marginalized tests do. Tests on pairwise frequency (F) matrices, strongly (P < 0.001) reject the most general phylogenetic (GTR) models commonly in use. It is also clear (P < 0.01) that the sequences are not stationary in their nucleotide composition. Deviations from stationarity and homogeneity seem to be unevenly distributed amongst taxa; not necessarily those expected from examining other regions of the genome. By marginalizing the 4( t ) patterns of the i.i.d. model to observed and expected parsimony counts, that is, from constant sites, to singletons, to parsimony informative characters of a minimum possible length, then the likelihood ratio test regains power, and it too rejects the evolutionary model with P < 0.001. Given such behavior over relatively recent evolutionary time, readers in general should maintain a healthy skepticism of results, as the scale of the systematic errors in published trees may really be far larger than the analytical methods (e.g., bootstrap) report.

  11. Eating disorder examination: Factor structure and norms in a clinical female pediatric eating disorder sample.

    Science.gov (United States)

    O'Brien, Amy; Watson, Hunna J; Hoiles, Kimberley J; Egan, Sarah J; Anderson, Rebecca A; Hamilton, Matthew J; Shu, Chloe; McCormack, Julie

    2016-01-01

    The factor structure of the eating disorder examination (EDE) has never been tested in a clinical pediatric sample, and no normative data exist. The factor structure of an adapted EDE was examined in a clinical sample of 665 females aged 9-17 years with anorexia nervosa spectrum (70%), bulimia nervosa spectrum (12%), purging disorder (3%), and unspecified feeding and eating disorders (15%). The original four-factor model was a good fit in a confirmatory factor analysis as well a higher order model with three dimensions of restraint, eating concern, and combined weight concern/shape concern. Normative data are reported for clinicians to identify the percentiles in which their patients' score. The findings support dimensions of restraint, eating concern, weight concern, and shape concern in a clinical pediatric sample. This supports the factorial validity of the EDE, and the norms may assist clinicians to evaluate symptoms in females under 18 years. © 2015 Wiley Periodicals, Inc.

  12. Comparability of the Patient-Reported Outcomes Measurement Information System Pediatric short form symptom measures across culture: examination between Chinese and American children with cancer.

    Science.gov (United States)

    Liu, Yanyan; Yuan, Changrong; Wang, Jichuan; Brown, Jeanne Geiger; Zhou, Fen; Zhao, Xiufang; Shen, Min; Hinds, Pamela S

    2016-10-01

    Patient-Reported Outcomes Measurement Information System (PROMIS) Pediatric forms measure symptoms and function of pediatric patients experiencing chronic disease by using the same measures. Comparability is one of the most important purposes of the PROMIS initiative. This study aimed to test the factorial structures of four symptom measures (i.e., Anxiety, Depression, Fatigue, and Pain Interference) in the original English and the Chinese versions and examine the measurement invariance of the measures across two cultures. Four PROMIS Pediatric measures were used to assess symptoms, respectively, in Chinese (n = 232) and American (n = 200) children and adolescents (8-17 years old) in treatment for cancer or in survivorship. The categorical confirmatory factor analysis (CCFA) model was used to examine factorial structures, and multigroup CCFA was applied to test measurement invariance of these measures between the Chinese and American samples. The CCFA models of the four PROMIS Pediatric symptom measures fit the data well for both the Chinese and American children and adolescents. Minor partial measurement invariance was identified. Factor means and factor variances of the four PROMIS measures were not significantly different between the two populations. Our results provide evidence that the four PROMIS Pediatric symptom measures have valid factorial structures and a statistical property of measurement invariance across American and Chinese children and adolescents with cancer. This means that the items of these measures were interpreted in a conceptually similar manner by two groups. They could be readily used for meaningful cross-cultural comparisons involving pediatric oncology patients in these two countries.

  13. Feasibility and Reliability of Tests Measuring Health-Related Physical Fitness in Children with Moderate to Severe Levels of Intellectual Disability

    Science.gov (United States)

    Wouters, Marieke; van der Zanden, Anna M.; Evenhuis, Heleen M.; Hilgenkamp, Thessa I. M.

    2017-01-01

    Physical fitness is an important marker for health. In this study we investigated the feasibility and reliability of health-related physical fitness tests in children with moderate to severe levels of intellectual disability. Thirty-nine children (2-18 yrs) performed tests for muscular strength and endurance, the modified 6-minute walk test (6mwt)…

  14. Variability in performance on a work simulation test of physical fitness for firefighters.

    Science.gov (United States)

    Boyd, Liam; Rogers, Todd; Docherty, David; Petersen, Stewart

    2015-04-01

    The Canadian Forces Firefighter Physical Fitness Maintenance Evaluation (FF PFME) requires firefighters in full fire-protective ensemble, including self-contained breathing apparatus, to correctly complete 10 work-related tasks on a measured and calibrated course. Fitness for duty is inferred from completion time of the course. We hypothesized that completion time may be dependent on pacing strategy and day-to-day fluctuations in biological function. To examine variability in performance, 20 females and 31 males (mean ± SD; age, 27.6 ± 10.5 years; height, 176.7 ± 8.3 cm; mass, 77.3 ± 13.4 kg) were familiarized with the FF PFME and then completed the test on 6 separate days. Pre-test behaviours (e.g., sleep, diet) and test conditions (e.g., calibration, time of day) were consistent. Repeated-measures ANOVA revealed a significant decrease in completion time between tests 1 and 6 (18.7%) and between all sequential pairs (e.g., tests 1 and 2). There was also a small but significant increase in the fraction of total test time for task completion and a corresponding decrease in the time to transition between tasks. The performance improvements cannot be explained by differences in effort (heart rate and perceived exertion). Coefficient of variation for tests 1, 2, and 3 was 7% and for tests 4, 5, and 6 was 2.6%. The results indicate the importance of practice on performance and the potential for false-positive or false-negative decision errors if biological variability is not taken into account.

  15. Assessing child belt fit, volume II : effect of restraint configuration, booster seat designs, seating procedure, and belt fit on the dynamic response of the hybrid III 10-year-old ATD in sled tests.

    Science.gov (United States)

    2008-09-01

    A total of 49 dynamic sled tests were performed with the Hybrid III 10YO to examine issues relating to child belt fit. The goals of these tests were to evaluate ATD response to realistic belt geometries and belt fit, develop methods for accurate, rep...

  16. A Sport Education Fitness Season's Impact on Students' Fitness Levels, Knowledge, and In-Class Physical Activity.

    Science.gov (United States)

    Ward, Jeffery Kurt; Hastie, Peter A; Wadsworth, Danielle D; Foote, Shelby; Brock, Sheri J; Hollett, Nikki

    2017-09-01

    The purpose of this study was to determine the extent to which a sport education season of fitness could provide students with recommended levels of in-class moderate-to-vigorous physical activity (MVPA) while also increasing students' fitness knowledge and fitness achievement. One hundred and sixty-six 5th-grade students (76 boys, 90 girls) participated in a 20-lesson season called "CrossFit Challenge" during a 4-week period. The Progressive Aerobic Cardiovascular Endurance Run, push-ups, and curl-ups tests of the FITNESSGRAM® were used to assess fitness at pretest and posttest, while fitness knowledge was assessed through a validated, grade-appropriate test of health-related fitness knowledge (HRF). Physical activity was measured with Actigraph GT3X triaxial accelerometers. Results indicated a significant time effect for all fitness tests and the knowledge test. Across the entire season, the students spent an average of 54.5% of lesson time engaged in MVPA, irrespective of the type of lesson (instruction, free practice, or competition). The results suggest that configuring the key principles of sport education within a unit of fitness is an efficient model for providing students with the opportunity to improve fitness skill and HRF knowledge while attaining recommended levels of MVPA.

  17. Design of a sentence identification test with pictures (TIS-F based on the pediatric speech intelligibility test

    Directory of Open Access Journals (Sweden)

    Fernanda Freitas Vellozo

    Full Text Available ABSTRACT Purposes: to design a sentence identification test with pictures for adults (Teste de Identificação de Sentenças com Figuras (TIS-F as an alternative for evaluation of auditory figure-background ability for verbal sounds, based on the Pediatric Speech Intelligibility Test and also for assessment of unskillful individuals who cannot accomplish other tests with higher levels of difficulty and greater demands. Methods: the Adobe Illustrator software was used and the image vectorization technique applied for figures creation. The sentences and the competitive message were audio-recorded in a sound treated room by a female announcer, using the software - REAPER - FM Digital Audio Workstation. Results: the TIS-F consisted of a 32 x 45 cm card, containing 10 figures, each one measuring 12 x 12 cm; one compact disc containing a track with the test calibration tone and seven test tracks, each one containing ten sentences and a competitive message and a specific protocol. Conclusion: the TIS-F is composed of a compact disc with dual-channel recording, with seven tracks containing ten sentences and the competitive story, one card containing ten pictures and a labeling protocol for all presentations and S/N in use, as well as the established normality values.

  18. A Rigorous Test of the Fit of the Circumplex Model to Big Five Personality Data: Theoretical and Methodological Issues and Two Large Sample Empirical Tests.

    Science.gov (United States)

    DeGeest, David Scott; Schmidt, Frank

    2015-01-01

    Our objective was to apply the rigorous test developed by Browne (1992) to determine whether the circumplex model fits Big Five personality data. This test has yet to be applied to personality data. Another objective was to determine whether blended items explained correlations among the Big Five traits. We used two working adult samples, the Eugene-Springfield Community Sample and the Professional Worker Career Experience Survey. Fit to the circumplex was tested via Browne's (1992) procedure. Circumplexes were graphed to identify items with loadings on multiple traits (blended items), and to determine whether removing these items changed five-factor model (FFM) trait intercorrelations. In both samples, the circumplex structure fit the FFM traits well. Each sample had items with dual-factor loadings (8 items in the first sample, 21 in the second). Removing blended items had little effect on construct-level intercorrelations among FFM traits. We conclude that rigorous tests show that the fit of personality data to the circumplex model is good. This finding means the circumplex model is competitive with the factor model in understanding the organization of personality traits. The circumplex structure also provides a theoretically and empirically sound rationale for evaluating intercorrelations among FFM traits. Even after eliminating blended items, FFM personality traits remained correlated.

  19. Adaptive Test Selection for Factorization-based Surrogate Fitness in Genetic Programming

    Directory of Open Access Journals (Sweden)

    Krawiec Krzysztof

    2017-12-01

    Full Text Available Genetic programming (GP is a variant of evolutionary algorithm where the entities undergoing simulated evolution are computer programs. A fitness function in GP is usually based on a set of tests, each of which defines the desired output a correct program should return for an exemplary input. The outcomes of interactions between programs and tests in GP can be represented as an interaction matrix, with rows corresponding to programs in the current population and columns corresponding to tests. In previous work, we proposed SFIMX, a method that performs only a fraction of interactions and employs non-negative matrix factorization to estimate the outcomes of remaining ones, shortening GP’s runtime. In this paper, we build upon that work and propose three extensions of SFIMX, in which the subset of tests drawn to perform interactions is selected with respect to test difficulty. The conducted experiment indicates that the proposed extensions surpass the original SFIMX on a suite of discrete GP benchmarks.

  20. Feasibility of a pre-implantation fitting test for an implantable hearing aid using a VR (virtual reality) software

    International Nuclear Information System (INIS)

    Dammann, F.; Bode, A.; Heuschmid, M.; Schwaderer, E.; Schaich, M.; Seemann, M.; Claussen, C.D.; Maassen, M.; Zenner, H.P.

    2001-01-01

    Purpose: To prove the feasibility of a preoperative fitting test for an implantable hearing aid using a VR environment. Methods: A high-resolution spiral CT was performed after mastoidectomy in 10 temporal bone specimens. The bony structures were segmented and merged with the computer-aided design (CAD) data of the hearing aid in a VR environment. For each specimen a three-dimensional fitting test was carried out by three examiners determining the implantability of the hearing aid. The implantation simulation was compared with the real implantation procedure performed by an experienced ENT surgeon. Results: The used VR system enabled real-time 3D-visualisation and manipulation of CT- and CAD-data. All objects could be independently moved in all three dimensions. The VR fitting test corresponded closely with the real implantation. The implantability of the hearing aid was properly predicted by all three examiners. Conclusion: Merging CT and CAD data in a virtual reality environment bears high potential for the presurgical determination of the fit and mountability of medical implants in complex anatomical regions. (orig.) [de

  1. Physical Activity Self-Efficacy and Fitness: Family Environment Relationship Correlates and Self-Esteem as a Mediator among Adolescents Who Are Overweight or Obese.

    Science.gov (United States)

    Nock, Nora L; Ievers-Landis, Carolyn E; Dajani, Rachel; Knight, Darryl; Rigda, Alexander; Narasimhan, Sumana; Uli, Naveen

    2016-10-01

    Little is known regarding how dimensions of the family social environment relate to fitness levels and physical activity self-efficacy (PASE) among adolescents who are overweight or obese and whether these relationships are mediated by self-esteem. Potential associations were evaluated between relationship subdomains (cohesion, conflict, expressivity) of the Family Environment Scale (FES), self-esteem (Rosenberg Self-Esteem Scale, RSES), and PASE and fitness, using recovery heart rate [RHR, beats per minute (bpm)] from a 3-minute submaximal step test at baseline. Participants were 108 adolescents who were overweight or obese and were seeking weight-loss treatment as part of the Healthy Kids, Healthy Weight 12-week multidisciplinary pediatric weight management program. Structural equation modeling (SEM) was used to simultaneously evaluate paths between these variables and test for mediation. In multivariable models, higher FES cohesion (β = -2.18, s.e. = 0.98; p = 0.02), expressivity (β = -1.97, s.e. = 0.99; p self-esteem, PASE, and physical fitness in adolescents who are overweight or obese.

  2. Between-Day Reliability and Usefulness of a Fitness Testing Battery in Youth Sport Athletes: Reference Data for Practitioners

    Science.gov (United States)

    Sawczuk, Thomas; Jones, Ben; Scantlebury, Sean; Weakley, Jonathan; Read, Dale; Costello, Nessan; Darrall-Jones, Joshua David; Stokes, Keith; Till, Kevin

    2018-01-01

    This study aimed to evaluate the between-day reliability and usefulness of a fitness testing battery in a group of youth sport athletes. Fifty-nine youth sport athletes (age = 17.3 ± 0.7 years) undertook a fitness testing battery including the isometric mid-thigh pull, counter-movement jump, 5-40 m sprint splits, and the 5-0-5 change of direction…

  3. Piecewise Polynomial Fitting with Trend Item Removal and Its Application in a Cab Vibration Test

    Directory of Open Access Journals (Sweden)

    Wu Ren

    2018-01-01

    Full Text Available The trend item of a long-term vibration signal is difficult to remove. This paper proposes a piecewise integration method to remove trend items. Examples of direct integration without trend item removal, global integration after piecewise polynomial fitting with trend item removal, and direct integration after piecewise polynomial fitting with trend item removal were simulated. The results showed that direct integration of the fitted piecewise polynomial provided greater acceleration and displacement precision than the other two integration methods. A vibration test was then performed on a special equipment cab. The results indicated that direct integration by piecewise polynomial fitting with trend item removal was highly consistent with the measured signal data. However, the direct integration method without trend item removal resulted in signal distortion. The proposed method can help with frequency domain analysis of vibration signals and modal parameter identification for such equipment.

  4. Virtual Pediatric Hospital

    Science.gov (United States)

    ... Thoracopaedia - An Imaging Encyclopedia of Pediatric Thoracic Disease Virtual Pediatric Hospital is the Apprentice's Assistant™ Last revised ... pediatric resources: GeneralPediatrics.com | PediatricEducation.org | SearchingPediatrics.com Virtual Pediatric Hospital is curated by Donna M. D' ...

  5. Urine testing and urinary tract infections in febrile infants seen in office settings: the Pediatric Research in Office Settings' Febrile Infant Study.

    Science.gov (United States)

    Newman, Thomas B; Bernzweig, Jane A; Takayama, John I; Finch, Stacia A; Wasserman, Richard C; Pantell, Robert H

    2002-01-01

    To determine the predictors and results of urine testing of young febrile infants seen in office settings. Prospective cohort study. Offices of 573 pediatric practitioners from 219 practices in the American Academy of Pediatrics Pediatric Research in Office Settings' research network. A total of 3066 infants 3 months or younger with temperatures of 38 degrees C or higher were evaluated and treated according to the judgment of their practitioners. Urine testing results, early and late urinary tract infections (UTIs), and UTIs with bacteremia. Fifty-four percent of the infants initially had urine tested, of whom 10% had a UTI. The height of the fever was associated with urine testing and a UTI among those tested (adjusted odds ratio per degree Celsius, 2.2 for both). Younger age, ill appearance, and lack of a fever source were associated with urine testing but not with a UTI, whereas lack of circumcision (adjusted odds ratio, 11.6), female sex (adjusted odds ratio, 5.4), and longer duration of fever (adjusted odds ratio, 1.8 for fever lasting > or = 24 hours) were not associated with urine testing but were associated with a UTI. Bacteremia accompanied the UTI in 10% of the patients, including 17% of those younger than 1 month. Among 807 infants not initially tested or treated with antibiotics, only 2 had a subsequent documented UTI; both did well. Practitioners order urine tests selectively, focusing on younger and more ill-appearing infants and on those without an apparent fever source. Such selective urine testing, with close follow-up, was associated with few late UTIs in this large study. Urine testing should focus particularly on uncircumcised boys, girls, the youngest and sickest infants, and those with persistent fever.

  6. Pediatric Specialists

    Science.gov (United States)

    ... Healthy Children > Family Life > Medical Home > Pediatric Specialists Pediatric Specialists Article Body ​Your pediatrician may refer your child to a pediatric specialist for further evaluation and treatment. Pediatric specialists ...

  7. Pharmacotherapy in the Management of Pediatric Obesity.

    Science.gov (United States)

    Kelly, Aaron S; Fox, Claudia K

    2017-08-01

    This review provides a rationale for the use of pharmacotherapy in pediatric weight management, summarizes results of some of the key pediatric clinical trials of approved and "off-label" obesity medications, introduces new options in the pediatric pipeline, and offers a glimpse into the future of pediatric obesity medicine. Despite the need for adjunctive treatments to enhance the outcomes of lifestyle modification therapy among youth with obesity, none of the obesity medications evaluated to date have been shown to meaningfully reduce BMI or cardiometabolic risk factors. Promising medications recently approved for the treatment of obesity in adults will soon be tested in pediatric trials, offering hope that new therapeutic options will soon be available. As new medications are approved to treat pediatric obesity, it will be important to evaluate the safety and efficacy of combination pharmacotherapy and investigate predictors of response. Application of precision medicine approaches to the field of pediatric obesity management will improve the long-term outlook for the tens of millions of youth afflicted with this serious and recalcitrant disease.

  8. Social cognition in pediatric-onset multiple sclerosis (MS).

    Science.gov (United States)

    Charvet, L E; Cleary, R E; Vazquez, K; Belman, A L; Krupp, L B

    2014-10-01

    Pediatric-onset multiple sclerosis (MS) patients represent a subpopulation who are diagnosed during the course of development. Social cognitive deficits have recently been recognized in adults with MS. It is critical to identify whether these youngest patients with the disorder are also at risk. To determine whether pediatric-onset MS is associated with social cognitive deficits. Consecutively-recruited participants with pediatric-onset MS were compared to a group of age- and gender-matched healthy controls on Theory of Mind (ToM) task performance. Tasks measured facial affect recognition (Reading the Mind in the Eyes Test), detecting social faux pas (Faux Pas Test), and understanding the perspective of another (False Beliefs Task). Twenty-eight (28) pediatric-onset MS participants (median age 17 years) and 32 healthy controls (median age 16 years) completed the study. The MS participants performed worse than controls on all three ToM tasks: Reading the Mind in the Eyes Test (p = 0.008), the Faux Pas Test (p = 0.009), and the False Beliefs Task (p = 0.06). While more MS than control participants were impaired on a measure of information processing speed (the Symbol Digit Modalities Test; 38% versus 6%), it did not account for the differences in ToM performance. Social cognition may represent an area of cognitive functioning affected by MS in the pediatric-onset population. These processes are especially important to study in younger patients as they may have long range implications for social adjustment, employment, and well-being. © The Author(s) 2014.

  9. Goodness-of-Fit Tests For Elliptical and Independent Copulas through Projection Pursuit

    Directory of Open Access Journals (Sweden)

    Jacques Touboul

    2011-04-01

    Full Text Available Two goodness-of-fit tests for copulas are being investigated. The first one deals with the case of elliptical copulas and the second one deals with independent copulas. These tests result from the expansion of the projection pursuit methodology that we will introduce in the present article. This method enables us to determine on which axis system these copulas lie as well as the exact value of these very copulas in the basis formed by the axes previously determined irrespective of their value in their canonical basis. Simulations are also presented as well as an application to real datasets.

  10. The relationship between physical activity and physical self-esteem in adolescents: The role of physical fitness indices

    OpenAIRE

    Haugen, Tommy; Ommundsen, Yngvar; Seiler, Stephen

    2013-01-01

    Publised version of an article from the journal: Pediatric Exercise Science. Also available from Human Kinetics: http://journals.humankinetics.com/pes-back-issues/pes-volume-25-issue-1-february/the-relationship-between-physical-activity-and-physical-self-esteem-in-adolescents-the-role-of-physical-fitness-indices The aim of this study was to investigate if physical fitness (strength/power, endurance, flexibility and coordination) mediates the cross-sectional relationship between physical ac...

  11. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... type your comment or suggestion into the following text box: Comment: E-mail: Area code: Phone no: Thank ... View full size with caption Pediatric Content Some imaging tests ...

  12. Physical employment standard for Canadian wildland firefighters: examining test-retest reliability and the impact of familiarisation and physical fitness training.

    Science.gov (United States)

    Gumieniak, Robert J; Gledhill, Norman; Jamnik, Veronica K

    2018-05-04

    To assess the impact of repeat performances (familiarisation) plus exercise training on completion time for the Ontario Wildland Firefighter (WFF) Fitness Test circuit (WFX-FIT), normally active general population participants (n = 145) were familiarised to the protocol then randomised into (i) exercise training, (ii) circuit only weekly performances or (iii) controls. At Baseline, the WFX-FIT pass rate for all groups combined was 11% for females and 73% for males, indicating that the Ontario WFX-FIT standard had a possible adverse impact on females. Following test familiarisation, mean circuit completion times improved by 11.9% and 10.2% for females and males, respectively. There were significant improvements in completion time for females (19.8%) and males (16.9%) who trained, plus females (12.2%) and males (9.8%) who performed the circuit only, while control participants were unchanged. Post training, the pass rate of the training group was 80% for females and 100% for males. Practitioner Summary: This paper details the impact of familiarisation plus exercise training as accommodation to mitigate potential adverse impact on initial attack wildland firefighter test performance. The results underscore the importance of test familiarisation opportunities and physical fitness training programmes that are specific to the demands of the job.

  13. Social pediatrics: weaving horizontal and vertical threads through pediatric residency.

    Science.gov (United States)

    van den Heuvel, Meta; Martimianakis, Maria Athina Tina; Levy, Rebecca; Atkinson, Adelle; Ford-Jones, Elizabeth; Shouldice, Michelle

    2017-01-13

    Social pediatrics teaches pediatric residents how to understand disease within their patients' social, environmental and political contexts. It's an essential component of pediatric residency training; however there is very little literature that addresses how such a broad-ranging topic can be taught effectively. The aim of this study was to determine and characterize social pediatric education in our pediatric residency training in order to identify strengths and gaps. A social pediatrics curriculum map was developed, attending to 3 different dimensions: (1) the intended curriculum as prescribed by the Objectives of Training for Pediatrics of the Royal College of Physicians and Surgeons of Canada (RCPSC), (2) the formal curriculum defined by rotation-specific learning objectives, and (3) the informal/hidden curriculum as reflected in resident and teacher experiences and perceptions. Forty-one social pediatric learning objectives were extracted from the RCPSC Objectives of Training for Pediatrics, most were listed in the Medical Expert (51%) and Health Advocate competencies (24%). Almost all RCPSC social pediatric learning objectives were identified in more than one rotation and/or seminar. Adolescent Medicine (29.2%), Pediatric Ambulatory Medicine (26.2%) and Developmental Pediatrics (25%) listed the highest proportion of social pediatric learning objectives. Four (10%) RCPSC social pediatric objectives were not explicitly named within learning objectives of the formal curriculum. The informal curriculum revealed that both teachers and residents viewed social pediatrics as integral to all clinical encounters. Perceived barriers to teaching and learning of social pediatrics included time constraints, particularly in a tertiary care environment, and the value of social pediatrics relative to medical expert knowledge. Despite the lack of an explicit thematic presentation of social pediatric learning objectives by the Royal College and residency training program

  14. Validation of an Instrument to Measure High School Students' Attitudes toward Fitness Testing

    Science.gov (United States)

    Mercier, Kevin; Silverman, Stephen

    2014-01-01

    Purpose: The purpose of this investigation was to develop an instrument that has scores that are valid and reliable for measuring students' attitudes toward fitness testing. Method: The method involved the following steps: (a) an elicitation study, (b) item development, (c) a pilot study, and (d) a validation study. The pilot study included 427…

  15. A systematic review to determine reliability and usefulness of the field-based test batteries for the assessment of physical fitness in adolescents – The ASSO Project

    Directory of Open Access Journals (Sweden)

    Antonino Bianco

    2015-06-01

    Full Text Available The aim of the present review is to investigate the main field-based tests, used alone or included in sport or fitness batteries, for the assessment of health- and skill-related physical fitness components in adolescents. Different scientific databases were searched through using the selected key words related to physical fitness and its components for adolescence. The search focused on original articles and reviews/meta-analyses using valid, reproducible and feasible tests that fit within the school environment. A total of 100 scientific manuscripts were included in the qualitative synthesis. The present systematic review pointed out 5 fitness tests that well adapt to the evaluation of the components of physical fitness of adolescents within a school environment: the 20 m shuttle run test for cardio-respiratory endurance; the handgrip strength test for upper body maximal strength; the standing broad jump test for lower body maximal strength; the sit-up test to exhaustion for muscular endurance and the 4×10 m shuttle run test for speed, agility and coordination. These fitness tests have been finally selected and incorporated into the Adolescents and Surveillance System for the Obesity prevention – Fitness Test Battery (ASSO-FTB, and will be adopted within the ASSO Project for evaluation purposes. This instrument could be also provided to teachers and people working in schools in order to assess physical fitness of adolescents over time and prevent obesity and related diseases.

  16. Use of the bootstrap method to develop a physical fitness test for public safety officers who serve as both police officers and firefighters.

    Science.gov (United States)

    Adams, Jenny; Cheng, Dunlei; Lee, John; Shock, Tiffany; Kennedy, Kathleen; Pate, Scotty

    2014-07-01

    Physical fitness testing is a common tool for motivating employees with strenuous occupations to reach and maintain a minimum level of fitness. Nevertheless, the use of such tests can be hampered by several factors, including required compliance with US antidiscrimination laws. The Highland Park (Texas) Department of Public Safety implemented testing in 1991, but no single test adequately evaluated its sworn employees, who are cross-trained and serve as police officers and firefighters. In 2010, the department's fitness experts worked with exercise physiologists from Baylor Heart and Vascular Hospital to develop and evaluate a single test that would be equitable regardless of race/ethnicity, disability, sex, or age >50 years. The new test comprised a series of exercises to assess overall fitness, followed by two sequences of job-specific tasks related to firefighting and police work, respectively. The study group of 50 public safety officers took the test; raw data (e.g., the number of repetitions performed or the time required to complete a task) were collected during three quarterly testing sessions. The statistical bootstrap method was then used to determine the levels of performance that would correlate with 0, 1, 2, or 3 points for each task. A sensitivity analysis was done to determine the overall minimum passing score of 17 points. The new physical fitness test and scoring system have been incorporated into the department's policies and procedures as part of the town's overall employee fitness program.

  17. Do pediatric gastroenterology doctors address pediatric obesity?

    OpenAIRE

    Batra, Suruchi; Yee, Caitlin; Diez, Bernadette; Nguyen, Nicholas; Sheridan, Michael J; Tufano, Mark; Sikka, Natalie; Townsend, Stacie; Hourigan, Suchitra

    2017-01-01

    Objectives: To assess how often obesity is acknowledged at pediatric gastroenterology outpatient visits. Methods: A retrospective chart review was performed to identify obese children seen at a gastroenterology subspecialty clinic over a 1-year period of time; 132 children were identified. Demographics, obesity comorbidities, reasons for referral, diagnosis of obesity, and a plan to address obesity were abstracted. Chi-square or Fisher?s exact tests were used to examine statistical associatio...

  18. Goodness-of-Fit Tests for Generalized Normal Distribution for Use in Hydrological Frequency Analysis

    Science.gov (United States)

    Das, Samiran

    2018-04-01

    The use of three-parameter generalized normal (GNO) as a hydrological frequency distribution is well recognized, but its application is limited due to unavailability of popular goodness-of-fit (GOF) test statistics. This study develops popular empirical distribution function (EDF)-based test statistics to investigate the goodness-of-fit of the GNO distribution. The focus is on the case most relevant to the hydrologist, namely, that in which the parameter values are unidentified and estimated from a sample using the method of L-moments. The widely used EDF tests such as Kolmogorov-Smirnov, Cramer von Mises, and Anderson-Darling (AD) are considered in this study. A modified version of AD, namely, the Modified Anderson-Darling (MAD) test, is also considered and its performance is assessed against other EDF tests using a power study that incorporates six specific Wakeby distributions (WA-1, WA-2, WA-3, WA-4, WA-5, and WA-6) as the alternative distributions. The critical values of the proposed test statistics are approximated using Monte Carlo techniques and are summarized in chart and regression equation form to show the dependence of shape parameter and sample size. The performance results obtained from the power study suggest that the AD and a variant of the MAD (MAD-L) are the most powerful tests. Finally, the study performs case studies involving annual maximum flow data of selected gauged sites from Irish and US catchments to show the application of the derived critical values and recommends further assessments to be carried out on flow data sets of rivers with various hydrological regimes.

  19. Empirical Power Comparison Of Goodness of Fit Tests for Normality In The Presence of Outliers

    International Nuclear Information System (INIS)

    Saculinggan, Mayette; Balase, Emily Amor

    2013-01-01

    Most statistical tests such as t-tests, linear regression analysis and Analysis of Variance (ANOVA) require the normality assumptions. When the normality assumption is violated, interpretation and inferences may not be reliable. Therefore it is important to assess such assumption before using any appropriate statistical test. One of the commonly used procedures in determining whether a random sample of size n comes from a normal population are the goodness-of-fit tests for normality. Several studies have already been conducted on the comparison of the different goodness-of-fit(see, for example [2]) but it is generally limited to the sample size or to the number of GOF tests being compared(see, for example [2] [5] [6] [7] [8]). This paper compares the power of six formal tests of normality: Kolmogorov-Smirnov test (see [3]), Anderson-Darling test, Shapiro-Wilk test, Lilliefors test, Chi-Square test (see [1]) and D'Agostino-Pearson test. Small, moderate and large sample sizes and various contamination levels were used to obtain the power of each test via Monte Carlo simulation. Ten thousand samples of each sample size and contamination level at a fixed type I error rate α were generated from the given alternative distribution. The power of each test was then obtained by comparing the normality test statistics with the respective critical values. Results show that the power of all six tests is low for small sample size(see, for example [2]). But for n = 20, the Shapiro-Wilk test and Anderson – Darling test have achieved high power. For n = 60, Shapiro-Wilk test and Liliefors test are most powerful. For large sample size, Shapiro-Wilk test is most powerful (see, for example [5]). However, the test that achieves the highest power under all conditions for large sample size is D'Agostino-Pearson test (see, for example [9]).

  20. Self-reported physical fitness of older persons : A substitute for performance-based measures of physical fitness?

    NARCIS (Netherlands)

    vanHeuvelen, MJG; Kempen, GIJM; Ormel, J; de Greef, M.H.G.

    1997-01-01

    To evaluate the validity of self-report measures of physical fitness as substitutes for performance-based tests, self-reports and performance-based tests of physical fitness were compared. Subjects were a community-based sample of older adults (N = 624) aged 57 and over. The performance-based tests

  1. The Association Between Self-Rated Fitness and Cardiorespiratory Fitness in Adults

    DEFF Research Database (Denmark)

    Jensen, Karina Gregersen; Rosthøj, Susanne; Linneberg, Allan

    2018-01-01

    To assess criterion validity of a single item question on self-rated physical fitness against objectively measured cardiorespiratory fitness. From the Health2008 study 749 men and women between 30 and 60 years of age rated their fitness as excellent, very good, good, fair or poor. Cardiorespiratory...... fitness was estimated with the watt-max test. Agreement between self-rated and objectively measured physical fitness was assessed by Cohen's weighted kappa coefficient. Correlation was determined by Goodman & Kruskal's gamma correlation coefficient. All analyses were stratified according to gender. Data...... from 323 men and 426 women were analysed. There was a slight agreement between self-rated and objectively measured fitness in men (weighted kappa: 0.18, [95%CI: 0.13;0.23]) and a fair agreement in women (weighted kappa: 0.27, [95%CI: 0.22;0.32]). In both genders, self-rated fitness was positively...

  2. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available Toggle navigation Test/Treatment Patient Type Screening/Wellness Disease/Condition Safety En Español More Info Images/Videos About Us News Physician Resources Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine ...

  3. Pediatric neurocritical care.

    Science.gov (United States)

    Murphy, Sarah

    2012-01-01

    Pediatric neurocritical care is an emerging multidisciplinary field of medicine and a new frontier in pediatric critical care and pediatric neurology. Central to pediatric neurocritical care is the goal of improving outcomes in critically ill pediatric patients with neurological illness or injury and limiting secondary brain injury through optimal critical care delivery and the support of brain function. There is a pressing need for evidence based guidelines in pediatric neurocritical care, notably in pediatric traumatic brain injury and pediatric stroke. These diseases have distinct clinical and pathophysiological features that distinguish them from their adult counterparts and prevent the direct translation of the adult experience to pediatric patients. Increased attention is also being paid to the broader application of neuromonitoring and neuroprotective strategies in the pediatric intensive care unit, in both primary neurological and primary non-neurological disease states. Although much can be learned from the adult experience, there are important differences in the critically ill pediatric population and in the circumstances that surround the emergence of neurocritical care in pediatrics.

  4. Improving health-related fitness in adolescents: the CrossFit Teens™ randomised controlled trial.

    Science.gov (United States)

    Eather, Narelle; Morgan, Philip James; Lubans, David Revalds

    2016-01-01

    The aim of this study was to evaluate the preliminary efficacy and feasibility of the CrossFit Teens™ resistance training programme for improving health-related fitness and resistance training skill competency in adolescents. This assessor-blinded randomised controlled trial was conducted in one secondary school in the Hunter Region, Australia, from July to September 2013. Ninety-six (96) students (age = 15.4 (.5) years, 51.5% female) were randomised into intervention (n = 51) or control (n = 45) conditions for 8-weeks (60 min twice per week). Waist circumference, body mass index (BMI), BMI-Z score (primary outcomes), cardiorespiratory fitness (shuttle run test), muscular fitness (standing jump, push-up, handgrip, curl-up test), flexibility (sit and reach) and resistance training skill competency were measured at baseline and immediate post-intervention. Feasibility measures of recruitment, retention, adherence and satisfaction were assessed. Significant group-by-time intervention effects were found for waist circumference [-3.1 cm, P CrossFit Teens™ is a feasible and efficacious programme for improving health-related fitness in adolescents.

  5. Testing for strategy-structure fit and its importance for performance

    Directory of Open Access Journals (Sweden)

    Ana Aleksić

    2017-01-01

    Full Text Available Understanding different organizational elements, their mutual influence and creating congruence among them has been recognized as an important determinant of organizational performance. These complex interrelationships, and necessity of creating a fit between them, raises the question of how to align different organizational elements to contribute to overall organizational performance. In that sense, this paper addresses the issue of fit and, more specifically, analyses the presence and influence of strategy-structure fit on organizational performance. By using Miles and Snow typology, our goal was to capture and determine the pattern of relationships between strategy, structure, and strategy implementation processes and their influence on organizational performance. This paper presents results of a cross-sectional field research on a sample of 113 organizations in order to gain a better understanding of strategy-structure fit and its relation to performance. Results reinforce the existing literature and confirm the importance of fit among strategy, structure and strategy implementation process for higher levels of organizational performance.

  6. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... through blood vessels. Ultrasound imaging is a noninvasive medical test that helps physicians diagnose and treat medical conditions. Children's (pediatric) abdominal ultrasound imaging produces pictures ...

  7. A Monte Carlo-adjusted goodness-of-fit test for parametric models describing spatial point patterns

    KAUST Repository

    Dao, Ngocanh; Genton, Marc G.

    2014-01-01

    Assessing the goodness-of-fit (GOF) for intricate parametric spatial point process models is important for many application fields. When the probability density of the statistic of the GOF test is intractable, a commonly used procedure is the Monte

  8. The GP tests of competence assessment: which part best predicts fitness to practise decisions?

    Science.gov (United States)

    Jayaweera, Hirosha Keshani; Potts, Henry W W; Keshwani, Karim; Valerio, Chris; Baker, Magdalen; Mehdizadeh, Leila; Sturrock, Alison

    2018-01-02

    The General Medical Council (GMC) conducts Tests of Competence (ToC) for doctors referred for Fitness to Practise (FtP) issues. GPs take a single best answer knowledge test, an Objective Structured Clinical Examination (OSCE), and a Simulated Surgery (SimSurg) assessment which is a simulated GP consultation. The aim of this study was to examine the similarities between OSCEs and SimSurg to determine whether each assessment contributed something unique to GP ToCs. A mixed methods approach was used. Data were collated on 153 GPs who were required to undertake a ToC as a part of being investigated for FtP issues between February 2010 and October 2016. Using correlation analysis, we examined to what degree performance on the knowledge test, OSCE, and SimSurg related to case examiner recommendations and FtP outcomes, including the unique predictive power of these three assessments. The outcome measures were case examiner recommendations (i) not fit to practise; ii) fit to practise on a limited basis; or iii) fit to practise) as well as FtP outcomes (i) erased/removed from the register; ii) having restrictions/conditions; or iii) be in good standing). For the qualitative component, 45 GP assessors were asked to rate whether they assess the same competencies and which assessment provides better feedback about candidates. There was significant overlap between OSCEs and SimSurg, p < 0.001. SimSurg had additional predictive power in the presence of OSCEs and the knowledge test (p = 0.030) in distinguishing doctors from different FtP categories, while OSCEs did not (p = 0.080). Both the OSCEs (p = 0.004) and SimSurg (p < 0.001) had significant negative correlations with case examiner recommendations when accounting for the effects of the other two assessments. Inductive thematic analysis of the responses to the questionnaire showed that assessors perceived OSCEs to be better suited to target specific knowledge and skills. SimSurg was thought to produce a

  9. Chronicle of pediatric radiology

    International Nuclear Information System (INIS)

    Benz-Bohm, Gabriele; Richter, Ernst

    2012-01-01

    The chronicle of pediatric radiology covers the following issues: Development of pediatric radiology in Germany (BRD, DDR, pediatric radiological accommodations); development of pediatric radiology in the Netherlands (chronology and pediatric radiological accommodations); development of pediatric radiology in Austria (chronology and pediatric radiological accommodations); development of pediatric radiology in Switzerland (chronology and pediatric radiological accommodations).

  10. Assessing Competence in Pediatric Cardiology

    Science.gov (United States)

    Johnson, Apul E.; And Others

    1976-01-01

    In response to the need to assure physician competence, a rating scale was developed at the University of Minnesota Medical School for use in evaluating clinical competence in pediatric cardiology. It was tested on first- and second-year specialists. Development and testing procedures are described. (JT)

  11. Development of a Pediatric Adverse Events Terminology.

    Science.gov (United States)

    Gipson, Debbie S; Kirkendall, Eric S; Gumbs-Petty, Brenda; Quinn, Theresa; Steen, A; Hicks, Amanda; McMahon, Ann; Nicholas, Savian; Zhao-Wong, Anna; Taylor-Zapata, Perdita; Turner, Mark; Herreshoff, Emily; Jones, Charlotte; Davis, Jonathan M; Haber, Margaret; Hirschfeld, Steven

    2017-01-01

    In 2009, the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) established the Pediatric Terminology Harmonization Initiative to establish a core library of terms to facilitate the acquisition and sharing of knowledge between pediatric clinical research, practice, and safety reporting. A coalition of partners established a Pediatric Terminology Adverse Event Working Group in 2013 to develop a specific terminology relevant to international pediatric adverse event (AE) reporting. Pediatric specialists with backgrounds in clinical care, research, safety reporting, or informatics, supported by biomedical terminology experts from the National Cancer Institute's Enterprise Vocabulary Services participated. The multinational group developed a working definition of AEs and reviewed concepts (terms, synonyms, and definitions) from 16 pediatric clinical domains. The resulting AE terminology contains >1000 pediatric diseases, disorders, or clinical findings. The terms were tested for proof of concept use in 2 different settings: hospital readmissions and the NICU. The advantages of the AE terminology include ease of adoption due to integration with well-established and internationally accepted biomedical terminologies, a uniquely temporal focus on pediatric health and disease from conception through adolescence, and terms that could be used in both well- and underresourced environments. The AE terminology is available for use without restriction through the National Cancer Institute's Enterprise Vocabulary Services and is fully compatible with, and represented in, the Medical Dictionary for Regulatory Activities. The terminology is intended to mature with use, user feedback, and optimization. Copyright © 2017 by the American Academy of Pediatrics.

  12. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... Test/Treatment Patient Type Screening/Wellness Disease/Condition Safety En Español More Info About Us News Physician ... such low-dose exposure. For more information about safety in pediatric radiology procedures, visit the Image Gently ...

  13. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... Test/Treatment Patient Type Screening/Wellness Disease/Condition Safety En Español More Info Images/Videos About Us ... such low-dose exposure. For more information about safety in pediatric radiology procedures, visit the Image Gently ...

  14. The interpretation of Charpy impact test data using hyper-logistic fitting functions

    International Nuclear Information System (INIS)

    Helm, J.L.

    1996-01-01

    The hyperbolic tangent function is used almost exclusively for computer assisted curve fitting of Charpy impact test data. Unfortunately, there is no physical basis to justify the use of this function and it cannot be generalized to test data that exhibits asymmetry. Using simple physical arguments, a semi-empirical model is derived and identified as a special case of the so called hyper-logistic equation. Although one solution of this equation is the hyperbolic tangent, other more physically interpretable solutions are provided. From the mathematics of the family of functions derived from the hyper-logistic equation, several useful generalizations are made such that asymmetric and wavy Charpy data can be physically interpreted

  15. Measures of effect size for chi-squared and likelihood-ratio goodness-of-fit tests.

    Science.gov (United States)

    Johnston, Janis E; Berry, Kenneth J; Mielke, Paul W

    2006-10-01

    A fundamental shift in editorial policy for psychological journals was initiated when the fourth edition of the Publication Manual of the American Psychological Association (1994) placed emphasis on reporting measures of effect size. This paper presents measures of effect size for the chi-squared and the likelihood-ratio goodness-of-fit statistic tests.

  16. Enhancing TB case detection: experience in offering upfront Xpert MTB/RIF testing to pediatric presumptive TB and DR TB cases for early rapid diagnosis of drug sensitive and drug resistant TB.

    Directory of Open Access Journals (Sweden)

    Neeraj Raizada

    Full Text Available Diagnosis of pulmonary tuberculosis (PTB in children is challenging due to difficulties in obtaining good quality sputum specimens as well as the paucibacillary nature of disease. Globally a large proportion of pediatric tuberculosis (TB cases are diagnosed based only on clinical findings. Xpert MTB/RIF, a highly sensitive and specific rapid tool, offers a promising solution in addressing these challenges. This study presents the results from pediatric groups taking part in a large demonstration study wherein Xpert MTB/RIF testing replaced smear microscopy for all presumptive PTB cases in public health facilities across India.The study covered a population of 8.8 million across 18 programmatic sub-district level tuberculosis units (TU, with one Xpert MTB/RIF platform established at each study TU. Pediatric presumptive PTB cases (both TB and Drug Resistant TB (DR-TB accessing any public health facilities in study area were prospectively enrolled and tested on Xpert MTB/RIF following a standardized diagnostic algorithm.4,600 pediatric presumptive pulmonary TB cases were enrolled. 590 (12.8%, CI 11.8-13.8 pediatric PTB were diagnosed. Overall 10.4% (CI 9.5-11.2 of presumptive PTB cases had positive results by Xpert MTB/RIF, compared with 4.8% (CI 4.2-5.4 who had smear-positive results. Upfront Xpert MTB/RIF testing of presumptive PTB and presumptive DR-TB cases resulted in diagnosis of 79 and 12 rifampicin resistance cases, respectively. Positive predictive value (PPV for rifampicin resistance detection was high (98%, CI 90.1-99.9, with no statistically significant variation with respect to past history of treatment.Upfront access to Xpert MTB/RIF testing in pediatric presumptive PTB cases was associated with a two-fold increase in bacteriologically-confirmed PTB, and increased detection of rifampicin-resistant TB cases under routine operational conditions across India. These results suggest that routine Xpert MTB/RIF testing is a promising

  17. [Sedentarism and physical fitness in postmenopausal women].

    Science.gov (United States)

    Morales, Silvia; Gómez-Cabello, Alba; González-Agüero, Alejandro; Casajús, José Antonio; Ara, Ignacio; Vicente-Rodríguez, Germán

    2013-01-01

    The aging process is accompanied by several changes, such as a decrease in physical fitness. To establish the relationship between a sedentary behavior (sit ≥4 hours/day) and physical fitness in 457 women aged 65 years or older. Physical fitness was evaluated by 8 adapted tests from "Senior Fitness Test" and "Eurofit Testing Battery". ANOVA was used to analyze differences between groups according to the hours of sitting and logistic regression analysis was used to study the association of the sedentary behavior with low fitness, using as reference the 20th percentile of the normative values in Spain (EXERNET Project). Sedentary women had lower balance, legs and arms strength, arms flexibility, walking speed and endurance (p < 0.05). In addition, those women who sat ≥4 hours/day had higher odds for having low fitness in most of the mentioned tests, regardless of the hours of walking (p < 0.05). Sitting for a long time has a negative influence on physical fitness among postmenopausal women independently of walking time. Copyright © AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.

  18. A new fit-for-purpose model testing framework: Decision Crash Tests

    Science.gov (United States)

    Tolson, Bryan; Craig, James

    2016-04-01

    Decision-makers in water resources are often burdened with selecting appropriate multi-million dollar strategies to mitigate the impacts of climate or land use change. Unfortunately, the suitability of existing hydrologic simulation models to accurately inform decision-making is in doubt because the testing procedures used to evaluate model utility (i.e., model validation) are insufficient. For example, many authors have identified that a good standard framework for model testing called the Klemes Crash Tests (KCTs), which are the classic model validation procedures from Klemeš (1986) that Andréassian et al. (2009) rename as KCTs, have yet to become common practice in hydrology. Furthermore, Andréassian et al. (2009) claim that the progression of hydrological science requires widespread use of KCT and the development of new crash tests. Existing simulation (not forecasting) model testing procedures such as KCTs look backwards (checking for consistency between simulations and past observations) rather than forwards (explicitly assessing if the model is likely to support future decisions). We propose a fundamentally different, forward-looking, decision-oriented hydrologic model testing framework based upon the concept of fit-for-purpose model testing that we call Decision Crash Tests or DCTs. Key DCT elements are i) the model purpose (i.e., decision the model is meant to support) must be identified so that model outputs can be mapped to management decisions ii) the framework evaluates not just the selected hydrologic model but the entire suite of model-building decisions associated with model discretization, calibration etc. The framework is constructed to directly and quantitatively evaluate model suitability. The DCT framework is applied to a model building case study on the Grand River in Ontario, Canada. A hypothetical binary decision scenario is analysed (upgrade or not upgrade the existing flood control structure) under two different sets of model building

  19. Pulmonary Function Tests in Emergency Department Pediatric Patients with Acute Wheezing/Asthma Exacerbation

    Directory of Open Access Journals (Sweden)

    Kathryn Giordano

    2012-01-01

    Full Text Available Background. Pulmonary function tests (PFT have been developed to analyze tidal breathing in patients who are minimally cooperative due to age and respiratory status. This study used tidal breathing tests in the ED to measure asthma severity. Design/Method. A prospective pilot study in pediatric patients (3 to 18 yrs with asthma/wheezing was conducted in an ED setting using respiratory inductance plethysmography and pneumotachography. The main outcome measures were testing feasibility, compliance, and predictive value for admission versus discharge. Results. Forty patients were studied, of which, 14 (35% were admitted. Fifty-five percent of the patients were classified as a mild-intermittent asthmatic, 30% were mild-persistent asthmatics, 12.5% were moderate-persistent asthmatics, and 2.5% were severe-persistent. Heart rate was higher in admitted patients as was labored breathing index, phase angle, and asthma score. Conclusions. Tidal breathing tests provide feasible, objective assessment of patient status in the enrolled age group and may assist in the evaluation of acute asthma exacerbation in the ED. Our results demonstrate that PFT measurements, in addition to asthma scores, may be useful in indicating the severity of wheezing/asthma and the need for admission.

  20. Physical activity enhances metabolic fitness independently of cardiorespiratory fitness in marathon runners

    DEFF Research Database (Denmark)

    Laye, M J; Nielsen, M B; Hansen, L S

    2015-01-01

    High levels of cardiovascular fitness (CRF) and physical activity (PA) are associated with decreased mortality and risk to develop metabolic diseases. The independent contributions of CRF and PA to metabolic disease risk factors are unknown. We tested the hypothesis that runners who run consisten......High levels of cardiovascular fitness (CRF) and physical activity (PA) are associated with decreased mortality and risk to develop metabolic diseases. The independent contributions of CRF and PA to metabolic disease risk factors are unknown. We tested the hypothesis that runners who run...... consistently >50 km/wk and/or >2 marathons/yr for the last 5 years have superior metabolic fitness compared to matched sedentary subjects (CRF, age, gender, and BMI). Case-control recruitment of 31 pairs of runner-sedentary subjects identified 10 matched pairs with similar VO2max (mL/min/kg) (similar-VO2max......). The similar-VO2max group was compared with a group of age, gender, and BMI matched pairs who had the largest difference in VO2max (different-VO2max). Primary outcomes that defined metabolic fitness including insulin response to an oral glucose tolerance test, fasting lipids, and fasting insulin were superior...

  1. Motor competence and physical fitness in adolescents.

    Science.gov (United States)

    Gísladóttir, Ordís; Haga, Monika; Sigmundsson, Hermundur

    2014-01-01

    In this study we examined the relationship between physical fitness and motor competence in adolescents aged 15 to 16 years. A sample of 94 adolescents participated in the study. To test motor competence, the Movement Assessment Battery for Children-2 was used. Physical fitness was assessed using the following test items: standing broad jump, 20-m dash, reduced Cooper test, and sit-and-reach test. The results revealed a significant but weak relationship (0.248) between motor competence and physical fitness for the whole sample. More specifically, the correlation between the 2 variables was significant for girls (0.353) but not for boys (0.248). The relatively weak relationship between motor competence and physical fitness suggests that motor competence might not be critical in adolescents to maintain their physical fitness.

  2. Six-minute walking distance and decrease in oxygen saturation during the six-minute walk test in pediatric pulmonary arterial hypertension

    NARCIS (Netherlands)

    Douwes, Johannes M.; Hegeman, Anneke K.; van der Krieke-van der Horst, Merel; Roofthooft, Marcus T. R.; Hillege, Hans L.; Berger, Rolf M. F.

    2016-01-01

    Objective: To investigate the prognostic value of the 6-minute walking distance (6-MWD), transcutaneous saturation (tcSO2) and heart rate (HR) obtained during the 6-minute walk test (6-MWT) in pediatric pulmonary arterial hypertension (PAH). Methods: This was an observational study with forty-seven

  3. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... type your comment or suggestion into the following text box: Comment: E-mail: Area code: Phone no: Thank ... View full size with caption Pediatric Content Some imaging tests ...

  4. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... type your comment or suggestion into the following text box: Comment: E-mail: Area code: Phone no: Thank ... View full size with caption Pediatric Content Some imaging tests ...

  5. Children's (Pediatric) Magnetic Resonance Imaging

    Medline Plus

    Full Text Available ... type your comment or suggestion into the following text box: Comment: E-mail: Area code: Phone no: Thank ... View full size with caption Pediatric Content Some imaging tests ...

  6. Pediatric Asthma

    Science.gov (United States)

    ... Science Education & Training Home Conditions Asthma (Pediatric) Asthma (Pediatric) Make an Appointment Refer a Patient Ask a ... meet the rising demand for asthma care. Our pediatric asthma team brings together physicians, nurses, dietitians, physical ...

  7. Pediatric sleep apnea

    Science.gov (United States)

    Sleep apnea - pediatric; Apnea - pediatric sleep apnea syndrome; Sleep-disordered breathing - pediatric ... Untreated pediatric sleep apnea may lead to: High blood pressure Heart or lung problems Slow growth and development

  8. Measurement of cardiorespiratory fitness in children from two commonly used field tests after accounting for body fatness and maturity.

    Science.gov (United States)

    Hamlin, Michael J; Fraser, Meegan; Lizamore, Catherine A; Draper, Nick; Shearman, Jeremy P; Kimber, Nicholas E

    2014-03-27

    Body fat and maturation both influence cardiorespiratory fitness, however few studies have taken these variables into account when using field tests to predict children's fitness levels. The purpose of this study was to determine the relationship between two field tests of cardiorespiratory fitness (20 m Maximal Multistage Shuttle Run [20-MST], 550 m distance run [550-m]) and direct measurement of VO2max after adjustment for body fatness and maturity levels. Fifty-three participants (25 boys, 28 girls, age 10.6 ± 1.2 y, mean ± SD) had their body fat levels estimated using bioelectrical impedance (16.6% ± 6.0% and 20.0% ± 5.8% for boys and girls, respectively). Participants performed in random order, the 20-MST and 550-m run followed by a progressive treadmill test to exhaustion during which gas exchange measures were taken. Pearson correlation coefficient analysis revealed that the participants' performance in the 20-MST and 550-m run were highly correlated to VO2max obtained during the treadmill test to exhaustion (r = 0.70 and 0.59 for 20-MST and 550-m run, respectively). Adjusting for body fatness and maturity levels in a multivariate regression analysis increased the associations between the field tests and VO2max (r = 0.73 for 20-MST and 0.65 for 550-m). We may conclude that both the 20-MST and the 550-m distance run are valid field tests of cardiorespiratory fitness in New Zealand 8-13 year old children and incorporating body fatness and maturity levels explains an additional 5-7% of the variance.

  9. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available Toggle navigation Test/Treatment Patient Type Screening/Wellness Disease/Condition Safety En Español More Info About Us News Physician Resources Professions Site Index A-Z Children's (Pediatric) ...

  10. A simple field test for the assessment of physical fitness.

    Science.gov (United States)

    1963-04-01

    An essential factor in air safety is the physical and mental fitness of all personnel directly involved in operations of general, commercial, and military aviation. Standardization and classification of fitness, however, have not been established to ...

  11. Pediatric Sinusitis

    Science.gov (United States)

    ... ENTCareers Marketplace Find an ENT Doctor Near You Pediatric Sinusitis Pediatric Sinusitis Patient Health Information News media interested in ... sinuses are present at birth. Unlike in adults, pediatric sinusitis is difficult to diagnose because symptoms of ...

  12. Bridging naturalistic and laboratory assessment of memory: the Baycrest mask fit test.

    Science.gov (United States)

    Armson, Michael J; Abdi, Hervé; Levine, Brian

    2017-09-01

    Autobiographical memory tests provide a naturalistic counterpoint to the artificiality of laboratory research methods, yet autobiographical events are uncontrolled and, in most cases, unverifiable. In this study, we capitalised on a scripted, complex naturalistic event - the mask fit test (MFT), a standardised procedure required of hospital employees - to bridge the gap between naturalistic and laboratory memory assessment. We created a test of recognition memory for the MFT and administered it to 135 hospital employees who had undertaken the MFT at various points over the past five years. Multivariate analysis revealed two dimensions defined by accuracy and response bias. Accuracy scores showed the expected relationship to encoding-test delay, supporting the validity of this measure. Relative to younger adults, older adults' memory for this naturalistic event was better than would be predicted from the cognitive ageing literature, a result consistent with the notion that older adults' memory performance is enhanced when stimuli are naturalistic and personally relevant. These results demonstrate that testing recognition memory for a scripted event is a viable method of studying autobiographical memory.

  13. Contact Dermatitis in Pediatrics.

    Science.gov (United States)

    Pelletier, Janice L; Perez, Caroline; Jacob, Sharon E

    2016-08-01

    Contact dermatitis is an umbrella term that describes the skin's reaction to contacted noxious or allergenic substances. The two main categories of contact dermatitis are irritant type and allergic type. This review discusses the signs, symptoms, causes, and complications of contact dermatitis. It addresses the testing, treatment, and prevention of contact dermatitis. Proper management of contact dermatitis includes avoidance measures for susceptible children. Implementation of a nickel directive (regulating the use of nickel in jewelry and other products that come into contact with the skin) could further reduce exposure to the most common allergens in the pediatric population. [Pediatr Ann. 2016;45(8):e287-e292.]. Copyright 2016, SLACK Incorporated.

  14. Rising utilization of inpatient pediatric asthma pathways.

    Science.gov (United States)

    Kaiser, Sunitha V; Rodean, Jonathan; Bekmezian, Arpi; Hall, Matt; Shah, Samir S; Mahant, Sanjay; Parikh, Kavita; Morse, Rustin; Puls, Henry; Cabana, Michael D

    2018-02-01

    Clinical pathways are detailed care plans that operationalize evidence-based guidelines into an accessible format for health providers. Their goal is to link evidence to practice to optimize patient outcomes and delivery efficiency. It is unknown to what extent inpatient pediatric asthma pathways are being utilized nationally. (1) Describe inpatient pediatric asthma pathway design and implementation across a large hospital network. (2) Compare characteristics of hospitals with and without pathways. We conducted a descriptive, cross-sectional, survey study of hospitals in the Pediatric Research in Inpatient Settings Network (75% children's hospitals, 25% community hospitals). Our survey determined if each hospital used a pathway and pathway characteristics (e.g. pathway elements, implementation methods). Hospitals with and without pathways were compared using Chi-square tests (categorical variables) and Student's t-tests (continuous variables). Surveys were distributed to 3-5 potential participants from each hospital and 302 (74%) participants responded, representing 86% (106/123) of surveyed hospitals. From 2005-2015, the proportion of hospitals utilizing inpatient asthma pathways increased from 27% to 86%. We found variation in pathway elements, implementation strategies, electronic medical record integration, and compliance monitoring across hospitals. Hospitals with pathways had larger inpatient pediatric programs [mean 12.1 versus 6.1 full-time equivalents, p = 0.04] and were more commonly free-standing children's hospitals (52% versus 23%, p = 0.05). From 2005-2015, there was a dramatic rise in implementation of inpatient pediatric asthma pathways. We found variation in many aspects of pathway design and implementation. Future studies should determine optimal implementation strategies to better support hospital-level efforts in improving pediatric asthma care and outcomes.

  15. Adiposity, Aerobic Fitness, Muscle Fitness, and Markers of Inflammation in Children

    DEFF Research Database (Denmark)

    Steene-Johannessen, Jostein; Kolle, Elin; Andersen, Lars Bo

    2013-01-01

    PURPOSE: The purpose of this study was to describe levels of inflammation markers in Norwegian children and to examine the associations of adiposity, aerobic fitness and muscle fitness with markers of inflammation. METHODS: In 2005-2006, 1467 9-year-olds wererandomly selected from all regions...... explosive, isometric and endurance strength. Aerobic fitness was measured directly during a maximal cycle ergometer test. Adiposity was expressed as waist circumference (WC). RESULTS: The girls had significantly higher levels of CRP, leptin, adiponectin and resistin and lower levels of TNF-α compared...

  16. Cost-effectiveness of point-of-care testing for dehydration in the pediatric ED.

    Science.gov (United States)

    Whitney, Rachel E; Santucci, Karen; Hsiao, Allen; Chen, Lei

    2016-08-01

    Acute gastroenteritis (AGE) and subsequent dehydration account for a large proportion of pediatric emergency department (PED) visits. Point-of-care (POC) testing has been used in conjunction with clinical assessment to determine the degree of dehydration. Despite the wide acceptance of POC testing, little formal cost-effective analysis of POC testing in the PED exists. We aim to examine the cost-effectiveness of using POC electrolyte testing vs traditional serum chemistry testing in the PED for children with AGE. This was a cost-effective analysis using data from a randomized control trial of children with AGE. A decision analysis model was constructed to calculate cost-savings from the point of view of the payer and the provider. We used parameters obtained from the trial, including cost of testing, admission rates, cost of admission, and length of stay. Sensitivity analyses were performed to evaluate the stability of our model. Using the data set of 225 subjects, POC testing results in a cost savings of $303.30 per patient compared with traditional serum testing from the point of the view of the payer. From the point-of-view of the provider, POC testing results in consistent mean savings of $36.32 ($8.29-$64.35) per patient. Sensitivity analyses demonstrated the stability of the model and consistent savings. This decision analysis provides evidence that POC testing in children with gastroenteritis-related moderate dehydration results in significant cost savings from the points of view of payers and providers compared to traditional serum chemistry testing. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. A Monte Carlo-adjusted goodness-of-fit test for parametric models describing spatial point patterns

    KAUST Repository

    Dao, Ngocanh

    2014-04-03

    Assessing the goodness-of-fit (GOF) for intricate parametric spatial point process models is important for many application fields. When the probability density of the statistic of the GOF test is intractable, a commonly used procedure is the Monte Carlo GOF test. Additionally, if the data comprise a single dataset, a popular version of the test plugs a parameter estimate in the hypothesized parametric model to generate data for theMonte Carlo GOF test. In this case, the test is invalid because the resulting empirical level does not reach the nominal level. In this article, we propose a method consisting of nested Monte Carlo simulations which has the following advantages: the bias of the resulting empirical level of the test is eliminated, hence the empirical levels can always reach the nominal level, and information about inhomogeneity of the data can be provided.We theoretically justify our testing procedure using Taylor expansions and demonstrate that it is correctly sized through various simulation studies. In our first data application, we discover, in agreement with Illian et al., that Phlebocarya filifolia plants near Perth, Australia, can follow a homogeneous Poisson clustered process that provides insight into the propagation mechanism of these plants. In our second data application, we find, in contrast to Diggle, that a pairwise interaction model provides a good fit to the micro-anatomy data of amacrine cells designed for analyzing the developmental growth of immature retina cells in rabbits. This article has supplementary material online. © 2013 American Statistical Association, Institute of Mathematical Statistics, and Interface Foundation of North America.

  18. Evaluation of one-year results of the full-face respirator quantitative man-test fitting program at the Lawrence Livermore Laboratory

    International Nuclear Information System (INIS)

    Held, B.J.; Cross, J.; Ellis, K.P.; Richards, C.P.; Rodriques, R.

    1976-01-01

    In August 1975, Lawrence Livermore Laboratory began to quantitatively fit all employees who are or may be required to wear any type of full-face respirator. After one year, 306 employees have been fitted. A total of 1362 tests were made, using seven makes of full-face respirators. Of the 306 employees fitted, 284 were tested using more than one make of full-face mask. All employees fitted could get a maximum use limit (MUL) of at least 100, 8 percent has a MUL of 100 to 499 on at least one of the makes of masks tested, 11 percent had an MUL of 500 to 999, 13 percent had an MUL of 1000 to 1999, 24 percent had an MUL of 2000 to 4999, and 44 percent had an MUL greater than 5000. These numbers were derived using the average of the peak leakages occurring during each of six exercises performed while wearing each mask. If the overall average leakage occurring during the six exercises rather than the peak average is used in the calculations, 90 percent of the employees could obtain an MUL over 1000 on at least one make of mask

  19. Pediatric Dentistese

    Directory of Open Access Journals (Sweden)

    Sharath Asokan

    2017-01-01

    Full Text Available Successful practice of pediatric dentistry depends on the establishment of a good relationship between the dentist and the child. Such a relationship is possible only through effective communication. Pediatric dentistry includes both an art and a science component. The focus has been mostly on the technical aspects of our science, and the soft skills we need to develop are often forgotten or neglected. This paper throws light on the communication skills we need to imbibe to be a successful pediatric dentist. A new terminology “Pediatric Dentistese” has been coined similar to motherese, parentese, or baby talk. Since baby talk cannot be applied to all age groups of children, pediatric dentistese has been defined as “the proactive development-based individualized communication between the pediatric dentist and the child which helps to build trust, allay fear, and treat the child effectively and efficiently.”

  20. Analysing model fit of psychometric process models: An overview, a new test and an application to the diffusion model.

    Science.gov (United States)

    Ranger, Jochen; Kuhn, Jörg-Tobias; Szardenings, Carsten

    2017-05-01

    Cognitive psychometric models embed cognitive process models into a latent trait framework in order to allow for individual differences. Due to their close relationship to the response process the models allow for profound conclusions about the test takers. However, before such a model can be used its fit has to be checked carefully. In this manuscript we give an overview over existing tests of model fit and show their relation to the generalized moment test of Newey (Econometrica, 53, 1985, 1047) and Tauchen (J. Econometrics, 30, 1985, 415). We also present a new test, the Hausman test of misspecification (Hausman, Econometrica, 46, 1978, 1251). The Hausman test consists of a comparison of two estimates of the same item parameters which should be similar if the model holds. The performance of the Hausman test is evaluated in a simulation study. In this study we illustrate its application to two popular models in cognitive psychometrics, the Q-diffusion model and the D-diffusion model (van der Maas, Molenaar, Maris, Kievit, & Boorsboom, Psychol Rev., 118, 2011, 339; Molenaar, Tuerlinckx, & van der Maas, J. Stat. Softw., 66, 2015, 1). We also compare the performance of the test to four alternative tests of model fit, namely the M 2 test (Molenaar et al., J. Stat. Softw., 66, 2015, 1), the moment test (Ranger et al., Br. J. Math. Stat. Psychol., 2016) and the test for binned time (Ranger & Kuhn, Psychol. Test. Asess. , 56, 2014b, 370). The simulation study indicates that the Hausman test is superior to the latter tests. The test closely adheres to the nominal Type I error rate and has higher power in most simulation conditions. © 2017 The British Psychological Society.

  1. Establishment of radiation doses for pediatric X-ray examinations in a large pediatric hospital in Turkey

    International Nuclear Information System (INIS)

    Olgar, T.; Sahmaran, T.

    2017-01-01

    Pediatric patients are more sensitive to ionizing radiation when compared with adults. The aim of this study was to evaluate the radiation doses for some common pediatric x-ray examinations performed with various digital radiography systems. Quality control tests of the digital radiography systems were carried out according to international published protocols before the pediatric dose measurements. Radiation dose measurement was performed by using the x-ray tube outputs and thermoluminescent dosimeter dose measurement methods. In the present study, radiation doses were assessed for 247 chest, 230 pelvis, 194 skull and 73 abdomen x-ray examinations and in total 744 pediatric patients doses were measured. Pediatric patients were classified into four age groups 0-1, 1-5, 5-10 and 10-15 years as given by European Commission guidance. Effective doses were determined for each examination using a PCXMC 2.0 Monte Carlo program. The mean measured entrance skin doses for the age interval 1-5 years and AP projection by using tube output measurement methods were 149 μGy for chest, 304 μGy for pelvis, 387 μGy for skull and 199 μGy for abdomen examinations. The radiation dose results obtained in this study were in the range of the published results in the literature. (authors)

  2. Association of Physical Fitness with Depression in Women with Fibromyalgia

    DEFF Research Database (Denmark)

    Soriano-Maldonado, Alberto; Estévez-López, Fernando; Segura-Jiménez, Víctor

    2016-01-01

    , muscle strength, flexibility, and motor agility) was assessed using the standardized Senior Fitness Test battery and the handgrip strength test. A standardized composite score for fitness was computed and divided into quintiles. RESULTS: . Overall, the fitness tests presented inverse associations......, arm-curl, and eight-feet up-and-go tests. When all the fitness tests were simultaneously considered, the back-scratch test was the only one independently associated with the total BDI-II score (P = 0.001; R(2) = 0.023). CONCLUSIONS: . Although higher physical fitness was generally associated...

  3. Is High-Intensity Functional Training (HIFT)/CrossFit Safe for Military Fitness Training?

    Science.gov (United States)

    Poston, Walker S C; Haddock, Christopher K; Heinrich, Katie M; Jahnke, Sara A; Jitnarin, Nattinee; Batchelor, David B

    2016-07-01

    High-intensity functional training (HIFT) is a promising fitness paradigm that gained popularity among military populations. Rather than biasing workouts toward maximizing fitness domains such as aerobic endurance, HIFT workouts are designed to promote general physical preparedness. HIFT programs have proliferated as a result of concerns about the relevance of traditional physical training (PT), which historically focused on aerobic condition via running. Other concerns about traditional PT include: (1) the relevance of service fitness tests given current combat demands, (2) the perception that military PT is geared toward passing service fitness tests, and (3) that training for combat requires more than just aerobic endurance. Despite its' popularity in the military, concerns have been raised about HIFT's injury potential, leading to some approaches being labeled as "extreme conditioning programs" by several military and civilian experts. Given HIFT programs' popularity in the military and concerns about injury, a review of data on HIFT injury potential is needed to inform military policy. The purpose of this review is to: (1) provide an overview of scientific methods used to appropriately compare injury rates among fitness activities and (2) evaluate scientific data regarding HIFT injury risk compared to traditional military PT and other accepted fitness activities. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

  4. The Use of Statistical Process Control-Charts for Person-Fit Analysis on Computerized Adaptive Testing. LSAC Research Report Series.

    Science.gov (United States)

    Meijer, Rob R.; van Krimpen-Stoop, Edith M. L. A.

    In this study a cumulative-sum (CUSUM) procedure from the theory of Statistical Process Control was modified and applied in the context of person-fit analysis in a computerized adaptive testing (CAT) environment. Six person-fit statistics were proposed using the CUSUM procedure, and three of them could be used to investigate the CAT in online test…

  5. Problems with Excessive Residual Lower Leg Length in Pediatric Amputees

    OpenAIRE

    Osebold, William R; Lester, Edward L; Christenson, Donald M

    2001-01-01

    We studied six pediatric amputees with long below-knee residual limbs, in order to delineate their functional and prosthetic situations, specifically in relation to problems with fitting for dynamic-response prosthetic feet. Three patients had congenital pseudoarthrosis of the tibia secondary to neurofibromatosis, one had fibular hemimelia, one had a traumatic amputation, and one had amputation secondary to burns. Five patients had Syme's amputations, one had a Boyd amputation. Ages at amputa...

  6. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available Toggle navigation Test/Treatment Patient Type Screening/Wellness Disease/Condition Safety En Español More Info Images/Videos About Us News Physician Resources Professions Site Index A-Z Children's (Pediatric) CT (Computed ...

  7. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available Toggle navigation Test/Treatment Patient Type Screening/Wellness Disease/Condition Safety En Español More Info Images/Videos About Us News Physician Resources Professions Site Index A-Z Children's (Pediatric) Ultrasound - Abdomen ...

  8. Validity of a Newly-Designed Rectilinear Stepping Ergometer Submaximal Exercise Test to Assess Cardiorespiratory Fitness

    OpenAIRE

    Rubin Zhang, Likui Zhan, Shaoming Sun, Wei Peng, Yining Sun

    2017-01-01

    The maximum oxygen uptake (V̇O2 max), determined from graded maximal or submaximal exercise tests, is used to classify the cardiorespiratory fitness level of individuals. The purpose of this study was to examine the validity and reliability of the YMCA submaximal exercise test protocol performed on a newly-designed rectilinear stepping ergometer (RSE) that used up and down reciprocating vertical motion in place of conventional circular motion and giving precise measurement of workload, to det...

  9. FITTING AND TESTING ALLOMETRIC EQUATIONS FOR MEXICO’S SINALOAN TROPICAL DRY TREES AND FOREST INVENTORY PLOTS

    Directory of Open Access Journals (Sweden)

    Jose de Jesus Navar Chaidez

    2016-05-01

    Full Text Available Aboveground tree biomass (bole, branches and foliage, M, plays a key role in the conventional and sustainable management of forest communities. The standard approach to assess tree or plot M is harvesting trees, developing and fitting allometric equations to trees or forest inventory plot data. In the absence of local tree allometry, it is usually recommended to fit off site allometric equations to evaluate tree or plot M. This research aims: (a to develop an updated on site allometric equation (b to fit available off site allometric equations to destructively harvested trees and (c to fit available allometric equations to plot M of Mexico’s Sinaloan tropical dry forests to understand sources of inherent tree and plot M variability. Results showed that: (a the improved on site allometric equation increases precision in contrast to the conventional biomass equation previously reported as well as to off site tree M equations, (b off site allometry projects tree and plot M deviates by close to one order of magnitude. Two tested and recommended approaches to increase tree and plot M precision when fitting off site equations are: (i to use all available tree allometric functions to come up with a mean equation or (ii to calibrate off site equations by fitting new, local parameters that can be calculated using statistical programs.These options would eventually increase tree and plot M precision in regional evaluations.

  10. Children's (Pediatric) Magnetic Resonance Imaging

    Medline Plus

    Full Text Available Toggle navigation Test/Treatment Patient Type Screening/Wellness Disease/Condition Safety En Español More Info Images/Videos About Us News Physician Resources Professions Site Index A-Z Children’s (Pediatric) Magnetic Resonance ...

  11. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... Ultrasound imaging is a noninvasive medical test that helps physicians diagnose and treat medical conditions. Children's (pediatric) ... uterus Abdominal ultrasound images can be used to help diagnose appendicitis in children. Except for traumatic injury, ...

  12. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... CT scans that are not clearly needed. Another strategy is to consider other tests, such as MRI ... for Radiation Safety in Pediatric Imaging's "Image Gently" Campaign top of page This page was reviewed on ...

  13. Children's (Pediatric) Magnetic Resonance Imaging

    Medline Plus

    Full Text Available ... it is useful to bring that to the attention of the technologist or scheduler before the exam. ... patient for magnetic resonance imaging (MRI) exam. View full size with caption Pediatric Content Some imaging tests ...

  14. Continuous performance test in pediatric obsessive-compulsive disorder and tic disorders: the role of sustained attention.

    Science.gov (United States)

    Lucke, Ilse M; Lin, Charlotte; Conteh, Fatmata; Federline, Amanda; Sung, Huyngmo; Specht, Matthew; Grados, Marco A

    2015-10-01

    Pediatric obsessive-compulsive disorder (OCD) and tic disorders (TD) are often associated with attention-deficit hyperactivity disorder (ADHD). In order to clarify the role of attention and inhibitory control in pediatric OCD and TD, a continuous performance test (CPT) was administered to a cohort of children and adolescents with OCD alone, TD alone, and OCD+TD. A clinical cohort of 48 children and adolescents with OCD alone (n=20), TD alone (n=15), or OCD+TD (n=13) was interviewed clinically and administered the Conners Continuous Performance Test II (CPT-II). The Conners CPT-II is a 14-minute normed computerized test consisting of 6 blocks. It taps into attention, inhibitory control, and sustained attention cognitive domains. Key parameters include errors of omission (distractability), commission (inhibitory control), and variable responding over time (sustained attention). Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria were applied in a best-estimate process to diagnose OCD, TD, ADHD, and anxiety disorders. Children with OCD+TD had more errors of omission (p=0.03), and more hit RT block change (p=0.003) and hit SE block change (p=0.02) than subjects with OCD alone and TD alone. These deficits in sustained attention were associated with younger age and hoarding tendencies. A clinical diagnosis of ADHD in the OCD+TD group also determined worse sustained attention. A deficit in sustained attention, a core marker of ADHD, is also a marker of OCD+TD, compared to OCD alone and TD alone. Biological correlates of sustained attention may serve to uncover the pathophysiology of OCD and TD through genetic and imaging studies.

  15. Pediatric hypertension: An approach to imaging

    International Nuclear Information System (INIS)

    Diament, M.J.; Stanley, P.; Gilsanz, V.; Boechat, M.I.; Kangarloo, H.; Lieberman, E.R.

    1986-01-01

    Since 1981, we have made diagnoses of secondary hypertension using state of art imaging equipment in 18 pediatric patients. The most valuable tests were ultrasound identifying renal parenchymal disease, computed body tomography for adrenal tumors and intra-arterial renal angiography for renovascular disorders. Based on our experience, we have formulated an algorithm for the evaluation of the hypertensive pediatric patient. The initial step is careful clinical and laboratory screening to identify those patients that are likely to have essential hypertension and who should not undergo imaging tests. In the cases where there is a possible secondary etiology, renal ultrasound is usually performed first to identify parenchymal disease. If catecholamines are elevated, then abdominal computed tomography is the initial test. If no etiology is identified from these noninvasive studies, then direct intraarterial renal angiography is performed. The authors do not feel that excretory urography, radionuclide renography, intravenous digital subtraction angiography or selective renal vein sampling for renin are useful or practical screening tests for renovascular hypertension. (orig.)

  16. Pediatric hypertension: An approach to imaging

    Energy Technology Data Exchange (ETDEWEB)

    Diament, M J; Stanley, P; Gilsanz, V; Boechat, M I; Kangarloo, H; Lieberman, E R

    1986-09-01

    Since 1981, we have made diagnoses of secondary hypertension using state of art imaging equipment in 18 pediatric patients. The most valuable tests were ultrasound identifying renal parenchymal disease, computed body tomography for adrenal tumors and intra-arterial renal angiography for renovascular disorders. Based on our experience, we have formulated an algorithm for the evaluation of the hypertensive pediatric patient. The initial step is careful clinical and laboratory screening to identify those patients that are likely to have essential hypertension and who should not undergo imaging tests. In the cases where there is a possible secondary etiology, renal ultrasound is usually performed first to identify parenchymal disease. If catecholamines are elevated, then abdominal computed tomography is the initial test. If no etiology is identified from these noninvasive studies, then direct intraarterial renal angiography is performed. The authors do not feel that excretory urography, radionuclide renography, intravenous digital subtraction angiography or selective renal vein sampling for renin are useful or practical screening tests for renovascular hypertension.

  17. Getting CSR communication fit

    DEFF Research Database (Denmark)

    Schmeltz, Line

    2017-01-01

    Companies experience increasing legal and societal pressure to communicate about their corporate social responsibility (CSR) engagements from a number of different publics. One very important group is that of young consumers who are predicted to be the most important and influential consumer group...... in the near future. From a value- theoretical base, this article empirically explores the role and applicability of ‘fit’ in strategic CSR communication targeted at young consumers. Point of departure is taken in the well-known strategic fit (a logical link between a company’s CSR commitment and its core...... values) and is further developed by introducing two additional fits, the CSR- Consumer fit and the CSR-Consumer-Company fit (Triple Fit). Through a sequential design, the three fits are empirically tested and their potential for meeting young consumers’ expectations for corporate CSR messaging...

  18. Altered structural brain changes and neurocognitive performance in pediatric HIV

    Directory of Open Access Journals (Sweden)

    Santosh K. Yadav

    2017-01-01

    Full Text Available Pediatric HIV patients often suffer with neurodevelopmental delay and subsequently cognitive impairment. While tissue injury in cortical and subcortical regions in the brain of adult HIV patients has been well reported there is sparse knowledge about these changes in perinatally HIV infected pediatric patients. We analyzed cortical thickness, subcortical volume, structural connectivity, and neurocognitive functions in pediatric HIV patients and compared with those of pediatric healthy controls. With informed consent, 34 perinatally infected pediatric HIV patients and 32 age and gender matched pediatric healthy controls underwent neurocognitive assessment and brain magnetic resonance imaging (MRI on a 3 T clinical scanner. Altered cortical thickness, subcortical volumes, and abnormal neuropsychological test scores were observed in pediatric HIV patients. The structural network connectivity analysis depicted lower connection strengths, lower clustering coefficients, and higher path length in pediatric HIV patients than healthy controls. The network betweenness and network hubs in cortico-limbic regions were distorted in pediatric HIV patients. The findings suggest that altered cortical and subcortical structures and regional brain connectivity in pediatric HIV patients may contribute to deficits in their neurocognitive functions. Further, longitudinal studies are required for better understanding of the effect of HIV pathogenesis on brain structural changes throughout the brain development process under standard ART treatment.

  19. Antibiotic Resistance in Pediatric Urinary Tract Infections.

    Science.gov (United States)

    Stultz, Jeremy S; Doern, Christopher D; Godbout, Emily

    2016-12-01

    Urinary tract infections (UTIs) are a common problem in pediatric patients. Resistance to common antibiotic agents appears to be increasing over time, although resistance rates may vary based on geographic region or country. Prior antibiotic exposure is a pertinent risk factor for acquiring resistant organisms during a first UTI and recurrent UTI. Judicious prescribing of antibiotics for common pediatric conditions is needed to prevent additional resistance from occurring. Complex pediatric patients with histories of hospitalizations, prior antibiotic exposure, and recurrent UTIs are also at high risk for acquiring UTIs due to extended spectrum beta-lactamase-producing organisms. Data regarding the impact of in vitro antibiotic susceptibility testing interpretation on UTI treatment outcomes is lacking.

  20. Assessment of obese children and adolescents: a survey of pediatric obesity-management programs.

    Science.gov (United States)

    Eisenmann, Joey C

    2011-09-01

    This article provides descriptive information on the assessments conducted in stage 3 or 4 pediatric obesity-management programs associated with National Association of Children's Hospital and Related Institutions hospitals enrolled in FOCUS on a Fitter Future. Eighteen institutions completed a survey that considered the following assessments: patient/family medical history; physical examination; blood pressure; body size and composition; blood chemistry; aerobic fitness; resting metabolic rate; muscle strength and flexibility; gross motor function; spirometry; sedentary behavior and physical activity; dietary behavior and nutrition; and psychological assessments. Frequency distributions were determined for each question. Overall, the results indicate that most programs that participated in this survey were following 2007 Expert Committee assessment recommendations; however, a variety of measurement tools were used. The variation in assessment tools, protocols, etc is partially caused by the program diversity dictated by personnel, both in terms of number and duties. It also shows the challenges in standardizing methodologies across clinics if we hope to establish a national registry for pediatric obesity clinics. In addition to providing a better understanding of the current assessment practices in pediatric obesity-management programs, the results provided herein should assist other clinics/hospitals that are developing pediatric obesity programs.

  1. Pediatric acute respiratory distress syndrome: definition, incidence, and epidemiology: proceedings from the Pediatric Acute Lung Injury Consensus Conference.

    Science.gov (United States)

    Khemani, Robinder G; Smith, Lincoln S; Zimmerman, Jerry J; Erickson, Simon

    2015-06-01

    Although there are similarities in the pathophysiology of acute respiratory distress syndrome in adults and children, pediatric-specific practice patterns, comorbidities, and differences in outcome necessitate a pediatric-specific definition. We sought to create such a definition. A subgroup of pediatric acute respiratory distress syndrome investigators who drafted a pediatric-specific definition of acute respiratory distress syndrome based on consensus opinion and supported by detailed literature review tested elements of the definition with patient data from previously published investigations. International PICUs. Children enrolled in published investigations of pediatric acute respiratory distress syndrome. None. Several aspects of the proposed pediatric acute respiratory distress syndrome definition align with the Berlin Definition of acute respiratory distress syndrome in adults: timing of acute respiratory distress syndrome after a known risk factor, the potential for acute respiratory distress syndrome to coexist with left ventricular dysfunction, and the importance of identifying a group of patients at risk to develop acute respiratory distress syndrome. There are insufficient data to support any specific age for "adult" acute respiratory distress syndrome compared with "pediatric" acute respiratory distress syndrome. However, children with perinatal-related respiratory failure should be excluded from the definition of pediatric acute respiratory distress syndrome. Larger departures from the Berlin Definition surround 1) simplification of chest imaging criteria to eliminate bilateral infiltrates; 2) use of pulse oximetry-based criteria when PaO2 is unavailable; 3) inclusion of oxygenation index and oxygen saturation index instead of PaO2/FIO2 ratio with a minimum positive end-expiratory pressure level for invasively ventilated patients; 4) and specific inclusion of children with preexisting chronic lung disease or cyanotic congenital heart disease. This

  2. The Chinese version of the Pediatric Quality of Life Inventory™ (PedsQL™) Family Impact Module: cross-cultural adaptation and psychometric evaluation.

    Science.gov (United States)

    Chen, Ruoqing; Hao, Yuantao; Feng, Lifen; Zhang, Yingfen; Huang, Zhuoyan

    2011-03-23

    A pediatric chronic health condition not only influences a child's life, but also has impacts on parent health-related quality of life (HRQOL) and family functioning. To provide care and social support to these families, a psychometrically well-developed instrument for measuring these impacts is of great importance. The present study is aimed to evaluate the psychometric properties of the Chinese version of the PedsQL™ Family Impact Module. The cross-cultural adaptation of the PedsQL™ Family Impact Module was performed following the PedsQL™ Measurement Model Translation Methodology. The Chinese version of the PedsQL™ Family Impact Module was administered to 136 parents of children with asthma and 264 parents of children with heart disease from four Triple A hospitals. The psychometric properties such as feasibility, internal consistency reliability, item-subscale correlations and construct validity were evaluated. The percentage of missing item responses was less than 0.1% for both asthma and heart disease sample groups. The Chinese version of the PedsQL™ Family Impact Module showed ceiling effects but had acceptable reliability (Cronbach's Alpha Coefficients were higher than 0.7 in all the subscales except "Daily Activities" in the asthma sample group). There were higher correlation coefficients between items and their hypothesized subscales than those with other subscales. The asthma sample group reported higher parent HRQOL and family functioning than the heart disease sample group. In the heart disease sample group, parents of outpatients reported higher parent HRQOL and family functioning than parents of inpatients. Confirmatory factor analysis showed that the instrument had marginally acceptable construct validity with some Goodness-of-Fit indices not reaching the standard indicating acceptable model fit. The Chinese version of the PedsQL™ Family Impact Module has adequate psychometric properties and could be used to assess the impacts of

  3. The Chinese version of the Pediatric Quality of Life Inventory™ (PedsQL™ Family Impact Module: cross-cultural adaptation and psychometric evaluation

    Directory of Open Access Journals (Sweden)

    Feng Lifen

    2011-03-01

    Full Text Available Abstract Background A pediatric chronic health condition not only influences a child's life, but also has impacts on parent health-related quality of life (HRQOL and family functioning. To provide care and social support to these families, a psychometrically well-developed instrument for measuring these impacts is of great importance. The present study is aimed to evaluate the psychometric properties of the Chinese version of the PedsQL™ Family Impact Module. Methods The cross-cultural adaptation of the PedsQL™ Family Impact Module was performed following the PedsQL™ Measurement Model Translation Methodology. The Chinese version of the PedsQL™ Family Impact Module was administered to 136 parents of children with asthma and 264 parents of children with heart disease from four Triple A hospitals. The psychometric properties such as feasibility, internal consistency reliability, item-subscale correlations and construct validity were evaluated. Results The percentage of missing item responses was less than 0.1% for both asthma and heart disease sample groups. The Chinese version of the PedsQL™ Family Impact Module showed ceiling effects but had acceptable reliability (Cronbach's Alpha Coefficients were higher than 0.7 in all the subscales except "Daily Activities" in the asthma sample group. There were higher correlation coefficients between items and their hypothesized subscales than those with other subscales. The asthma sample group reported higher parent HRQOL and family functioning than the heart disease sample group. In the heart disease sample group, parents of outpatients reported higher parent HRQOL and family functioning than parents of inpatients. Confirmatory factor analysis showed that the instrument had marginally acceptable construct validity with some Goodness-of-Fit indices not reaching the standard indicating acceptable model fit. Conclusions The Chinese version of the PedsQL™ Family Impact Module has adequate

  4. A Stepwise Fitting Procedure for automated fitting of Ecopath with Ecosim models

    Directory of Open Access Journals (Sweden)

    Erin Scott

    2016-01-01

    Full Text Available The Stepwise Fitting Procedure automates testing of alternative hypotheses used for fitting Ecopath with Ecosim (EwE models to observation reference data (Mackinson et al. 2009. The calibration of EwE model predictions to observed data is important to evaluate any model that will be used for ecosystem based management. Thus far, the model fitting procedure in EwE has been carried out manually: a repetitive task involving setting >1000 specific individual searches to find the statistically ‘best fit’ model. The novel fitting procedure automates the manual procedure therefore producing accurate results and lets the modeller concentrate on investigating the ‘best fit’ model for ecological accuracy.

  5. Design of a cross-sectional study on physical fitness and physical activity in children and adolescents after burn injury

    NARCIS (Netherlands)

    Disseldorp, Laurien M.; Mouton, Leonora J.; Takken, Tim; Van Brussel, Marco; Beerthuizen, Gerard I. J. M.; Van der Woude, Lucas H. V.; Nieuwenhuis, Marianne K.

    2012-01-01

    Background: Burn injuries have a major impact on the patient's physical and psychological functioning. The consequences can, especially in pediatric burns, persist long after the injury. A decrease in physical fitness seems logical as people survive burn injuries after an often extensive period of

  6. Relationship among Fitness, Morphological Characteristics, Skills ...

    African Journals Online (AJOL)

    The specific morphological and fitness demands of the sport are, therefore, not fully understood. The purpose of this ... The findings convincingly suggest that coaches should include fitness, morphological and skills tests in their coaching and fitness programmes, team selection and talent identification processes. Keywords: ...

  7. Testing Cort-Fitness and Cort-Adaptation hypotheses in a habitat suitability gradient for roe deer

    Science.gov (United States)

    Escribano-Avila, Gema; Pettorelli, Nathalie; Virgós, Emilio; Lara-Romero, Carlos; Lozano, Jorge; Barja, Isabel; Cuadra, Felipe S.; Puerta, Marisa

    2013-11-01

    According to the Cort-Fitness Hypothesis, higher stress levels (glucocorticoids) in vertebrates are correlated to lower fitness. However, recent studies have failed to validate this hypothesis. A proposed wider framework suggests that reproduction can be perceived as an overload adds up to other environmental challenges that individuals must adjust to. In this case, elevated glucocorticoids could help individuals to allocate resources to reproduction without comprising other functions, leading to the expectation of a positive cort-fitness relationship. This has been proposed as the Cort-Adaptation Hypothesis. Stress levels result from a complex interaction between the environment and the neuroendocrine system of animals. Accounting for physiological functions involved in how animals cope with their environment would help to clarify the relationship between glucocorticoids and animal performance. We used roe deer (Capreolus capreolus) inhabiting diverse habitats in the Iberian Peninsula to: i) test the Cort-Fitness and Cort-Adaptation hypotheses by indexing fitness using a comprehensive physiological approach which takes into account fundamental physiological functions and their trade-offs; and ii) evaluate the link between primary productivity and individuals' condition in a seasonal environment. We evaluated spatial and temporal variation in stress levels, reproductive hormone levels, nutritional status and immune function from fecal samples collected in 2010. Lower stress levels were related to better condition in non-reproductive seasons but not to higher primary productivity. In contrast, stress levels were always positively related to reproductive condition, which was better in most productive habitats. Summer and winter were the less productive seasons and the more challenging for the species in the habitat gradient studied. In winter, reproductive condition traded off against immune function being biased toward immune function in less productive habitats. In

  8. Strain Gage Load Calibration of the Wing Interface Fittings for the Adaptive Compliant Trailing Edge Flap Flight Test

    Science.gov (United States)

    Miller, Eric J.; Holguin, Andrew C.; Cruz, Josue; Lokos, William A.

    2014-01-01

    This is the presentation to follow conference paper of the same name. The adaptive compliant trailing edge (ACTE) flap experiment safety of flight requires that the flap to wing interface loads be sensed and monitored in real time to ensure that the wing structural load limits are not exceeded. This paper discusses the strain gage load calibration testing and load equation derivation methodology for the ACTE interface fittings. Both the left and right wing flap interfaces will be monitored and each contains four uniquely designed and instrumented flap interface fittings. The interface hardware design and instrumentation layout are discussed. Twenty one applied test load cases were developed using the predicted in-flight loads for the ACTE experiment.

  9. Synergy effects of fluoxetine and variability in temperature lead to proportionally greater fitness costs in Daphnia: A multigenerational test.

    Science.gov (United States)

    Barbosa, Miguel; Inocentes, Núrya; Soares, Amadeu M V M; Oliveira, Miguel

    2017-12-01

    Increased variability in water temperature is predicted to impose disproportionally greater fitness costs than mean increase in temperature. Additionally, water contaminants are currently a major source of human-induced stress likely to produce fitness costs. Global change models forecast an increase in these two human-induced stressors. Yet, in spite the growing interest in understanding how organisms respond to global change, the joint fitness effects of water pollution and increased variability in temperature remain unclear. Here, using a multigenerational design, we test the hypothesis that exposure to high concentrations of fluoxetine, a human medicine commonly found in freshwater systems, causes increased lifetime fitness costs, when associated with increased variability in temperature. Although fluoxetine and variability in temperature elicited some fitness cost when tested alone, when both stressors acted together the costs were disproportionally greater. The combined effect of fluoxetine and variability in temperature led to a reduction of 37% in lifetime reproductive success and a 17.9% decrease in population growth rate. Interestingly, fluoxetine and variability in temperature had no effect on the probability of survival. Freshwater systems are among the most imperilled ecosystems, often exposed to multiple human-induced stressors. Our results indicate that organisms face greater fitness risk when exposed to multiple stressors at the same time than when each stress acts alone. Our study highlights the importance of using a multi-generational approach to fully understand individual environmental tolerance and its responses to a global change scenario in aquatic systems. Copyright © 2017 Elsevier B.V. All rights reserved.

  10. Fitness Club

    CERN Multimedia

    Fitness Club

    2012-01-01

    Get in Shape for Summer with the CERN Fitness Club Saturday 23 June 2012 from 14:30 to 16.30 (doors open at 14.00) Germana’s Fitness Workshop. Build strength and stamina, sculpt and tone your body and get your heart pumping with Germana’s workout mixture of Cardio Attack, Power Pump, Power Step, Cardio Combat and Cross-Training. Where: 216 (Pump room – equipped with changing rooms and showers). What to wear: comfortable clothes and indoor sports shoes + bring a drink! How much: 15 chf Sign up here: https://espace.cern.ch/club-fitness/Lists/Test_Subscription/NewForm.aspx? Join the Party and dance yourself into shape at Marco + Marials Zumba Masterclass. Saturday 30 June 2012 from 15:00 to 16:30 Marco + Mariel’s Zumba Masterclass Where: 216 (Pump room – equipped with changing rooms and showers). What to wear: comfortable clothes and indoor sports shoes + bring a drink! How much: 25 chf Sign up here: https://espace.cern.ch/club-fitness/Lists/Zumba%20...

  11. Comparison between a pediatric health promotion center and a pediatric obesity clinic in detecting metabolic syndrome and non-alcoholic fatty liver disease in children.

    Science.gov (United States)

    Yang, Hye Ran; Yi, Dae Yong; Choi, Hyoung Soo

    2014-12-01

    This study was done to evaluate the efficacy of health check-ups in children in detecting metabolic syndrome and non-alcoholic fatty liver disease (NAFLD) by comparing the pediatric health promotion center with the pediatric obesity clinic. Children who visited a pediatric health promotion center (n=218) or a pediatric obesity clinic (n=178) were included. Anthropometric data, blood pressure, laboratory tests, and abdominal ultrasonography were evaluated. Two different criteria were applied to diagnose metabolic syndrome. The prevalence of metabolic syndrome in the 2 units was 3.2%-3.7% in a pediatric health promotion center and 23%-33.2% in a pediatric obesity clinic. Significant differences were observed in the prevalence of each component of metabolic syndrome between the 2 units including abdominal adiposity, blood pressure, serum triglycerides, and fasting blood glucose (Pobesity clinic targeting obese children than that among patients visiting the health promotion center offering routine check-ups. An obesity-oriented approach is required to prevent obesity-related health problems in children.

  12. The Obesity Paradox and Cardiorespiratory Fitness

    Directory of Open Access Journals (Sweden)

    Paul A. McAuley

    2012-01-01

    Full Text Available Cardiorespiratory fitness as an explanation for the obesity paradox warrants further examination. We evaluated independent and joint associations of cardiorespiratory fitness and adiposity with all-cause mortality in 811 middle-aged (age, 53.3±7.2 years male never smokers without documented cardiopulmonary disease or diabetes from the Veterans Exercise Testing Study (VETS. Cardiorespiratory fitness was quantified in metabolic equivalents (METs using final treadmill speed and grade achieved on a maximal exercise test. Subjects were grouped for analysis by METs: unfit (lowest third and fit (upper two-thirds; and by body mass index (kg/m2: nonobese (18.5−29.9 and obese (≥30.0. Associations of baseline fitness and adiposity measures with all-cause mortality were determined by Cox proportional hazards analysis adjusted for age, ethnicity, hypertension, hypercholesterolemia, family history of coronary artery disease, and cardiovascular medication use. In multivariate analysis, mortality risk for obese/fit men did not differ significantly from the nonobese/fit reference group. However, compared to the reference group, nonobese and obese unfit men were 2.2 (=0.01 and 1.9 (=0.03 times more likely to die, respectively. Cardiorespiratory fitness altered the obesity paradox such that mortality risk was lower for both obese and nonobese men who were fit.

  13. Isolated Rhabdomyolysis of the Infraspinatus Muscle Following the CrossFit "Sissy Test": A Report of Two Cases.

    Science.gov (United States)

    Routman, Howard D; Triplet, Jacob J; Kurowicki, Jennifer; Singh, Neil

    2018-01-01

    Following the completion of a CrossFit-style challenge (the "Sissy Test"), 2 patients presented with severe pain and swelling over the posterior aspect of the scapula. Magnetic resonance imaging demonstrated isolated edema of the infraspinatus muscle in both patients; the compartments were compressible. Neurovascular checks and observation of range of motion were performed. The patients were treated nonoperatively and were discharged with the diagnosis of overuse syndrome with rhabdomyolysis of the infraspinatus muscle. With marked increase in the popularity of extreme fitness, monitoring for rhabdomyolysis and potential renal dysfunction is essential.

  14. Is High Intensity Functional Training (HIFT)/CrossFit® Safe for Military Fitness Training?

    Science.gov (United States)

    Poston, Walker S.C.; Haddock, Christopher K.; Heinrich, Katie M.; Jahnke, Sara A.; Jitnarin, Nattinee; Batchelor, David B.

    2016-01-01

    High-intensity functional training (HIFT) is a promising fitness paradigm that gained popularity among military populations. Rather than biasing workouts toward maximizing fitness domains such as aerobic endurance, HIFT workouts are designed to promote general physical preparedness. HIFT programs have proliferated due to concerns about the relevance of traditional physical training (PT), which historically focused on aerobic condition via running. Other concerns about traditional PT include: 1) the relevance of service fitness tests given current combat demands; 2) the perception that military PT is geared toward passing service fitness tests; and 3) that training for combat requires more than just aerobic endurance. Despite its’ popularity in the military, concerns have been raised about HIFT’s injury potential, leading to some approaches being labeled as “extreme conditioning programs” by several military and civilian experts. Given HIFT programs’ popularity in the military and concerns about injury, a review of data on HIFT injury potential is needed to inform military policy. The purpose of this review is to: 1) provide an overview of scientific methods used to appropriately compare injury rates among fitness activities; and 2) evaluate scientific data regarding HIFT injury risk compared to traditional military PT and other accepted fitness activities PMID:27391615

  15. Evaluation of the hybrid III and Q-series pediatric ATD upper neck loads as compared to pediatric volunteers in low-speed frontal crashes.

    Science.gov (United States)

    Seacrist, Thomas; Mathews, Emily A; Balasubramanian, Sriram; Maltese, Matthew R; Arbogast, Kristy B

    2013-11-01

    Debate exists in the automotive community regarding the validity of the pediatric ATD neck response and corresponding neck loads. Previous research has shown that the pediatric ATDs exhibit hyper-flexion and chin-to-chest contact resulting in overestimations of neck loads and neck injury criteria. Our previous work comparing the kinematics of the Hybrid III and Q-series 6 and 10-year-old ATDs to pediatric volunteers in low-speed frontal sled tests revealed decreased ATD cervical and thoracic spine excursions. These kinematic differences may contribute to the overestimation of upper neck loads by the ATD. The current study compared upper neck loads of the Hybrid III and Q-series 6 and 10-year-old ATDs against size-matched male pediatric volunteers in low-speed frontal sled tests. A 3-D near-infrared target tracking system quantified the position of markers on the ATD and pediatric volunteers (head top, nasion, bilateral external auditory meatus). Shear force (F x ), axial force (F z ), bending moment (M y ), and head angular acceleration ([Formula: see text]) were calculated about the upper neck using standard equations of motion. In general, the ATDs underestimated axial force and overestimated bending moment compared to the human volunteers. The Hybrid III 6, Q6, and Q10 exhibited reduced head angular acceleration and modest increases in upper neck shear compared to the pediatric volunteers. The reduction in axial force and bending moment has important implications for neck injury predictions as both are used when calculating N ij . These analyses provide insight into the biofidelity of the pediatric ATD upper neck loads in low-speed crash environments.

  16. Peripheral doses from pediatric IMRT

    International Nuclear Information System (INIS)

    Klein, Eric E.; Maserang, Beth; Wood, Roy; Mansur, David

    2006-01-01

    Peripheral dose (PD) data exist for conventional fields (≥10 cm) and intensity-modulated radiotherapy (IMRT) delivery to standard adult-sized phantoms. Pediatric peripheral dose reports are limited to conventional therapy and are model based. Our goal was to ascertain whether data acquired from full phantom studies and/or pediatric models, with IMRT treatment times, could predict Organ at Risk (OAR) dose for pediatric IMRT. As monitor units (MUs) are greater for IMRT, it is expected IMRT PD will be higher; potentially compounded by decreased patient size (absorption). Baseline slab phantom peripheral dose measurements were conducted for very small field sizes (from 2 to 10 cm). Data were collected at distances ranging from 5 to 72 cm away from the field edges. Collimation was either with the collimating jaws or the multileaf collimator (MLC) oriented either perpendicular or along the peripheral dose measurement plane. For the clinical tests, five patients with intracranial or base of skull lesions were chosen. IMRT and conventional three-dimensional (3D) plans for the same patient/target/dose (180 cGy), were optimized without limitation to the number of fields or wedge use. Six MV, 120-leaf MLC Varian axial beams were used. A phantom mimicking a 3-year-old was configured per Center for Disease Control data. Micro (0.125 cc) and cylindrical (0.6 cc) ionization chambers were appropriated for the thyroid, breast, ovaries, and testes. The PD was recorded by electrometers set to the 10 -10 scale. Each system set was uniquely calibrated. For the slab phantom studies, close peripheral points were found to have a higher dose for low energy and larger field size and when MLC was not deployed. For points more distant from the field edge, the PD was higher for high-energy beams. MLC orientation was found to be inconsequential for the small fields tested. The thyroid dose was lower for IMRT delivery than that predicted for conventional (ratio of IMRT/cnventional ranged from

  17. Association of Physical Fitness With Fibromyalgia Severity in Women

    DEFF Research Database (Denmark)

    Soriano-Maldonado, Alberto; Henriksen, Marius; Segura-Jiménez, Víctor

    2015-01-01

    OBJECTIVES: To assess the association between physical fitness and fibromyalgia (FM) severity in women with FM as well as to assess whether different fitness components present an independent relation with FM severity. DESIGN: Population-based cross-sectional study. SETTING: University facilities...... and FM associations. PARTICIPANTS: Women with FM (N=444). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: FM severity was assessed with the Revised Fibromyalgia Impact Questionnaire (FIQR). Aerobic fitness (6-min walk test), muscle strength (handgrip, chair stand, and arm curl tests), flexibility...... (chair sit and reach and back scratch tests), and motor agility (8 foot Up and Go test) were measured with the Senior Fitness Test battery and digital dynamometry. A standardized composite score (hereafter "global fitness profile") was calculated and divided into quintiles. RESULTS: Overall, physical...

  18. The Meaning of Goodness-of-Fit Tests: Commentary on "Goodness-of-Fit Assessment of Item Response Theory Models"

    Science.gov (United States)

    Thissen, David

    2013-01-01

    In this commentary, David Thissen states that "Goodness-of-fit assessment for IRT models is maturing; it has come a long way from zero." Thissen then references prior works on "goodness of fit" in the index of Lord and Novick's (1968) classic text; Yen (1984); Drasgow, Levine, Tsien, Williams, and Mead (1995); Chen and…

  19. Clinical Experience of Auditory Brainstem Response Testing on Pediatric Patients in the Operating Room

    Directory of Open Access Journals (Sweden)

    Guangwei Zhou

    2012-01-01

    Full Text Available Objectives. To review our experience of conducting auditory brainstem response (ABR test on children in the operating room and discuss the benefits versus limitations of this practice. Methods. Retrospective review study conducted in a pediatric tertiary care facility. A total of 267 patients identified with usable data, including ABR results, medical and surgical notes, and follow-up evaluation. Results. Hearing status successfully determined in all patients based on the ABR results form the operating room. The degrees and the types of hearing loss also documented in most of the cases. In addition, multiple factors that may affect the outcomes of ABR in the operating room identified. Conclusions. Hearing loss in children with complicated medical issues can be accurately evaluated via ABR testing in the operating room. Efforts should be made to eliminate adverse factors to ABR recording, and caution should be taken when interpreting ABR results from the operating room.

  20. Epsilon aminocaproic acid reduces blood transfusion and improves the coagulation test after pediatric open-heart surgery: a meta-analysis of 5 clinical trials.

    Science.gov (United States)

    Lu, Jun; Meng, Haoyu; Meng, Zhaoyi; Sun, Ying; Pribis, John P; Zhu, Chunyan; Li, Quan

    2015-01-01

    Excessive postoperative blood loss after cardiopulmonary bypass is a common problem, especially in patients suffering from congenital heart diseases. The efficacy of epsilon aminocaproic acid (EACA) as a prophylactic treatment for postoperative bleeding after pediatric open-heart surgery has not been determined. This meta-analysis investigates the efficacy of EACA in the minimization of bleeding and blood transfusion and the maintenance of coagulation tests after pediatric open-heart surgery. A comprehensive literature search was performed to identify all randomized clinical trials on the subject. PubMed, Embase, the Cochrane Library, and the Chinese Medical Journal Network were screened. The primary outcome used for the analysis was postoperative blood loss. Secondary outcomes included postoperative blood transfusion, re-exploration rate and postoperative coagulation tests. The mean difference (MD) and risk ratio (RR) with 95% confidence intervals (CI) were used as summary statistics. Five trials were included in this meta-analysis of 515 patients. Prophylactic EACA was associated with a reduction in postoperative blood loss, but this difference did not reach statistical significance (MD: -7.08; 95% CI: -16.11 to 1.95; P = 0.12). Patients treated with EACA received fewer postoperative blood transfusions, including packed red blood cells (MD: -8.36; 95% CI: -12.63 to -4.09; P = 0.0001), fresh frozen plasma (MD: -3.85; 95% CI: -5.63 to -2.08; P open-heart surgery. Prophylactic EACA minimizes postoperative blood transfusion and helps maintain coagulation in pediatric patients undergoing open-heart surgery. Therefore, the results of this study indicate that adjunctive EACA is a good choice for the prevention of postoperative blood transfusion following pediatric cardiac surgery.

  1. Accuracy of a pediatric early warning score in the recognition of clinical deterioration

    Directory of Open Access Journals (Sweden)

    Juliana de Oliveira Freitas Miranda

    Full Text Available ABSTRACT Objective: to evaluate the accuracy of the version of the Brighton Pediatric Early Warning Score translated and adapted for the Brazilian context, in the recognition of clinical deterioration. Method: a diagnostic test study to measure the accuracy of the Brighton Pediatric Early Warning Score for the Brazilian context, in relation to a reference standard. The sample consisted of 271 children, aged 0 to 10 years, blindly evaluated by a nurse and a physician, specialists in pediatrics, with interval of 5 to 10 minutes between the evaluations, for the application of the Brighton Pediatric Early Warning Score for the Brazilian context and of the reference standard. The data were processed and analyzed using the Statistical Package for the Social Sciences and VassarStats.net programs. The performance of the Brighton Pediatric Early Warning Score for the Brazilian context was evaluated through the indicators of sensitivity, specificity, predictive values, area under the ROC curve, likelihood ratios and post-test probability. Results: the Brighton Pediatric Early Warning Score for the Brazilian context showed sensitivity of 73.9%, specificity of 95.5%, positive predictive value of 73.3%, negative predictive value of 94.7%, area under Receiver Operating Characteristic Curve of 91.9% and the positive post-test probability was 80%. Conclusion: the Brighton Pediatric Early Warning Score for the Brazilian context, presented good performance, considered valid for the recognition of clinical deterioration warning signs of the children studied.

  2. Task-technology fit of video telehealth for nurses in an outpatient clinic setting.

    Science.gov (United States)

    Cady, Rhonda G; Finkelstein, Stanley M

    2014-07-01

    Incorporating telehealth into outpatient care delivery supports management of consumer health between clinic visits. Task-technology fit is a framework for understanding how technology helps and/or hinders a person during work processes. Evaluating the task-technology fit of video telehealth for personnel working in a pediatric outpatient clinic and providing care between clinic visits ensures the information provided matches the information needed to support work processes. The workflow of advanced practice registered nurse (APRN) care coordination provided via telephone and video telehealth was described and measured using a mixed-methods workflow analysis protocol that incorporated cognitive ethnography and time-motion study. Qualitative and quantitative results were merged and analyzed within the task-technology fit framework to determine the workflow fit of video telehealth for APRN care coordination. Incorporating video telehealth into APRN care coordination workflow provided visual information unavailable during telephone interactions. Despite additional tasks and interactions needed to obtain the visual information, APRN workflow efficiency, as measured by time, was not significantly changed. Analyzed within the task-technology fit framework, the increased visual information afforded by video telehealth supported the assessment and diagnostic information needs of the APRN. Telehealth must provide the right information to the right clinician at the right time. Evaluating task-technology fit using a mixed-methods protocol ensured rigorous analysis of fit within work processes and identified workflows that benefit most from the technology.

  3. Pediatric Academic Productivity: Pediatric Benchmarks for the h- and g-Indices.

    Science.gov (United States)

    Tschudy, Megan M; Rowe, Tashi L; Dover, George J; Cheng, Tina L

    2016-02-01

    To describe h- and g-indices benchmarks in pediatric subspecialties and general academic pediatrics. Academic productivity is measured increasingly through bibliometrics that derive a statistical enumeration of academic output and impact. The h- and g-indices incorporate the number of publications and citations. Benchmarks for pediatrics have not been reported. Thirty programs were selected randomly from pediatric residency programs accredited by the Accreditation Council for Graduate Medical Education. The h- and g-indices of department chairs were calculated. For general academic pediatrics, pediatric gastroenterology, and pediatric nephrology, a random sample of 30 programs with fellowships were selected. Within each program, an MD faculty member from each academic rank was selected randomly. Google Scholar via Harzing's Publish or Perish was used to calculate the h-index, g-index, and total manuscripts. Only peer-reviewed and English language publications were included. For Chairs, calculations from Google Scholar were compared with Scopus. For all specialties, the mean h- and g-indices significantly increased with academic rank (all P calculation using different bibliographic databases only differed by ±1. Mean h-indices increased with academic rank and were not significantly different across the pediatric specialties. Benchmarks for h- and g-indices in pediatrics are provided and may be one measure of academic productivity and impact. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Correlations between the simulated military tasks performance and physical fitness tests at high altitude

    Directory of Open Access Journals (Sweden)

    Eduardo Borba Neves

    2017-11-01

    Full Text Available The aim of this study was to investigate the Correlations between the Simulated Military Tasks Performance and Physical Fitness Tests at high altitude. This research is part of a project to modernize the physical fitness test of the Colombian Army. Data collection was performed at the 13th Battalion of Instruction and Training, located 30km south of Bogota D.C., with a temperature range from 1ºC to 23ºC during the study period, and at 3100m above sea level. The sample was composed by 60 volunteers from three different platoons. The volunteers start the data collection protocol after 2 weeks of acclimation at this altitude. The main results were the identification of a high positive correlation between the 3 Assault wall in succession and the Simulated Military Tasks performance (r = 0.764, p<0.001, and a moderate negative correlation between pull-ups and the Simulated Military Tasks performance (r = -0.535, p<0.001. It can be recommended the use of the 20-consecutive overtaking of the 3 Assault wall in succession as a good way to estimate the performance in operational tasks which involve: assault walls, network of wires, military Climbing Nets, Tarzan jump among others, at high altitude.

  5. Fit for Duty?: Evaluating the Physical Fitness Requirements of Battlefield Airmen.

    Science.gov (United States)

    Sean, Robson; Maria C, Lytell; Carra S, Sims; Stephanie, Pezard; Thomas, Manacapilli; Amanda, Anderson; Therese, Bohusch; Abigail, Haddad

    2018-01-01

    Military occupations can be physically demanding, yet few attempts have been made to determine the physical readiness of today's airmen to perform their jobs. Although the Air Force conducts fitness testing of all its airmen, these tests and standards are not based on validated job requirements. As part of a broader Air Force effort to measure the physical readiness of airmen to perform their jobs, this study describes a methodology for establishing physical fitness standards for four physically demanding Air Force occupational specialties-combat controller, pararescue, special operations weather team, and tactical air control party. Airmen in these specialties are collectively known as battlefield airmen. The authors sought to identify the physically demanding tasks required of battlefield airmen and ways in which fitness standards might be established to ensure that individuals in these specialties are able to perform these tasks. They reviewed the research literature and relevant military documents, conducted focus groups and interviews with battlefield airmen and other subject matter experts, and analyzed the movement patterns and physical abilities associated with each task. They found a high demand across the four specialities for strength and muscular and cardiovascular endurance, followed by agility, anaerobic power, and equilibrium, whereas they found flexibility to be less critically important. The authors recommend that a validation study be conducted next, to (a) ensure that tests measure important physical abilities required for successful mission or job performance, (b) ensure that performance on tests is a good indicator of mission or job performance, and (c) identify minimum test standards that are associated with acceptable mission or job performance.

  6. Evaluation of Pediatric Questions on the Orthopaedic In-Training Examination-An Update.

    Science.gov (United States)

    Murphy, Robert F; Nunez, Leah; Barfield, William R; Mooney, James F

    2017-09-01

    Pediatric orthopaedics is tested frequently on the Orthopaedic In-Training Examination (OITE). The most recent data on the pediatrics section of the OITE were generated from content 10 years old. The purpose of this study is to assess the pediatric orthopaedic questions on the 2011 to 2014 OITE, and to compare question categories and cognitive taxonomy with previous data. Four years (2011 to 2014) of OITE questions, answers, and references were reviewed. The number of pediatric questions per year was recorded, as well as presence of a clinical photo or imaging modality. Each question was categorized and assigned a cognitive taxonomy level. Categories included: knowledge; knowledge-treatment modalities; diagnosis; diagnosis/recognition of associated conditions; diagnosis/further studies; and diagnosis/treatment. Cognitive taxonomy levels included: simple recall, interpretation of data, and advanced problem-solving. The 3 most commonly covered topics were upper extremity trauma (17.4%), scoliosis (10.1%), and developmental dysplasia of the hip (5.7%). Compared with previous data, the percentage of pediatric questions was constant (13% vs. 14%). Categorically, the more recent OITE examinations contained significantly fewer questions testing simple knowledge (19% vs. 39%, P=0.0047), and significantly more questions testing knowledge of treatment modalities (17% vs. 9%, P=0.016) and diagnosis with associated conditions (19% vs. 9%, P=0.0034). Regarding cognitive taxonomy, there was a significant increase in the average number of questions that required advanced problem-solving (57% vs. 46%, P=0.048). Significantly more questions utilized clinical photographs and imaging studies (62% vs. 48%, P=0.012). The most common reference materials provided to support correct responses included Lovell and Winter's Pediatric Orthopaedics (25.7%) and the Journal of Pediatric Orthopaedics (23.4%). Although the percentage of pediatric questions on the OITE has remained essentially

  7. FIREFLY (Fitting IteRativEly For Likelihood analYsis): a full spectral fitting code

    Science.gov (United States)

    Wilkinson, David M.; Maraston, Claudia; Goddard, Daniel; Thomas, Daniel; Parikh, Taniya

    2017-12-01

    We present a new spectral fitting code, FIREFLY, for deriving the stellar population properties of stellar systems. FIREFLY is a chi-squared minimization fitting code that fits combinations of single-burst stellar population models to spectroscopic data, following an iterative best-fitting process controlled by the Bayesian information criterion. No priors are applied, rather all solutions within a statistical cut are retained with their weight. Moreover, no additive or multiplicative polynomials are employed to adjust the spectral shape. This fitting freedom is envisaged in order to map out the effect of intrinsic spectral energy distribution degeneracies, such as age, metallicity, dust reddening on galaxy properties, and to quantify the effect of varying input model components on such properties. Dust attenuation is included using a new procedure, which was tested on Integral Field Spectroscopic data in a previous paper. The fitting method is extensively tested with a comprehensive suite of mock galaxies, real galaxies from the Sloan Digital Sky Survey and Milky Way globular clusters. We also assess the robustness of the derived properties as a function of signal-to-noise ratio (S/N) and adopted wavelength range. We show that FIREFLY is able to recover age, metallicity, stellar mass, and even the star formation history remarkably well down to an S/N ∼ 5, for moderately dusty systems. Code and results are publicly available.1

  8. Creating a pediatric digital library for pediatric health care providers and families: using literature and data to define common pediatric problems.

    Science.gov (United States)

    D'Alessandro, Donna; Kingsley, Peggy

    2002-01-01

    The goal of this study was to complete a literature-based needs assessment with regard to common pediatric problems encountered by pediatric health care providers (PHCPs) and families, and to develop a problem-based pediatric digital library to meet those needs. The needs assessment yielded 65 information sources. Common problems were identified and categorized, and the Internet was manually searched for authoritative Web sites. The created pediatric digital library (www.generalpediatrics.com) used a problem-based interface and was deployed in November 1999. From November 1999 to November 2000, the number of hyperlinks and authoritative Web sites increased 51.1 and 32.2 percent, respectively. Over the same time, visitors increased by 57.3 percent and overall usage increased by 255 percent. A pediatric digital library has been created that begins to bring order to general pediatric resources on the Internet. This pediatric digital library provides current, authoritative, easily accessed pediatric information whenever and wherever the PHCPs and families want assistance.

  9. Enhancing the ED Approach to Pediatric Sexual Assault Care: Implementation of a Pediatric SART Program

    Science.gov (United States)

    Goyal, MK; Mollen, CJ; Hayes, KL; Molnar, J; Christian, CW; Scribano, PV; Lavelle, J

    2013-01-01

    Objective Describe the experience of a novel pediatric Sexual Assault Response Team (SART) program in the first three years of implementation, and compare patient characteristics, evaluation, and treatment among subpopulations of patients. Methods Retrospective chart review of a consecutive sample of patients evaluated at a pediatric ED who met institutional criteria for a SART evaluation. Associations of evaluation and treatment with gender, menarchal status, and presence of injuries were measured using logistic regression. Results One hundred and eighty-four patients met criteria for SART evaluation, of whom 87.5% were female; mean age was 10.1 years (+/− 4.6 years). The majority of patients underwent forensic evidence collection (89.1%), which varied by menarchal status among females (p<0.01), but not by gender. Evidence of acute anogenital injury on physical exam was found in 20.6% of patients. As per the Center for Disease Control and Prevention guidelines for acute sexual assault evaluations in pediatric patients, menarchal females were more likely to undergo testing for sexually transmitted infections (STI) and pregnancy (p<0.01) and to be offered pregnancy, STI, and HIV prophylaxis (p<0.01). Conclusions In an effort to improve quality and consistency of acute sexual assault examinations in a pediatric ED, development of a SART program supported the majority of eligible patients undergoing forensic evidence collection. Furthermore, a substantial number of patients had evidence of injury on exam. These findings underscore the importance of having properly trained personnel to support ED care for pediatric victims of acute sexual assault. PMID:23974714

  10. Amino acids intake and physical fitness among adolescents.

    Science.gov (United States)

    Gracia-Marco, Luis; Bel-Serrat, Silvia; Cuenca-Garcia, Magdalena; Gonzalez-Gross, Marcela; Pedrero-Chamizo, Raquel; Manios, Yannis; Marcos, Ascensión; Molnar, Denes; Widhalm, Kurt; Polito, Angela; Vanhelst, Jeremy; Hagströmer, Maria; Sjöström, Michael; Kafatos, Anthony; de Henauw, Stefaan; Gutierrez, Ángel; Castillo, Manuel J; Moreno, Luis A

    2017-06-01

    The aim was to investigate whether there was an association between amino acid (AA) intake and physical fitness and if so, to assess whether this association was independent of carbohydrates intake. European adolescents (n = 1481, 12.5-17.5 years) were measured. Intake was assessed via two non-consecutive 24-h dietary recalls. Lower and upper limbs muscular fitness was assessed by standing long jump and handgrip strength tests, respectively. Cardiorespiratory fitness was assessed by the 20-m shuttle run test. Physical activity was objectively measured. Socioeconomic status was obtained via questionnaires. Lower limbs muscular fitness seems to be positively associated with tryptophan, histidine and methionine intake in boys, regardless of centre, age, socioeconomic status, physical activity and total energy intake (model 1). However, these associations disappeared once carbohydrates intake was controlled for (model 2). In girls, only proline intake seems to be positively associated with lower limbs muscular fitness (model 2) while cardiorespiratory fitness seems to be positively associated with leucine (model 1) and proline intake (models 1 and 2). None of the observed significant associations remained significant once multiple testing was controlled for. In conclusion, we failed to detect any associations between any of the evaluated AAs and physical fitness after taking into account the effect of multiple testing.

  11. [Comparing the young asthmatics running fitness].

    Science.gov (United States)

    Belányi, Kinga; Gyene, István; Bak, Zsuzsa; Mezei, Györgyi

    2007-02-25

    Nowadays, doctors strongly recommend physical activity for asthmatic children, since the resulting improved physical fitness and psychological change also raise the quality of life. The aim of this study was to compare the physical fitness of asthmatic children who regularly participate in therapeutic swimming, with asthmatic children who do not participate in this training and with non-swimming, healthy children using the 12 minute free running, Cooper test. The children from the swimmer asthmatic group (n= 51, age = 9-22 yrs) took part in a special, long term, swimming exercise program (Gyene method). Whereas, the non-swimmer asthmatics (n = 28, age = 8-22 yrs) and the healthy children (n: 179, age: 9-22 yrs) only took part in the normal school physical education classes. Fitness was measured using the Cooper test. Data was collected from 258 subjects and showed that the fitness of swimmer asthmatics is significantly better than that of the non-swimmer asthmatics and even better than that of the healthy subjects (swimmer/ non swimmer asthmatic p = 0.01; swimmer asthmatic/ healthy p test). The difference in the fitness acquired from swimming was the most pronounced for the 8-11 years old asthmatics, presumably because of greater motivational factors. No differences were found between genders for the two asthmatic groups, whereas healthy boys were found to have significantly greater levels of fitness than healthy girls. Fitness is substantially increased with regular swimming. The favourable effects of swimming are expressed not only in comparison with the non-swimmer asthmatics but with the healthy subjects too. The regular therapeutic swimming program helps the formation of running fitness too.

  12. Pediatric Audiology in North America: Current Clinical Practice and How It Relates to the American Academy of Audiology Pediatric Amplification Guideline.

    Science.gov (United States)

    Moodie, Sheila; Rall, Eileen; Eiten, Leisha; Lindley, George; Gordey, Dave; Davidson, Lisa; Bagatto, Marlene; Scollie, Susan

    2016-03-01

    There is broad consensus that screening and diagnosis of permanent hearing loss in children must be embedded within a comprehensive, evidence-based, family-centered intervention program. Clinical practice guidelines (CPGs) for pediatric hearing assessment and hearing aid verification aim to reduce variability in practice and increase the use of effective evidence-based diagnostic and treatment options so that optimal outcomes may be achieved. To be of value, guidelines must be translated and implemented into practice and ongoing monitoring of their use in practice should occur. This paper provides the results of two studies that aim to examine current pediatric audiology and amplification practice in North America. A concurrent embedded mixed methods design was used. An electronic survey was distributed to North American audiologists who delivered pediatric audiology services with 350 audiologists participating in study 1 and 63 audiologists participating in study 2. A quantitative approach was the predominant method of data collection. Respondents were prompted to provide additional qualitative text and detail regarding their quantitative response choice. This qualitative text was used during the analysis phase and combined with quantitative results to assist understanding of respondents' knowledge, skills, and barriers/facilitators to implement best practice in pediatric amplification. Approximately 70% of audiologists reported using best-practice protocols for pediatric hearing aid fitting. Despite widespread knowledge and increased use of CPGs over the last 18 yrs, results of these studies show that variation in practice patterns continue to exist. Several examples of implementation challenges are discussed with recommendations provided. In order for audiologists working with children who are deaf or hard of hearing and their families to achieve the principles of family-centered early intervention, practice guidelines must continue to be developed, disseminated

  13. A Spline-Based Lack-Of-Fit Test for Independent Variable Effect in Poisson Regression.

    Science.gov (United States)

    Li, Chin-Shang; Tu, Wanzhu

    2007-05-01

    In regression analysis of count data, independent variables are often modeled by their linear effects under the assumption of log-linearity. In reality, the validity of such an assumption is rarely tested, and its use is at times unjustifiable. A lack-of-fit test is proposed for the adequacy of a postulated functional form of an independent variable within the framework of semiparametric Poisson regression models based on penalized splines. It offers added flexibility in accommodating the potentially non-loglinear effect of the independent variable. A likelihood ratio test is constructed for the adequacy of the postulated parametric form, for example log-linearity, of the independent variable effect. Simulations indicate that the proposed model performs well, and misspecified parametric model has much reduced power. An example is given.

  14. Pediatric urinary incontinence: Classification, evaluation, and ...

    African Journals Online (AJOL)

    A.J. Schaeffer

    tinuous incontinence refers to constant leakage of urine and can occur even in .... evaluation of pediatric urinary incontinence and guide which tests, if any, should ..... ments taken during bladder filling and storage include the maximal bladder ...

  15. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... navigation Test/Treatment Patient Type Screening/Wellness Disease/Condition Safety En Español More Info Images/Videos About Us ... or better than those obtained by CT scanning. Working together, your primary care physician or ... Safety in Pediatric Imaging's "Image Gently" Campaign top of ...

  16. Pediatric Obesity Empowerment Model Group Medical Visits (POEM-GMV) as Treatment for Pediatric Obesity in an Underserved Community.

    Science.gov (United States)

    Geller, Jeffrey S; Dube, Eileen T; Cruz, Glavielinys A; Stevens, Jason; Keating Bench, Kara

    2015-10-01

    This is a retrospective cohort study to evaluate a novel group medical visit (GMV) program using an empowerment curriculum as treatment for pediatric obesity in a federally qualified community health center. Biometric and self-reported data were reviewed from 417 overweight or obese children ages 5-18 attending the pediatric obesity empowerment model GMV program (POEM-GMV) at least twice during a 3-year period. Variables were evaluated using paired means t-test. Pearson's correlation test was used to evaluate variables and the BMI z-score. Subanalysis by gender was performed. The average participant was 10.48 ± 2.53 years old and participated for 301 ± 287 days. BMI z-score reduced from 2.99 ± 0.96 to 2.88 ± 0.88 (p pediatric obesity in an underserved community. There were statistically significantly improved outcomes in obesity, especially for boys. Significant improvement was observed in many lifestyle factors associated with obesity. Weight loss most closely correlated with reduced stress levels and sugary beverage consumption. Additional studies are needed to further evaluate the efficacy of POEM-GMV.

  17. 78 FR 48438 - Pediatric Ethics Subcommittee of the Pediatric Advisory Committee; Notice of Meeting

    Science.gov (United States)

    2013-08-08

    ...] Pediatric Ethics Subcommittee of the Pediatric Advisory Committee; Notice of Meeting AGENCY: Food and Drug... of Subcommittee: Pediatric Ethics Subcommittee of the Pediatric Advisory Committee. General Function... pediatric ethical issues. Date and Time: The meeting will be held on September 9, 2013, from 8 a.m. to 5:30...

  18. Psychometric Properties of Turkish Version of Pediatric Daytime Sleepiness Scale (PDSS-T).

    Science.gov (United States)

    Bektas, Murat; Bektas, Ilknur; Ayar, Dijle; Selekoglu, Yasemin; Ayar, Ugur; Kudubes, Aslı Akdeniz; Altan, Sema Sal; Armstrong, Merry

    2016-03-01

    The aim of the research was to evaluate the psychometric properties of the Pediatric Daytime Sleepiness Scale-Turkish Version (PDSS-T). The researchers chose a study sample of 522 grade 5-11 students. Data were collected using a demographic data collection form and the PDSS-T. Cronbach α for the scale was .79 and Kaiser-Meyer-Olkin coefficient was .78. Item-total correlations for the scale varied between .53 and .73 (p < .001). The indices of model fit were determined to be the root mean square error of approximation at .07, the goodness of fit index at .97, and the comparative fit index at .97. The study's results showed that PDSS-T is a valid and reliable instrument for detecting Turkish-speaking children's and adolescents' daytime sleepiness. PDSS-T is convenient for professionals to prevent and manage daytime sleepiness. Copyright © 2016. Published by Elsevier B.V.

  19. Myocarditis - pediatric

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/007307.htm Myocarditis - pediatric To use the sharing features on this page, please enable JavaScript. Pediatric myocarditis is inflammation of the heart muscle in ...

  20. The computer-based Symbol Digit Modalities Test: establishing age-expected performance in healthy controls and evaluation of pediatric MS patients.

    Science.gov (United States)

    Bigi, Sandra; Marrie, R A; Till, C; Yeh, E A; Akbar, N; Feinstein, A; Banwell, B L

    2017-04-01

    Decreased information processing speed (IPS) is frequently reported in pediatric multiple sclerosis (MS) patients. The computerized version of the Symbol Digit Modalities Test (c-SDMT) measures IPS over eight consecutive trials per session and additionally captures changes in performance within the session. Here, we establish normative c-SDMT performance and test-retest reliability in healthy children (HC) and explore differences in the overall c-SDMT-performance between HC and MS patients. This cross-sectional study included 478 HC (237 female, 49.5%) divided into five age groups (2 years each), and 27 MS patients (22 female, 81.5%) aged 8-18 years. The average time to complete the c-SDMT increased with age (|r| 0.70, 95% CI -0.74, -0.64). Test-retest reliability was high (ICC = 0.91) in HC. The total time to complete the c-SDMT did not differ between children with MS and sex- and age- matched HC (p = 0.23). However, MS patients were less likely to show faster performance across all the successive eight trials compared to HC (p = 0.0001). Healthy children demonstrate faster IPS with increasing age, as well as during successive trials of the c-SDMT. The inability of pediatric MS patients to maintain the increase in processing speed over successive trials suggests a reduced capacity for procedural learning, possibly resulting from cognitive fatigue.

  1. Comparison of ductile-to-brittle transition curve fitting approaches

    International Nuclear Information System (INIS)

    Cao, L.W.; Wu, S.J.; Flewitt, P.E.J.

    2012-01-01

    Ductile-to-brittle transition (DBT) curve fitting approaches are compared over the transition temperature range for reactor pressure vessel steels with different kinds of data, including Charpy-V notch impact energy data and fracture toughness data. Three DBT curve fitting methods have been frequently used in the past, including the Burr S-Weibull and tanh distributions. In general there is greater scatter associated with test data obtained within the transition region. Therefore these methods give results with different accuracies, especially when fitting to small quantities of data. The comparison shows that the Burr distribution and tanh distribution can almost equally fit well distributed and large data sets extending across the test temperature range to include the upper and lower shelves. The S-Weibull distribution fit is poor for the lower shelf of the DBT curve. Overall for both large and small quantities of measured data the Burr distribution provides the best description. - Highlights: ► Burr distribution offers a better fit than that of a S-Weibull and tanh fit. ► Burr and tanh methods show similar fitting ability for a large data set. ► Burr method can fit sparse data well distributed across the test temperature. ► S-Weibull method cannot fit the lower shelf well and show poor fitting quality.

  2. An experimental test of fitness variation across a hydrologic gradient predicts willow and poplar species distributions.

    Science.gov (United States)

    Wei, Xiaojing; Savage, Jessica A; Riggs, Charlotte E; Cavender-Bares, Jeannine

    2017-05-01

    Environmental filtering is an important community assembly process influencing species distributions. Contrasting species abundance patterns along environmental gradients are commonly used to provide evidence for environmental filtering. However, the same abundance patterns may result from alternative or concurrent assembly processes. Experimental tests are an important means to decipher whether species fitness varies with environment, in the absence of dispersal constraints and biotic interactions, and to draw conclusions about the importance of environmental filtering in community assembly. We performed an experimental test of environmental filtering in 14 closely related willow and poplar species (family Salicaceae) by transplanting cuttings of each species into 40 common gardens established along a natural hydrologic gradient in the field, where competition was minimized and herbivory was controlled. We analyzed species fitness responses to the hydrologic environment based on cumulative growth and survival over two years using aster fitness models. We also examined variation in nine drought and flooding tolerance traits expected to contribute to performance based on a priori understanding of plant function in relation to water availability and stress. We found substantial evidence that environmental filtering along the hydrologic gradient played a critical role in determining species distributions. Fitness variation of each species in the field experiment was used to model their water table depth optima. These optima predicted 68% of the variation in species realized hydrologic niches based on peak abundance in naturally assembled communities in the surrounding region. Multiple traits associated with water transport efficiency and water stress tolerance were correlated with species hydrologic niches, but they did not necessarily covary with each other. As a consequence, species occupying similar hydrologic niches had different combinations of trait values

  3. Patient Safety Culture Survey in Pediatric Complex Care Settings: A Factor Analysis.

    Science.gov (United States)

    Hessels, Amanda J; Murray, Meghan; Cohen, Bevin; Larson, Elaine L

    2017-04-19

    Children with complex medical needs are increasing in number and demanding the services of pediatric long-term care facilities (pLTC), which require a focus on patient safety culture (PSC). However, no tool to measure PSC has been tested in this unique hybrid acute care-residential setting. The objective of this study was to evaluate the psychometric properties of the Nursing Home Survey on Patient Safety Culture tool slightly modified for use in the pLTC setting. Factor analyses were performed on data collected from 239 staff at 3 pLTC in 2012. Items were screened by principal axis factoring, and the original structure was tested using confirmatory factor analysis. Exploratory factor analysis was conducted to identify the best model fit for the pLTC data, and factor reliability was assessed by Cronbach alpha. The extracted, rotated factor solution suggested items in 4 (staffing, nonpunitive response to mistakes, communication openness, and organizational learning) of the original 12 dimensions may not be a good fit for this population. Nevertheless, in the pLTC setting, both the original and the modified factor solutions demonstrated similar reliabilities to the published consistencies of the survey when tested in adult nursing homes and the items factored nearly identically as theorized. This study demonstrates that the Nursing Home Survey on Patient Safety Culture with minimal modification may be an appropriate instrument to measure PSC in pLTC settings. Additional psychometric testing is recommended to further validate the use of this instrument in this setting, including examining the relationship to safety outcomes. Increased use will yield data for benchmarking purposes across these specialized settings to inform frontline workers and organizational leaders of areas of strength and opportunity for improvement.

  4. Pediatric oncologic endosurgery.

    Science.gov (United States)

    Boo, Yoon Jung; Goedecke, Jan; Muensterer, Oliver J

    2017-08-01

    Despite increasing popularity of minimal-invasive techniques in the pediatric population, their use in diagnosis and management of pediatric malignancy is still debated. Moreover, there is limited evidence to clarify this controversy due to low incidence of each individual type of pediatric tumor, huge diversity of the disease entity, heterogeneity of surgical technique, and lack of well-designed studies on pediatric oncologic minimal-invasive surgery. However, a rapid development of medical instruments and technologies accelerated the current trend toward less invasive surgery, including oncologic endosurgery. The aim of this article is to review current literatures about the application of the minimal-invasive approach for pediatric tumors and to give an overview of the current status, indications, individual techniques, and future perspectives.

  5. How Do US Pediatric Residency Programs Teach and Evaluate Community Pediatrics and Advocacy Training?

    Science.gov (United States)

    Lichtenstein, Cara; Hoffman, Benjamin D; Moon, Rachel Y

    2017-07-01

    In 2013, the Accreditation Council for Graduate Medical Education updated requirements for training in community pediatrics and advocacy in pediatric residency programs. In light of this update, the aim of this study was to better understand how community pediatrics is being taught and evaluated in pediatric residency programs in the United States. Cross-sectional exploratory study using a Web-based survey of pediatric residency program directors in September 2014. Questions focused on teaching and evaluation of 10 community pediatrics competencies. Of 85 programs (43% response rate), 30% offered a separate training track and/or 6-block individualized curriculum in community pediatrics or advocacy. More than 75% required all residents to learn 7 of 10 competencies queried. Respondents in urban settings were more likely to teach care of special populations (P = .02) and public speaking (P pediatrics and advocacy teaching among responding US pediatric residency programs. Although respondents reported a variety of teaching and evaluation methods, there were few statistically significant differences between programs. Copyright © 2017 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  6. Attention for pediatric interventional radiology

    International Nuclear Information System (INIS)

    Zhu Ming; Cheng Yongde

    2005-01-01

    Radiological interventions possess wide utilization in the diagnosis and treatment for pediatric patients. Pediatric interventional radiology is an important branch of interventional radiology and also an important branch of pediatric radiology. Pediatric interventional radiology has grown substantially over the last 30 years, radiologists closely cooperation with surgeons and other physicians providing a new horizon in the management of pediatric diseases in western countries. It includes pediatric cardiac interventional radiology, pediatric neuro-interventional radiology, pediatric vascular interventional radiology, pediatric nonvascular interventional radiology, pediatric tumor interventional radiology and others. In the United States, every children hospital which owns two hundred beds has to have special trained interventional radiologists in radiologic department installing with advanced digital subtraction angiographic equipment. Interventional therapeutic procedures and diagnostic angiography have been proceeding more and more for the congenital and acquired diseases of children. The promising results give use uprising and interventional therapy as an alternative or a replacement or supplement to surgical operation. Pediatric interventional radiology is rather underdeveloped in China with a few special pediatric interventional radiologist, lack of digital subtraction angiography equipment. Pediatric radiologists have no enough field for interventional procedures such as pediatric neuro-interventional radiology and pediatric vascular interventional radiology. In the contrary adult interventional radiologists do have better interventional jobs in China and Pediatric cardiologists also share the same trend. They perform angiocardiography for congenital heart diseases and treat congenital heart disease with interventional procedures including balloon dilation of valves and vessels, coil embolization of collaterals, patent ducts and other arterial fistulae

  7. Beyond word recognition: understanding pediatric oral health literacy.

    Science.gov (United States)

    Richman, Julia Anne; Huebner, Colleen E; Leggott, Penelope J; Mouradian, Wendy E; Mancl, Lloyd A

    2011-01-01

    Parental oral health literacy is proposed to be an indicator of children's oral health. The purpose of this study was to test if word recognition, commonly used to assess health literacy, is an adequate measure of pediatric oral health literacy. This study evaluated 3 aspects of oral health literacy and parent-reported child oral health. A 3-part pediatric oral health literacy inventory was created to assess parents' word recognition, vocabulary knowledge, and comprehension of 35 terms used in pediatric dentistry. The inventory was administered to 45 English-speaking parents of children enrolled in Head Start. Parents' ability to read dental terms was not associated with vocabulary knowledge (r=0.29, P.06) of the terms. Vocabulary knowledge was strongly associated with comprehension (r=0.80, PParent-reported child oral health status was not associated with word recognition, vocabulary knowledge, or comprehension; however parents reporting either excellent or fair/poor ratings had higher scores on all components of the inventory. Word recognition is an inadequate indicator of comprehension of pediatric oral health concepts; pediatric oral health literacy is a multifaceted construct. Parents with adequate reading ability may have difficulty understanding oral health information.

  8. A Clinical Prediction Algorithm to Stratify Pediatric Musculoskeletal Infection by Severity

    Science.gov (United States)

    Benvenuti, Michael A; An, Thomas J; Mignemi, Megan E; Martus, Jeffrey E; Mencio, Gregory A; Lovejoy, Stephen A; Thomsen, Isaac P; Schoenecker, Jonathan G; Williams, Derek J

    2016-01-01

    Objective There are currently no algorithms for early stratification of pediatric musculoskeletal infection (MSKI) severity that are applicable to all types of tissue involvement. In this study, the authors sought to develop a clinical prediction algorithm that accurately stratifies infection severity based on clinical and laboratory data at presentation to the emergency department. Methods An IRB-approved retrospective review was conducted to identify patients aged 0–18 who presented to the pediatric emergency department at a tertiary care children’s hospital with concern for acute MSKI over a five-year period (2008–2013). Qualifying records were reviewed to obtain clinical and laboratory data and to classify in-hospital outcomes using a three-tiered severity stratification system. Ordinal regression was used to estimate risk for each outcome. Candidate predictors included age, temperature, respiratory rate, heart rate, C-reactive protein, and peripheral white blood cell count. We fit fully specified (all predictors) and reduced models (retaining predictors with a p-value ≤ 0.2). Discriminatory power of the models was assessed using the concordance (c)-index. Results Of the 273 identified children, 191 (70%) met inclusion criteria. Median age was 5.8 years. Outcomes included 47 (25%) children with inflammation only, 41 (21%) with local infection, and 103 (54%) with disseminated infection. Both the full and reduced models accurately demonstrated excellent performance (full model c-index 0.83, 95% CI [0.79–0.88]; reduced model 0.83, 95% CI [0.78–0.87]). Model fit was also similar, indicating preference for the reduced model. Variables in this model included C-reactive protein, pulse, temperature, and an interaction term for pulse and temperature. The odds of a more severe outcome increased by 30% for every 10-unit increase in C-reactive protein. Conclusions Clinical and laboratory data obtained in the emergency department may be used to accurately

  9. Comparison of machine learning techniques to predict all-cause mortality using fitness data: the Henry ford exercIse testing (FIT) project.

    Science.gov (United States)

    Sakr, Sherif; Elshawi, Radwa; Ahmed, Amjad M; Qureshi, Waqas T; Brawner, Clinton A; Keteyian, Steven J; Blaha, Michael J; Al-Mallah, Mouaz H

    2017-12-19

    Prior studies have demonstrated that cardiorespiratory fitness (CRF) is a strong marker of cardiovascular health. Machine learning (ML) can enhance the prediction of outcomes through classification techniques that classify the data into predetermined categories. The aim of this study is to present an evaluation and comparison of how machine learning techniques can be applied on medical records of cardiorespiratory fitness and how the various techniques differ in terms of capabilities of predicting medical outcomes (e.g. mortality). We use data of 34,212 patients free of known coronary artery disease or heart failure who underwent clinician-referred exercise treadmill stress testing at Henry Ford Health Systems Between 1991 and 2009 and had a complete 10-year follow-up. Seven machine learning classification techniques were evaluated: Decision Tree (DT), Support Vector Machine (SVM), Artificial Neural Networks (ANN), Naïve Bayesian Classifier (BC), Bayesian Network (BN), K-Nearest Neighbor (KNN) and Random Forest (RF). In order to handle the imbalanced dataset used, the Synthetic Minority Over-Sampling Technique (SMOTE) is used. Two set of experiments have been conducted with and without the SMOTE sampling technique. On average over different evaluation metrics, SVM Classifier has shown the lowest performance while other models like BN, BC and DT performed better. The RF classifier has shown the best performance (AUC = 0.97) among all models trained using the SMOTE sampling. The results show that various ML techniques can significantly vary in terms of its performance for the different evaluation metrics. It is also not necessarily that the more complex the ML model, the more prediction accuracy can be achieved. The prediction performance of all models trained with SMOTE is much better than the performance of models trained without SMOTE. The study shows the potential of machine learning methods for predicting all-cause mortality using cardiorespiratory fitness

  10. Obesity prevention in pediatrics: A pilot pediatric resident curriculum intervention on nutrition and obesity education and counseling.

    Science.gov (United States)

    Gonzalez, Jose L; Gilmer, Loise

    2006-09-01

    Obesity is a highly burdensome public health issue associated with premature death, multiple comorbid disabilities and staggering healthcare costs. Between 1980-2000, the prevalence of obesity among children and adolescents nearly tripled. Obesity subjects youth to social stigmatization and discrimination. These economic and personal burdens mandate targeted prevention and detection educational programs for all individuals at risk. The most cost-effective method of approaching this obesity epidemic is through education of health professionals. As part of an "Obesity Prevention in Pediatrics" curriculum, postgraduate-year (PGY)-2 residents first observed and then participated in the dietary evaluation and counseling of pediatric patients and their families. Attitudinal questionnaires, multiple-choice knowledge examinations and a pre-established checklist of desired skills and behaviors provided evaluation of the curriculum's effect on the participants' ability and willingness to manage actually obese or at-risk pediatric patients and their families. Attitudinal survey and knowledge test scores from control PGY-3 residents generally confirmed that their knowledge and counseling skills on obesity prevention and management were well below expectation. Following participation in the curriculum, study residents' knowledge tended to improve, as did their level of comfort in counseling obese and at-risk children, adolescents and their parents. Implementation of an "Obesity Prevention in Pediatrics" curriculum appears to improve participants' knowledge base as well as their skills and level of personal comfort in the recognition, evaluation and management, including counseling, of both obese and at-risk pediatric patients and their families.

  11. Why is muscularity sexy? Tests of the fitness indicator hypothesis.

    Science.gov (United States)

    Frederick, David A; Haselton, Martie G

    2007-08-01

    Evolutionary scientists propose that exaggerated secondary sexual characteristics are cues of genes that increase offspring viability or reproductive success. In six studies the hypothesis that muscularity is one such cue is tested. As predicted, women rate muscular men as sexier, more physically dominant and volatile, and less committed to their mates than nonmuscular men. Consistent with the inverted-U hypothesis of masculine traits, men with moderate muscularity are rated most attractive. Consistent with past research on fitness cues, across two measures, women indicate that their most recent short-term sex partners were more muscular than their other sex partners (ds = .36, .47). Across three studies, when controlling for other characteristics (e.g., body fat), muscular men rate their bodies as sexier to women (partial rs = .49-.62) and report more lifetime sex partners (partial rs = .20-.27), short-term partners (partial rs = .25-.28), and more affairs with mated women (partial r = .28).

  12. Demographics of US pediatric contact dermatitis registry providers.

    Science.gov (United States)

    Goldenberg, Alina; Jacob, Sharon E

    2015-01-01

    Children are as likely as adults to be sensitized and reactive to contact allergens. However, the prevailing data on pediatric allergic contact dermatitis are quantitatively and qualitatively limited because of a narrow geographic localization of data-reporting providers. The aim of the study was to present the first quarter results from the Loma Linda Pediatric Contact Dermatitis Registry focused on registered providers who self-identified as providing care for pediatric allergic contact dermatitis (ACD) within the United States. The US providers were invited to join the registry via completion of an online, secure, 11-question registration survey addressing demographics and clinical practice essentials. The presented results reflect data gathered within the first quarter of registry recruitment; registration is ongoing. Of 169 responders from 48 states, the majority of providers were female (60.4%), academic (55.6%), and dermatologists (76.3%). Based on individual provider averages, the minimum cumulative number of pediatric patch-test evaluations performed each year ranged between 1372 and 3468 children. The Pediatric Contact Dermatitis Registry provides a description of the current leaders in the realm of pediatric ACD and gaps, which are in need of attention. The registry allows for a collaborative effort to exchange information, educate providers, and foster investigative research with the hope of legislation that can reduce the disease burden of ACD in US children.

  13. Pediatric Stroke

    Science.gov (United States)

    ... and Patient Resources Home » Patients & Families » About Stroke » Pediatric Stroke » Introduction Introduction What is a Stroke? Ischemic Stroke Intracerebral Hemorrhage Subarachnoid Hemorrhage Pediatric Stroke Introduction Types of Stroke Diagnosis and Treatment ...

  14. Sedation in Pediatric Esophagogastroduodenoscopy

    Directory of Open Access Journals (Sweden)

    Seak Hee Oh

    2018-03-01

    Full Text Available Pediatric esophagogastroduodenoscopy (EGD has become an established diagnostic and therapeutic modality in pediatric gastroenterology. Effective sedation strategies have been adopted to improve patient tolerance during pediatric EGD. For children, safety is a fundamental consideration during this procedure as they are at a higher risk of severe adverse events from procedural sedation compared to adults. Therefore, a detailed risk evaluation is required prior to the procedure, and practitioners should be aware of the benefits and risks associated with sedation regimens during pediatric EGD. In addition, pediatric advanced life support by endoscopists or immediate intervention by anesthesiologists should be available in the event that severe adverse events occur during pediatric EGD.

  15. Do Fitness Apps Need Text Reminders? An Experiment Testing Goal-Setting Text Message Reminders to Promote Self-Monitoring.

    Science.gov (United States)

    Liu, Shuang; Willoughby, Jessica F

    2018-01-01

    Fitness tracking apps have the potential to change unhealthy lifestyles, but users' lack of compliance is an issue. The current intervention examined the effectiveness of using goal-setting theory-based text message reminders to promote tracking activities on fitness apps. We conducted a 2-week experiment with pre- and post-tests with young adults (n = 50). Participants were randomly assigned to two groups-a goal-setting text message reminder group and a generic text message reminder group. Participants were asked to use a fitness tracking app to log physical activity and diet for the duration of the study. Participants who received goal-setting reminders logged significantly more physical activities than those who only received generic reminders. Further, participants who received goal-setting reminders liked the messages and showed significantly increased self-efficacy, awareness of personal goals, motivation, and intention to use the app. The study shows that incorporating goal-setting theory-based text message reminders can be useful to boost user compliance with self-monitoring fitness apps by reinforcing users' personal goals and enhancing cognitive factors associated with health behavior change.

  16. A 45-Second Self-Test for Cardiorespiratory Fitness: Heart Rate-Based Estimation in Healthy Individuals.

    Science.gov (United States)

    Sartor, Francesco; Bonato, Matteo; Papini, Gabriele; Bosio, Andrea; Mohammed, Rahil A; Bonomi, Alberto G; Moore, Jonathan P; Merati, Giampiero; La Torre, Antonio; Kubis, Hans-Peter

    2016-01-01

    Cardio-respiratory fitness (CRF) is a widespread essential indicator in Sports Science as well as in Sports Medicine. This study aimed to develop and validate a prediction model for CRF based on a 45 second self-test, which can be conducted anywhere. Criterion validity, test re-test study was set up to accomplish our objectives. Data from 81 healthy volunteers (age: 29 ± 8 years, BMI: 24.0 ± 2.9), 18 of whom females, were used to validate this test against gold standard. Nineteen volunteers repeated this test twice in order to evaluate its repeatability. CRF estimation models were developed using heart rate (HR) features extracted from the resting, exercise, and the recovery phase. The most predictive HR feature was the intercept of the linear equation fitting the HR values during the recovery phase normalized for the height2 (r2 = 0.30). The Ruffier-Dickson Index (RDI), which was originally developed for this squat test, showed a negative significant correlation with CRF (r = -0.40), but explained only 15% of the variability in CRF. A multivariate model based on RDI and sex, age and height increased the explained variability up to 53% with a cross validation (CV) error of 0.532 L ∙ min-1 and substantial repeatability (ICC = 0.91). The best predictive multivariate model made use of the linear intercept of HR at the beginning of the recovery normalized for height2 and age2; this had an adjusted r2 = 0. 59, a CV error of 0.495 L·min-1 and substantial repeatability (ICC = 0.93). It also had a higher agreement in classifying CRF levels (κ = 0.42) than RDI-based model (κ = 0.29). In conclusion, this simple 45 s self-test can be used to estimate and classify CRF in healthy individuals with moderate accuracy and large repeatability when HR recovery features are included.

  17. A 45-Second Self-Test for Cardiorespiratory Fitness: Heart Rate-Based Estimation in Healthy Individuals.

    Directory of Open Access Journals (Sweden)

    Francesco Sartor

    Full Text Available Cardio-respiratory fitness (CRF is a widespread essential indicator in Sports Science as well as in Sports Medicine. This study aimed to develop and validate a prediction model for CRF based on a 45 second self-test, which can be conducted anywhere. Criterion validity, test re-test study was set up to accomplish our objectives. Data from 81 healthy volunteers (age: 29 ± 8 years, BMI: 24.0 ± 2.9, 18 of whom females, were used to validate this test against gold standard. Nineteen volunteers repeated this test twice in order to evaluate its repeatability. CRF estimation models were developed using heart rate (HR features extracted from the resting, exercise, and the recovery phase. The most predictive HR feature was the intercept of the linear equation fitting the HR values during the recovery phase normalized for the height2 (r2 = 0.30. The Ruffier-Dickson Index (RDI, which was originally developed for this squat test, showed a negative significant correlation with CRF (r = -0.40, but explained only 15% of the variability in CRF. A multivariate model based on RDI and sex, age and height increased the explained variability up to 53% with a cross validation (CV error of 0.532 L ∙ min-1 and substantial repeatability (ICC = 0.91. The best predictive multivariate model made use of the linear intercept of HR at the beginning of the recovery normalized for height2 and age2; this had an adjusted r2 = 0. 59, a CV error of 0.495 L·min-1 and substantial repeatability (ICC = 0.93. It also had a higher agreement in classifying CRF levels (κ = 0.42 than RDI-based model (κ = 0.29. In conclusion, this simple 45 s self-test can be used to estimate and classify CRF in healthy individuals with moderate accuracy and large repeatability when HR recovery features are included.

  18. Sample Size and Statistical Conclusions from Tests of Fit to the Rasch Model According to the Rasch Unidimensional Measurement Model (Rumm) Program in Health Outcome Measurement.

    Science.gov (United States)

    Hagell, Peter; Westergren, Albert

    Sample size is a major factor in statistical null hypothesis testing, which is the basis for many approaches to testing Rasch model fit. Few sample size recommendations for testing fit to the Rasch model concern the Rasch Unidimensional Measurement Models (RUMM) software, which features chi-square and ANOVA/F-ratio based fit statistics, including Bonferroni and algebraic sample size adjustments. This paper explores the occurrence of Type I errors with RUMM fit statistics, and the effects of algebraic sample size adjustments. Data with simulated Rasch model fitting 25-item dichotomous scales and sample sizes ranging from N = 50 to N = 2500 were analysed with and without algebraically adjusted sample sizes. Results suggest the occurrence of Type I errors with N less then or equal to 500, and that Bonferroni correction as well as downward algebraic sample size adjustment are useful to avoid such errors, whereas upward adjustment of smaller samples falsely signal misfit. Our observations suggest that sample sizes around N = 250 to N = 500 may provide a good balance for the statistical interpretation of the RUMM fit statistics studied here with respect to Type I errors and under the assumption of Rasch model fit within the examined frame of reference (i.e., about 25 item parameters well targeted to the sample).

  19. A Bayesian goodness of fit test and semiparametric generalization of logistic regression with measurement data.

    Science.gov (United States)

    Schörgendorfer, Angela; Branscum, Adam J; Hanson, Timothy E

    2013-06-01

    Logistic regression is a popular tool for risk analysis in medical and population health science. With continuous response data, it is common to create a dichotomous outcome for logistic regression analysis by specifying a threshold for positivity. Fitting a linear regression to the nondichotomized response variable assuming a logistic sampling model for the data has been empirically shown to yield more efficient estimates of odds ratios than ordinary logistic regression of the dichotomized endpoint. We illustrate that risk inference is not robust to departures from the parametric logistic distribution. Moreover, the model assumption of proportional odds is generally not satisfied when the condition of a logistic distribution for the data is violated, leading to biased inference from a parametric logistic analysis. We develop novel Bayesian semiparametric methodology for testing goodness of fit of parametric logistic regression with continuous measurement data. The testing procedures hold for any cutoff threshold and our approach simultaneously provides the ability to perform semiparametric risk estimation. Bayes factors are calculated using the Savage-Dickey ratio for testing the null hypothesis of logistic regression versus a semiparametric generalization. We propose a fully Bayesian and a computationally efficient empirical Bayesian approach to testing, and we present methods for semiparametric estimation of risks, relative risks, and odds ratios when parametric logistic regression fails. Theoretical results establish the consistency of the empirical Bayes test. Results from simulated data show that the proposed approach provides accurate inference irrespective of whether parametric assumptions hold or not. Evaluation of risk factors for obesity shows that different inferences are derived from an analysis of a real data set when deviations from a logistic distribution are permissible in a flexible semiparametric framework. © 2013, The International Biometric

  20. Differences in physical-fitness test scores between actively and passively recruited older adults : Consequences for norm-based classification

    NARCIS (Netherlands)

    van Heuvelen, M.J.G.; Stevens, M.; Kempen, G.I.J.M.

    This study investigated differences in physical-fitness test scores between actively and passively recruited older adults and the consequences thereof for norm-based classification of individuals. Walking endurance, grip strength, hip flexibility, balance, manual dexterity, and reaction time were

  1. Epigenetics and sex-specific fitness: an experimental test using male-limited evolution in Drosophila melanogaster.

    Science.gov (United States)

    Abbott, Jessica K; Innocenti, Paolo; Chippindale, Adam K; Morrow, Edward H

    2013-01-01

    When males and females have different fitness optima for the same trait but share loci, intralocus sexual conflict is likely to occur. Epigenetic mechanisms such as genomic imprinting (in which expression is altered according to parent-of-origin) and sex-specific maternal effects have been suggested as ways by which this conflict can be resolved. However these ideas have not yet been empirically tested. We designed an experimental evolution protocol in Drosophila melanogaster that enabled us to look for epigenetic effects on the X-chromosome-a hotspot for sexually antagonistic loci. We used special compound-X females to enforce father-to-son transmission of the X-chromosome for many generations, and compared fitness and gene expression levels between Control males, males with a Control X-chromosome that had undergone one generation of father-son transmission, and males with an X-chromosome that had undergone many generations of father-son transmission. Fitness differences were dramatic, with experimentally-evolved males approximately 20% greater than controls, and with males inheriting a non-evolved X from their father about 20% lower than controls. These data are consistent with both strong intralocus sexual conflict and misimprinting of the X-chromosome under paternal inheritance. However, expression differences suggested that reduced fitness under paternal X inheritance was largely due to deleterious maternal effects. Our data confirm the sexually-antagonistic nature of Drosophila's X-chromosome and suggest that the response to male-limited X-chromosome evolution entails compensatory evolution for maternal effects, and perhaps modification of other epigenetic effects via coevolution of the sex chromosomes.

  2. Physical Fitness Measures Among Adolescents With High and Low Motor Competence

    Directory of Open Access Journals (Sweden)

    Þórdís Gísladóttir

    2013-08-01

    Full Text Available Physical fitness level is considered to yield substantial health benefits. Earlier studies have demonstrated poor physical fitness outcomes and reduced level of physical activity among adolescents. There have been very few studies on adolescents concerning motor competence and its possible relationship with physical fitness. This study’s aim was to compare physical fitness in adolescents aged 15 to 16 years with high (HMC and low motor competence (LMC. From an initial sample of 94 adolescents, a group of 18 were identified as having HMC or LMC on the Movement Assessment Battery for Children-2. Eight adolescents (3 girls and 5 boys comprised the LMC group, and 10 children (5 girls and 5 boys made up the HMC group. To measure physical fitness, four tasks were used: one endurance test, one power test, one speed test (Test of Physical Fitness and one flexibility test (EUROFIT. A one-way ANOVA revealed significant differences between the group with LMC and the HMC group in all tasks except the endurance task (Reduced Cooper Test. The findings suggest that physical fitness components are negatively associated with LMC. However, no significant difference between the two groups in the Reduced Cooper Test might indicate that adolescents with LMC can enhance their cardiovascular fitness despite their poor motor coordination.

  3. A multi-source feedback tool for measuring a subset of Pediatrics Milestones.

    Science.gov (United States)

    Schwartz, Alan; Margolis, Melissa J; Multerer, Sara; Haftel, Hilary M; Schumacher, Daniel J

    2016-10-01

    The Pediatrics Milestones Assessment Pilot employed a new multisource feedback (MSF) instrument to assess nine Pediatrics Milestones among interns and subinterns in the inpatient context. To report validity evidence for the MSF tool for informing milestone classification decisions. We obtained MSF instruments by different raters per learner per rotation. We present evidence for validity based on the unified validity framework. One hundred and ninety two interns and 41 subinterns at 18 Pediatrics residency programs received a total of 1084 MSF forms from faculty (40%), senior residents (34%), nurses (22%), and other staff (4%). Variance in ratings was associated primarily with rater (32%) and learner (22%). The milestone factor structure fit data better than simpler structures. In domains except professionalism, ratings by nurses were significantly lower than those by faculty and ratings by other staff were significantly higher. Ratings were higher when the rater observed the learner for longer periods and had a positive global opinion of the learner. Ratings of interns and subinterns did not differ, except for ratings by senior residents. MSF-based scales correlated with summative milestone scores. We obtain moderately reliable MSF ratings of interns and subinterns in the inpatient context to inform some milestone assignments.

  4. Comment on the asymptotics of a distribution-free goodness of fit test statistic.

    Science.gov (United States)

    Browne, Michael W; Shapiro, Alexander

    2015-03-01

    In a recent article Jennrich and Satorra (Psychometrika 78: 545-552, 2013) showed that a proof by Browne (British Journal of Mathematical and Statistical Psychology 37: 62-83, 1984) of the asymptotic distribution of a goodness of fit test statistic is incomplete because it fails to prove that the orthogonal component function employed is continuous. Jennrich and Satorra (Psychometrika 78: 545-552, 2013) showed how Browne's proof can be completed satisfactorily but this required the development of an extensive and mathematically sophisticated framework for continuous orthogonal component functions. This short note provides a simple proof of the asymptotic distribution of Browne's (British Journal of Mathematical and Statistical Psychology 37: 62-83, 1984) test statistic by using an equivalent form of the statistic that does not involve orthogonal component functions and consequently avoids all complicating issues associated with them.

  5. Respirators. Does your face fit

    Energy Technology Data Exchange (ETDEWEB)

    Caro, N M; Else, D

    1981-04-01

    The authors carried out a survey of face sizes of men and women of four different ethnic origins and carried out face-seal leakage trials on four corresponding test panels. No single respirator design is likely to fit all members of the workforce, and it may be necessary to stock respirators from more than one manufacturers.Three or four different respirators or size of respirator may be needed. However, the use of lossely-fitting respirators such as Airsteam helmets could remove the necessity for exhaustive fitting procedures.

  6. Privacy and ethics in pediatric environmental health research-part II: protecting families and communities.

    Science.gov (United States)

    Fisher, Celia B

    2006-10-01

    In pediatric environmental health research, information about family members is often directly sought or indirectly obtained in the process of identifying child risk factors and helping to tease apart and identify interactions between genetic and environmental factors. However, federal regulations governing human subjects research do not directly address ethical issues associated with protections for family members who are not identified as the primary "research participant." Ethical concerns related to family consent and privacy become paramount as pediatric environmental health research increasingly turns to questions of gene-environment interactions. In this article I identify issues arising from and potential solutions for the privacy and informed consent challenges of pediatric environmental health research intended to adequately protect the rights and welfare of children, family members, and communities. I first discuss family members as secondary research participants and then the specific ethical challenges of longitudinal research on late-onset environmental effects and gene-environment interactions. I conclude with a discussion of the confidentiality and social risks of recruitment and data collection of research conducted within small or unique communities, ethnic minority populations, and low-income families. The responsible conduct of pediatric environmental health research must be conceptualized as a goodness of fit between the specific research context and the unique characteristics of subjects and other family stakeholders.

  7. Deficits in social cognition and response flexibility in pediatric bipolar disorder.

    Science.gov (United States)

    McClure, Erin B; Treland, Julia E; Snow, Joseph; Schmajuk, Mariana; Dickstein, Daniel P; Towbin, Kenneth E; Charney, Dennis S; Pine, Daniel S; Leibenluft, Ellen

    2005-09-01

    Little is known about neuropsychological and social-cognitive function in patients with pediatric bipolar disorder. Identification of specific deficits and strengths that characterize pediatric bipolar disorder would facilitate advances in diagnosis, treatment, and research on pathophysiology. The purpose of this study was to test the hypothesis that youths with bipolar disorder would perform more poorly than matched healthy comparison subjects on measures of social cognition, motor inhibition, and response flexibility. Forty outpatients with pediatric bipolar disorder and 22 comparison subjects (no differences in age, gender, and IQ) completed measures of social cognition (the pragmatic judgment subtest of the Comprehensive Assessment of Spoken Language, facial expression recognition subtests of the Diagnostic Analysis of Nonverbal Accuracy Scale, the oral expression subtest of the Test of Language Competence), inhibition and response flexibility (stop and stop-change tasks), and motor inhibition (continuous performance tasks). Pediatric bipolar disorder patients performed more poorly than comparison subjects on social-cognitive measures (pragmatic judgment of language, facial expression recognition) and on a task requiring response flexibility. These deficits were present in euthymic patients. Differences between patients and comparison subjects could not be attributed to comorbid attention deficit hyperactivity disorder. Findings of impaired social cognition and response flexibility in youths with pediatric bipolar disorder suggest continuity between pediatric bipolar disorder and adult bipolar disorder. These findings provide a foundation for neurocognitive research designed to identify the neural mechanisms underlying these deficits.

  8. Abdominal emergencies in pediatrics.

    Science.gov (United States)

    Coca Robinot, D; Liébana de Rojas, C; Aguirre Pascual, E

    2016-05-01

    Abdominal symptoms are among the most common reasons for pediatric emergency department visits, and abdominal pain is the most frequently reported symptom. Thorough history taking and physical examination can often reach the correct diagnosis. Knowing the abdominal conditions that are most common in each age group can help radiologists narrow the differential diagnosis. When imaging tests are indicated, ultrasonography is usually the first-line technique, enabling the diagnosis or adding relevant information with the well-known advantages of this technique. Nowadays, plain-film X-ray studies are reserved for cases in which perforation, bowel obstruction, or foreign body ingestion is suspected. It is also important to remember that abdominal pain can also occur secondary to basal pneumonia. CT is reserved for specific indications and in individual cases, for example, in patients with high clinical suspicion of abdominal disease and inconclusive findings at ultrasonography. We review some of the most common conditions in pediatric emergencies, the different imaging tests indicated in each case, and the imaging signs in each condition. Copyright © 2016 SERAM. Published by Elsevier España, S.L.U. All rights reserved.

  9. The universal Higgs fit

    DEFF Research Database (Denmark)

    Giardino, P. P.; Kannike, K.; Masina, I.

    2014-01-01

    We perform a state-of-the-art global fit to all Higgs data. We synthesise them into a 'universal' form, which allows to easily test any desired model. We apply the proposed methodology to extract from data the Higgs branching ratios, production cross sections, couplings and to analyse composite...... Higgs models, models with extra Higgs doublets, supersymmetry, extra particles in the loops, anomalous top couplings, and invisible Higgs decays into Dark Matter. Best fit regions lie around the Standard Model predictions and are well approximated by our 'universal' fit. Latest data exclude the dilaton...... as an alternative to the Higgs, and disfavour fits with negative Yukawa couplings. We derive for the first time the SM Higgs boson mass from the measured rates, rather than from the peak positions, obtaining M-h = 124.4 +/- 1.6 GeV....

  10. Job Satisfaction and Relocation Desire among Pediatric Dentists in Puerto Rico.

    Science.gov (United States)

    Arévalo, Oscar; Saman, Daniel M; Tabares, Miguel; Hernández, Ana; Sanders-Ward, Rebecca

    2015-12-01

    To determine the levels of satisfaction, license status, and desire to relocate of pediatric dentists in Puerto Rico. Pediatric dentists in Puerto Rico were surveyed via telephone interviews. Data were collected through a 34-item questionnaire that explored satisfaction as related to income, continuing education, professional goals, and participation in the Mi Salud program. Frequencies, chi-square analysis, and Fisher's exact 2-tailed t-test were utilized to determine the relationships between satisfaction and the demographics of the pediatric dentists. Sixty pediatric dentists participated in our survey-77% of the total number of pediatric dentists practicing in Puerto Rico. Overall, 65% of the participating pediatric dentists expressed dissatisfaction. Male pediatric dentists were more dissatisfied than their female colleagues were. Most pediatric dentists participating in Mi Salud expressed dissatisfaction. When asked about whether or not they had considered migrating to the mainland, those who were dissatisfied were more likely to have considered that idea than were those who were satisfied. Overall, 57% of the pediatric dentists comprising our sample had considered relocating to the continental United States. In general, the pediatric dentists who participated in our study expressed dissatisfaction in most areas except when asked about their ability to reach professional goals. Determining the levels of satisfaction of health care providers is important in the maintaining of an adequate workforce. As current levels of dissatisfaction are high, it is important to determine what variables are related to satisfaction so that corrective measures can be taken to ensure that retention rates improve, thereby maintaining an adequate pediatric dental workforce.

  11. Pediatric heart surgery - discharge

    Science.gov (United States)

    ... discharge; Heart valve surgery - children - discharge; Heart surgery - pediatric - discharge; Heart transplant - pediatric - discharge ... Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics . 20th ed. Philadelphia, PA: Elsevier; 2016:chap 434. ...

  12. Does childhood motor skill proficiency predict adolescent fitness?

    Science.gov (United States)

    Barnett, Lisa M; Van Beurden, Eric; Morgan, Philip J; Brooks, Lyndon O; Beard, John R

    2008-12-01

    To determine whether childhood fundamental motor skill proficiency predicts subsequent adolescent cardiorespiratory fitness. In 2000, children's proficiency in a battery of skills was assessed as part of an elementary school-based intervention. Participants were followed up during 2006/2007 as part of the Physical Activity and Skills Study, and cardiorespiratory fitness was measured using the Multistage Fitness Test. Linear regression was used to examine the relationship between childhood fundamental motor skill proficiency and adolescent cardiorespiratory fitness controlling for gender. Composite object control (kick, catch, throw) and locomotor skill (hop, side gallop, vertical jump) were constructed for analysis. A separate linear regression examined the ability of the sprint run to predict cardiorespiratory fitness. Of the 928 original intervention participants, 481 were in 28 schools, 276 (57%) of whom were assessed. Two hundred and forty-four students (88.4%) completed the fitness test. One hundred and twenty-seven were females (52.1%), 60.1% of whom were in grade 10 and 39.0% were in grade 11. As children, almost all 244 completed each motor assessments, except for the sprint run (n = 154, 55.8%). The mean composite skill score in 2000 was 17.7 (SD 5.1). In 2006/2007, the mean number of laps on the Multistage Fitness Test was 50.5 (SD 24.4). Object control proficiency in childhood, adjusting for gender (P = 0.000), was associated with adolescent cardiorespiratory fitness (P = 0.012), accounting for 26% of fitness variation. Children with good object control skills are more likely to become fit adolescents. Fundamental motor skill development in childhood may be an important component of interventions aiming to promote long-term fitness.

  13. Pediatric maxillary fractures.

    Science.gov (United States)

    Yu, Jack; Dinsmore, Robert; Mar, Philip; Bhatt, Kirit

    2011-07-01

    Pediatric craniofacial structures differ from those of adults in many ways. Because of these differences, management of pediatric craniofacial fractures is not the same as those in adults. The most important differences that have clinical relevance are the mechanical properties, craniofacial anatomy, healing capacity, and dental morphology. This article will review these key differences and the management of pediatric maxillary fractures. From the mechanical properties' perspective, pediatric bones are much more resilient than adult bones; as such, they undergo plastic deformation and ductile failure. From the gross anatomic perspective, the relative proportion of the cranial to facial structures is much larger for the pediatric patients and the sinuses are not yet developed. The differences related to dentition and dental development are more conical crowns, larger interdental spaces, and presence of permanent tooth buds in the pediatric population. The fracture pattern, as a result of all the above, does not follow the classic Le Fort types. The maxillomandibular fixation may require circum-mandibular wires, drop wires, or Ivy loops. Interfragmentary ligatures using absorbable sutures play a much greater role in these patients. The use of plates and screws should take into consideration the future development with respect to growth centers and the location of the permanent tooth buds. Pediatric maxillary fractures are not common, require different treatments, and enjoy better long-term outcomes.

  14. Development and clinical application of a color pediatric visual acuity chart

    Directory of Open Access Journals (Sweden)

    Shu-Guo Yin

    2014-12-01

    Full Text Available AIM: To introduce a new color pediatric visual acuity chart and its clinical application.METHODS:The color pediatric visual acuity chart was designed based on principle of visual angle. The optotype on the color chart had graphics. The progression rate of optotype size between 2 lines was 10(101/2 and 1.2589. A regular geometric progression of optotype sizes and distribution was employed to arrange 8 lines with 11 optotype on the color chart. The testing distance was 3m. The visual acuity score could be recorded as logarithm of the minimum angle of resolution notation or decimal notation. The reliability of naked distant measurements with this new chart was tested in one eye of 100 children(4 ~6 years oldtaking the Chinese national standard logarithm visual acuity chart standard. RESULTS: The color pediatric visual acuity chart and logarithmic chart controls, visual acuity test results that in the two groups had no significant difference(t=1.2671, P>0.05. Two sets of vision data existed positive correlation(r=0.924, PCONCLUSION:Children are easier to accept used new color pediatric visual acuity chart to inspect vision. New chart is reliability and apply to children's vision screening.

  15. Effects of Pregnancy on the Army Physical Fitness Test

    National Research Council Canada - National Science Library

    Usher, Stacy

    2003-01-01

    The purpose of this study was to determine the actual and perceived amount of time needed for the postpartum soldier to return to pre-pregnancy fitness condition as evidenced by APFT scores before and after...

  16. Anthropometry of a Fit Test Sample used in Evaluating the Current and Improved MCU-2/P Masks

    Science.gov (United States)

    1989-03-01

    METHOD Forty-two head and face measurements were taken on each subject after he/she had completed MSA’s series of fit tests. Of these, 15 were measured...BREADTH Using spreading calipers, the hori- zontal distance between the fronto- temporale landmarks. 25 MEASUREMENT DESCRIPTIONS (cont’d) 13. NASAL

  17. What Is a Pediatric Rheumatologist?

    Science.gov (United States)

    ... Text Size Email Print Share What is a Pediatric Rheumatologist? Page Content Article Body If your child ... a pediatric rheumatologist. What Kind of Training Do Pediatric Rheumatologists Have? Pediatric rheumatologists are medical doctors who ...

  18. Serological biomarkers in triage of FIT-positive subjects?

    DEFF Research Database (Denmark)

    Nielsen, Hans J; Christensen, Ib Jarle; Andersen, Berit

    2017-01-01

    with neoplastic lesions missed by increased cut-off levels appears to be much higher than expected. Therefore, tests that identify those patients missed by increased FIT cut-off levels must be developed. Preliminary results of determination of one of several biomarker entities currently under investigation show...... that nucleosome blood tests may be one option for identifying some of these patients. Implementation of a triage test consisting of FIT, blood-based biomarkers and plus/minus colonoscopy is suggested to identify subjects with FIT levels between the initial and the increased cut-off level that must be offered...

  19. Childhood cardiorespiratory fitness, muscular fitness and adult measures of glucose homeostasis.

    Science.gov (United States)

    Fraser, Brooklyn J; Blizzard, Leigh; Schmidt, Michael D; Juonala, Markus; Dwyer, Terence; Venn, Alison J; Magnussen, Costan G

    2018-02-14

    To assess whether childhood cardiorespiratory fitness (CRF) and muscular fitness phenotypes (strength, power, endurance) predict adult glucose homeostasis measures. Prospective longitudinal study. Study examining participants who had physical fitness measured in childhood (aged 7-15 years) and who attended follow-up clinics approximately 20 years later and provided a fasting blood sample which was tested for glucose and insulin. Physical fitness measurements included muscular strength (right and left grip, shoulder flexion, shoulder and leg extension), power (standing long jump distance) and endurance (number of push-ups in 30s), and CRF (1.6km run duration). In adulthood, fasting glucose and insulin levels were used to derive glucose homeostasis measures of insulin resistance (HOMA2-IR) and beta cell function (HOMA2-β). A standard deviation increase in childhood CRF or muscular strength (males) was associated with fasting glucose (CRF: β=-0.06mmol/L), fasting insulin (CRF: β=-0.73mU/L; strength: β=-0.40mU/L), HOMA2-IR (CRF: β=-0.06; strength: β=-0.05) and HOMA2-β (CRF: β=-3.06%; strength: β=-2.62%) in adulthood, independent of the alternative fitness phenotype (all p0.06). CRF and muscular fitness in childhood were inversely associated with measures of fasting insulin, insulin resistance and beta cell function in adulthood. Childhood CRF and muscular fitness could both be potential independent targets for strategies to help reduce the development of adverse glucose homeostasis. Copyright © 2018 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  20. Effects of Pregnancy on the Army Physical Fitness Test

    National Research Council Canada - National Science Library

    Usher, Stacy

    2003-01-01

    The purpose of this study was to determine the actual and perceived amount of time needed for the postpartum soldier to return to pre-pregnancy fitness condition as evidenced by APFT scores before and after pregnancy...

  1. Age Limit of Pediatrics.

    Science.gov (United States)

    Hardin, Amy Peykoff; Hackell, Jesse M

    2017-09-01

    Pediatrics is a multifaceted specialty that encompasses children's physical, psychosocial, developmental, and mental health. Pediatric care may begin periconceptionally and continues through gestation, infancy, childhood, adolescence, and young adulthood. Although adolescence and young adulthood are recognizable phases of life, an upper age limit is not easily demarcated and varies depending on the individual patient. The establishment of arbitrary age limits on pediatric care by health care providers should be discouraged. The decision to continue care with a pediatrician or pediatric medical or surgical subspecialist should be made solely by the patient (and family, when appropriate) and the physician and must take into account the physical and psychosocial needs of the patient and the abilities of the pediatric provider to meet these needs. Copyright © 2017 by the American Academy of Pediatrics.

  2. Local fit evaluation of structural equation models using graphical criteria.

    Science.gov (United States)

    Thoemmes, Felix; Rosseel, Yves; Textor, Johannes

    2018-03-01

    Evaluation of model fit is critically important for every structural equation model (SEM), and sophisticated methods have been developed for this task. Among them are the χ² goodness-of-fit test, decomposition of the χ², derived measures like the popular root mean square error of approximation (RMSEA) or comparative fit index (CFI), or inspection of residuals or modification indices. Many of these methods provide a global approach to model fit evaluation: A single index is computed that quantifies the fit of the entire SEM to the data. In contrast, graphical criteria like d-separation or trek-separation allow derivation of implications that can be used for local fit evaluation, an approach that is hardly ever applied. We provide an overview of local fit evaluation from the viewpoint of SEM practitioners. In the presence of model misfit, local fit evaluation can potentially help in pinpointing where the problem with the model lies. For models that do fit the data, local tests can identify the parts of the model that are corroborated by the data. Local tests can also be conducted before a model is fitted at all, and they can be used even for models that are globally underidentified. We discuss appropriate statistical local tests, and provide applied examples. We also present novel software in R that automates this type of local fit evaluation. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  3. Children's (Pediatric) Nuclear Medicine

    Science.gov (United States)

    ... Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine Children’s (pediatric) nuclear medicine imaging uses small amounts ... Children's Nuclear Medicine? What is Children's (Pediatric) Nuclear Medicine? Nuclear medicine is a branch of medical imaging ...

  4. Health-related quality of life in children with dysphonia and validation of the French Pediatric Voice Handicap Index.

    Science.gov (United States)

    Oddon, P A; Boucekine, M; Boyer, L; Triglia, J M; Nicollas, R

    2018-01-01

    voice disorders are common in the pediatric population and can negatively affect children's quality of life. The pediatric voice handicap Index (pVHI) is a valid instrument to assess parental perception of their children voice but it is not translated into French language. The aim of the present study was to adapt a French version of the pVHI and to evaluate its psychometric properties including construct validity, reliability, and some aspects of external validity. we performed a cross sectional study including 32 dysphonic children and 60 children with no history of voice problems between 3 and 12 years of age. The original pVHI was translated into French language according to forward-backward rules and then administered to parents or caregivers. Construct validity and internal consistency were explored using confirmatory factor analysis and Cronbach's alpha. The questionnaire was filled twice to assess test-retest reliability using the intra-class correlation coefficient. The external validity was explored by comparing the French pVHI total and subscales scores between dysphonic and asymptomatic children. Correlations between the French pVHI and both the perceptual GRBAS scale and the health-related quality of life (HRQOL) survey "Vécu et Santé Perçu de l'Adolescent et de l'Enfant" (VSP-Ap) were also performed. the structure of the French pVHI showed a good fit with excellent reliability (α = 0.929) and high test-retest reliability. Significant differences were found between the group of dysphonic children and the control group (p life in children with voice disorder. We recommend its use in the multidimensional protocols for assessing voice disorder in the pediatric population. Copyright © 2017. Published by Elsevier B.V.

  5. Pediatric dental chair vs. traditional dental chair: A pediatric dentist′s poll

    Directory of Open Access Journals (Sweden)

    Khushboo Barjatya

    2015-01-01

    Full Text Available Objective: Proper positioning of the child patient, can not only have positive ramifications for the operator′s posture, comfort, and career longevity - it can also lead to better treatment and increased productivity. The aim of the survey questionnaire was to assess the utilization, need, and attitude concerning dental chairs among pediatric dentist while working on and managing the child patient. Study Design: The questions were structured using adobe forms central online software, regarding the user-friendliness of pediatric dental chair vs. traditional adult dental chair available in the market. Results: Our result shows that out of 337 respondents, 79% worked on pediatric dental chair, whereas 21% had no experience of it. Of these 79% pediatric dentist, 48% preferred pediatric dental chair. But pediatric dental problem still has certain disadvantages like higher cost, leg space problem, lower availability, etc. Conclusion: During the research it was found that ergonomics and usability issues were the main problems. Thus, pediatric dental chair is not so popular in the current scenario. This study allowed for general ideas for the improvement of dental chairs and thus improved dental chair would fill the gap in the current scenario.

  6. Artifact in Pediatric Oculomotor Findings during Videonystagmography: A Retrospective Analysis.

    Science.gov (United States)

    Doettl, Steven M; Plyler, Patrick N; McCaslin, Devin L

    2017-04-01

    Accurate measurement of oculomotor function using videonystagmography (VNG) is imperative for diagnosis and management of patients with reported dizziness. The oculomotor evaluation during VNG utilizes video-oculography providing valuable information regarding the central structures and pathways that control eye movements. Artifact may have an effect on the overall validity and reliability of VNG oculomotor tracings and can result from patient and/or recording errors. It is postulated that artifact could occur more frequently in the pediatric population due to both patient and equipment factors. The purpose of this study was to systematically evaluate the occurrence and impact of artifact on saccades, smooth pursuit, and optokinetic (OPK) testing in normal pediatric and adult subjects using commercially available clinical VNG equipment and standard clinical protocols for oculomotor testing. The present study utilized a retrospective analysis of a repeated measures design. Oculomotor results from a total of 62 participants were analyzed. Portions of these data have been presented in a previous research study. Group 1 consisted of twenty-nine 4- to 6-yr-olds with an average age of 4.86 (SD = 0.88) yr. Group 2 consisted of thirty-three 22- to 44-yr-olds with an average age of 25.2 (SD = 5.34) yr. Raw oculomotor recordings were analyzed "offline" by a single masked, trained investigator. Each tracing was evaluated for instances of artifact including eye blinks, eye closure, eyes moving in opposite direction of the target, eye tracking software problems, and overall poor morphology. The number of instances of artifact were noted and recorded for each participant in both groups. Individual eye movements not affected by artifact were included for final analysis. Artifact rejection techniques were also compared. The results indicated increased artifact for the pediatric group for saccade and smooth pursuit testing. Additionally, a significant decrease in instances of

  7. The role of advanced practice providers in pediatric otolaryngology academic practices.

    Science.gov (United States)

    Reilly, Brian K; Brandon, Gretchen; Shah, Rahul; Preciado, Diego; Zalzal, George

    2013-01-01

    The goal of this study was to examine the roles of Physician Assistants (PAs) and Nurse Practitioners (NPs) in pediatric academic otolaryngology programs to provide a better understanding of their scope of practice, levels of autonomy, clinical duties, teaching opportunities and research participation. An anonymous web-based electronic survey tool was sent to all pediatric otolaryngology fellowship program directors in the United States. Nurse Practitioners and Physician Assistants are utilized in approximately 3 out of every 4 pediatric otolaryngology practices. The top three job activities of both the PA and NP were: (1) seeing patients independently, (2) working alongside doctors in clinic, and (3) answering phone lines/parental calls. A higher percentage of PAs (83%), worked alongside doctors in clinic, as compared to NPs, where only 55% work alongside MDs. Over half of PAs round with the in-patient team and see consults as compared to just over one third of NPs who participate in such activities. Twenty-five percent of practices reported that PAs cover call and assist in the OR. Most PAs/NPs saw between 11 and 15 patients per clinic which provides a clear productivity advantage when looking to screen patients, provide medical care, generate surgical cases, and maximize billings. NPs and PAs have complimentary skill sets ideal for the pediatric otolaryngology workplace, although job activities and "best fit" are hospital and practice dependent. Our study suggests that the use of PAs and NPs will continue to grow to meet increased demand for services in the field of pediatric otolaryngology. Employing advanced practice providers enables academic centers to improve access, provide additional financial remuneration, reduce wait times for new patients, and allow attending physicians to meet increased practice demands. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  8. Pharmacologic treatment of acute pediatric methamphetamine toxicity.

    Science.gov (United States)

    Ruha, Anne-Michelle; Yarema, Mark C

    2006-12-01

    To report our experience with the use of benzodiazepines and haloperidol for sedation of pediatric patients with acute methamphetamine poisoning. We performed a retrospective chart review of 18 pediatric patients who were admitted to an intensive care unit for methamphetamine toxicity from January 1997 to October 2004 and treated with benzodiazepines or haloperidol. Clinical features, dose of drug received, and laboratory test results were noted. Adverse effects from the use of haloperidol such as prolonged QTc, dystonic reactions, and torsades de pointes were recorded. Eighteen patients received a benzodiazepine, the dose of which varied depending on the agent used. Twelve patients also received parenteral haloperidol. No complications developed from the use of either haloperidol or benzodiazepines. In this case series of pediatric patients poisoned with methamphetamine, parenteral benzodiazepines and haloperidol were used to control agitation. No serious adverse effects were observed from the use of these agents.

  9. Different fits satisfy different needs: linking person-environment fit to employee commitment and performance using self-determination theory.

    Science.gov (United States)

    Greguras, Gary J; Diefendorff, James M

    2009-03-01

    Integrating and expanding upon the person-environment fit (PE fit) and the self-determination theory literatures, the authors hypothesized and tested a model in which the satisfaction of the psychological needs for autonomy, relatedness, and competence partially mediated the relations between different types of perceived PE fit (i.e., person-organization fit, person-group fit, and job demands-abilities fit) with employee affective organizational commitment and overall job performance. Data from 163 full-time working employees and their supervisors were collected across 3 time periods. Results indicate that different types of PE fit predicted different types of psychological need satisfaction and that psychological need satisfaction predicted affective commitment and performance. Further, person-organization fit and demands-abilities fit also evidenced direct effects on employee affective commitment. These results begin to explicate the processes through which different types of PE fit relate to employee attitudes and behaviors. (c) 2009 APA, all rights reserved.

  10. Physical fitness reference standards in European children: the IDEFICS study.

    Science.gov (United States)

    De Miguel-Etayo, P; Gracia-Marco, L; Ortega, F B; Intemann, T; Foraita, R; Lissner, L; Oja, L; Barba, G; Michels, N; Tornaritis, M; Molnár, D; Pitsiladis, Y; Ahrens, W; Moreno, L A

    2014-09-01

    A low fitness status during childhood and adolescence is associated with important health-related outcomes, such as increased future risk for obesity and cardiovascular diseases, impaired skeletal health, reduced quality of life and poor mental health. Fitness reference values for adolescents from different countries have been published, but there is a scarcity of reference values for pre-pubertal children in Europe, using harmonised measures of fitness in the literature. The IDEFICS study offers a good opportunity to establish normative values of a large set of fitness components from eight European countries using common and well-standardised methods in a large sample of children. Therefore, the aim of this study is to report sex- and age-specific fitness reference standards in European children. Children (10,302) aged 6-10.9 years (50.7% girls) were examined. The test battery included: the flamingo balance test, back-saver sit-and-reach test (flexibility), handgrip strength test, standing long jump test (lower-limb explosive strength) and 40-m sprint test (speed). Moreover, cardiorespiratory fitness was assessed by a 20-m shuttle run test. Percentile curves for the 1st, 3rd, 10th, 25th, 50th, 75th, 90th, 97th and 99th percentiles were calculated using the General Additive Model for Location Scale and Shape (GAMLSS). Our results show that boys performed better than girls in speed, lower- and upper-limb strength and cardiorespiratory fitness, and girls performed better in balance and flexibility. Older children performed better than younger children, except for cardiorespiratory fitness in boys and flexibility in girls. Our results provide for the first time sex- and age-specific physical fitness reference standards in European children aged 6-10.9 years.

  11. Training medical staff for pediatric disaster victims: a comparison of different teaching methods.

    Science.gov (United States)

    Behar, Solomon; Upperman, Jeffrey S; Ramirez, Marizen; Dorey, Fred; Nager, Alan

    2008-01-01

    The goal of this study was to assess the effectiveness of the different types of healthcare worker training in pediatric disaster medicine knowledge over time and to analyze the effects of training type on healthcare workers' attitude toward pediatric disaster medicine. Prospective randomized controlled longitudinal study. Large, urban, tertiary academic children's hospital. Physicians and nurses employed at Children's Hospital Los Angeles randomly selected from a global hospital e-mail server over a 3-week time frame were invited to participate and receive an incentive on completion. Forty-three controls and 42 intervention subjects (22 lecture + tabletop exercise, 20 lecture only) completed the study. Subjects with disaster training in the prior 6 months were excluded. Subjects underwent a didactic lecture or a combination of didactic lecture and tabletop exercise. Preintervention and postintervention testing took place using a 37-question multiple-choice test on pediatric disaster medical topics. Posttesting took place immediately after intervention and then 1, 3, and 6 months after the intervention. Subjects also were surveyed before and after intervention regarding their attitudes toward pediatric disaster medicine. (1) Scores on a 37-question knowledge test and (2) Likert scores on self-perceptions of knowledge, comfort, and interest in pediatric disaster medicine. Regardless of intervention type, participant scores on a postintervention pediatric disaster medicine tests over a 6-month period increased and remained well above pretest means for intervention and control pretest scores. There were no differences in scores comparing type of intervention. However, subjects who underwent the tabletop simulation had a better sense of knowledge and comfort with the topics compared with those who only underwent a didactic lecture. Didactic lecture and tabletop exercises both increase healthcare worker's knowledge of pediatric disaster medical topics. This knowledge

  12. Profile of Physical Fitness of Young Football Players at SDN Cibeusi

    Directory of Open Access Journals (Sweden)

    Subashini Periasamy

    2015-06-01

    Full Text Available Background: Health-related physical fitness components are important in hypokinetic disease prevention and good sports performance. The aim of this research is to evaluate the physical fitness profile of the SDN Cibeusi young football players based on Fitnessgram. Methods: This study was participated by 20 subjects ranging from 10 to 12 years old boys who played for the school football team in SDN Cibeusi. This descriptive study was conducted in the school field in the month of November 2012. Physical fitness components that were tested are aerobic capacity,V02 max using the one-mile run test, muscle endurance by performing push-up and curl-up test, flexibility using the flexometer and body composition by measuring the body mass index and fat fold measurement. The mean and standard deviation of the results were tabulated. Results: Aerobic capacity and percentage of body fat showed 100% of them scored in the category of healthy fitness zone. For body mass index, 55% scored in healthy fitness zone, 25% ni-some risk, and 10% each for ni-high risk and very lean. For push-up test and curl-up test, 80% and 65% scored in the healthy fitness zone while the remaining 20% and 35% respectively scored in the not healthy fitness zone. For flexibility, 75% of them scored in healthy fitness zone and 25% scored in not healthy fitness zone. Conclusions: The physical fitness level in these young football players is mostly in healthy fitness zone.

  13. Physical Fitness Reference Standards in French Youth: The BOUGE Program.

    Science.gov (United States)

    Vanhelst, Jérémy; Labreuche, Julien; Béghin, Laurent; Drumez, Elodie; Fardy, Paul S; Chapelot, Didier; Mikulovic, Jacques; Ulmer, Zékya

    2017-06-01

    The aim of this study was to establish sex- and age-specific physical fitness percentiles in French youth. A sample of 11,186 children and adolescents (5,546 boys and 5,640 girls), aged between 10 and 15 years, was assessed in the French national BOUGE study. Participants were tested for their cardiorespiratory fitness, muscular endurance, speed, flexibility, and agility using the following tests: 20-m shuttle run tests, curl-ups test, 50-m sprint test, back-saver sit and reach test, and 10 × 5-m shuttle run test. Percentile values were estimated for French youth as a function of age stratified by sex using the generalized additive model for location, scale, and shape (GAMLSS). In general, physical fitness was better in boys than in girls, except for the back-saver sit and reach test, in which girls performed better. Except for the back-saver sit and reach test and 10 × 5-m shuttle run test, physical fitness performance was significantly associated with age. Sex- and age-specific normative values for physical fitness tests in French youth expressed as percentiles from the fifth to the 95th are provided. Reference values provide normative data for French youth. The data are useful in identifying special needs for appropriate intervention programs.

  14. Community-Based Colorectal Cancer Screening in a Rural Population: Who Returns Fecal Immunochemical Test (FIT) Kits?

    Science.gov (United States)

    Crosby, Richard A; Stradtman, Lindsay; Collins, Tom; Vanderpool, Robin

    2017-09-01

    To determine the return rate of community-delivered fecal immunochemical test (FIT) kits in a rural population and to identify significant predictors of returning kits. Residents were recruited in 8 rural Kentucky counties to enroll in the study and receive an FIT kit. Of 345 recruited, 82.0% returned an FIT kit from the point of distribution. These participants were compared to the remainder relative to age, sex, marital status, having an annual income below $15,000, not graduating from high school, not having a regular health care provider, not having health care coverage, being a current smoker, indicating current overweight or obese status, and a scale measure of fatalism pertaining to colorectal cancer. Predictors achieving significance at the bivariate level were entered into a stepwise logistic regression model to calculate adjusted OR and 95% CI. The return rate was 82.0%. In adjusted analyses, those indicating an annual income of less than $15,000 were 2.85 times more likely to return their kits (95% CI: 1.56-5.24; P < .001). Also, those not perceiving themselves to be overweight/obese were 1.95 times more likely to return their kits (95% CI: 1.07-3.55; P = .029). An outreach-based colorectal cancer screening program in a rural population may yield high return rates. People with annual incomes below $15,000 and those not having perceptions of being overweight/obese may be particularly likely to return FIT kits. © 2016 National Rural Health Association.

  15. Children's (Pediatric) Nuclear Medicine

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    Full Text Available ... Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine Children’s (pediatric) nuclear medicine imaging uses small amounts ... Children's Nuclear Medicine? What is Children's (Pediatric) Nuclear Medicine? Nuclear medicine is a branch of medical imaging ...

  16. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... Physician Resources Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine Children’s (pediatric) nuclear medicine imaging uses ... limitations of Children's Nuclear Medicine? What is Children's (Pediatric) Nuclear Medicine? Nuclear medicine is a branch of ...

  17. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... News Physician Resources Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine Children’s (pediatric) nuclear medicine imaging ... the limitations of Children's Nuclear Medicine? What is Children's (Pediatric) Nuclear Medicine? Nuclear medicine is a branch ...

  18. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... Resources Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine Children’s (pediatric) nuclear medicine imaging uses small ... of Children's Nuclear Medicine? What is Children's (Pediatric) Nuclear Medicine? Nuclear medicine is a branch of medical ...

  19. Top 10 Research Questions Related to Youth Aerobic Fitness.

    Science.gov (United States)

    Armstrong, Neil

    2017-06-01

    Peak oxygen uptake ([Formula: see text] 2 ) is internationally recognized as the criterion measure of youth aerobic fitness, but despite pediatric data being available for almost 80 years, its measurement and interpretation in relation to growth, maturation, and health remain controversial. The trainability of youth aerobic fitness continues to be hotly debated, and causal mechanisms of training-induced changes and their modulation by chronological age, biological maturation, and sex are still to be resolved. The daily physical activity of youth is characterized by intermittent bouts and rapid changes in intensity, but physical activity of the intensity and duration required to determine peak [Formula: see text] 2 is rarely (if ever) experienced by most youth. In this context, it may therefore be the transient kinetics of pulmonary [Formula: see text] 2 that best reflect youth aerobic fitness. There are remarkably few rigorous studies of youth pulmonary [Formula: see text] 2 kinetics at the onset of exercise in different intensity domains, and the influence of chronological age, biological maturation, and sex during step changes in exercise intensity are not confidently documented. Understanding the trainability of the parameters of youth pulmonary [Formula: see text] 2 kinetics is primarily based on a few comparative studies of athletes and nonathletes. The underlying mechanisms of changes due to training require further exploration. The aims of the present article are therefore to provide a brief overview of aerobic fitness during growth and maturation, increase awareness of current controversies in its assessment and interpretation, identify gaps in knowledge, raise 10 relevant research questions, and indicate potential areas for future research.

  20. Prevalence of overweight and obesity associated with the levels of physical fitness among primary school age children in Assiut city

    Directory of Open Access Journals (Sweden)

    Osama Abdelkarim

    2017-07-01

    Conclusion: The present study showed a high percent of overweight, obese and skinny subjects among Egyptian children. This abnormal increase or decrease in body weight affects negatively the levels of children’s physical fitness. Thus, overweight and obesity should be more attracted by the Egyptian pediatric population with paying attention to the updated health information.

  1. Multidisciplinary Management of Pediatric Sports-Related Concussion.

    Science.gov (United States)

    Ellis, Michael J; Ritchie, Lesley J; McDonald, Patrick J; Cordingley, Dean; Reimer, Karen; Nijjar, Satnam; Koltek, Mark; Hosain, Shahid; Johnston, Janine; Mansouri, Behzad; Sawyer, Scott; Silver, Norm; Girardin, Richard; Larkins, Shannon; Vis, Sara; Selci, Erin; Davidson, Michael; Gregoire, Scott; Sam, Angela; Black, Brian; Bunge, Martin; Essig, Marco; MacDonald, Peter; Leiter, Jeff; Russell, Kelly

    2017-01-01

    To summarize the clinical characteristics and outcomes of pediatric sports-related concussion (SRC) patients who were evaluated and managed at a multidisciplinary pediatric concussion program and examine the healthcare resources and personnel required to meet the needs of this patient population. We conducted a retrospective review of all pediatric SRC patients referred to the Pan Am Concussion Program from September 1st, 2013 to May 25th, 2015. Initial assessments and diagnoses were carried out by a single neurosurgeon. Return-to-Play decision-making was carried out by the multidisciplinary team. 604 patients, including 423 pediatric SRC patients were evaluated at the Pan Am Concussion Program during the study period. The mean age of study patients was 14.30 years (SD: 2.32, range 7-19 years); 252 (59.57%) were males. Hockey (182; 43.03%) and soccer (60; 14.18%) were the most commonly played sports at the time of injury. Overall, 294 (69.50%) of SRC patients met the clinical criteria for concussion recovery, while 75 (17.73%) were lost to follow-up, and 53 (12.53%) remained in active treatment at the end of the study period. The median duration of symptoms among the 261 acute SRC patients with complete follow-up was 23 days (IQR: 15, 36). Overall, 25.30% of pediatric SRC patients underwent at least one diagnostic imaging test and 32.62% received referral to another member of our multidisciplinary clinical team. Comprehensive care of pediatric SRC patients requires access to appropriate diagnostic resources and the multidisciplinary collaboration of experts with national and provincially-recognized training in TBI.

  2. Face Masks for Noninvasive Ventilation: Fit, Excess Skin Hydration, and Pressure Ulcers.

    Science.gov (United States)

    Visscher, Marty O; White, Cynthia C; Jones, Jennifer M; Cahill, Thomas; Jones, Donna C; Pan, Brian S

    2015-11-01

    Pressure ulcers (stages III and IV) are serious safety events (ie, never events). Healthcare institutions are no longer reimbursed for costs to care for affected patients. Medical devices are the leading cause of pediatric pressure ulcers. Face masks for noninvasive ventilation were associated with a high percentage of pressure ulcers at our institution. A prospective cohort study investigated factors contributing to pressure ulcer development in 50 subjects using face masks for noninvasive ventilation. Color imaging, 3-dimensional surface imaging, and skin hydration measurements were used to identify early skin compromise and evaluate 3 interventions to reduce trauma: (1) a silicone foam dressing, (2) a water/polyethylene oxide hydrogel dressing, and (3) a flexible cloth mask. A novel mask fit technique was used to examine the impact of fit on the potential for skin compromise. Fifty subjects age 10.4 ± 9.1 y participated with color images for 22, hydration for 34, and mask fit analysis for 16. Of these, 69% had diagnoses associated with craniofacial anomalies. Stage I pressure ulcers were the most common injury. Skin hydration difference was 317 ± 29 for sites with erythema versus 75 ± 28 for sites without erythema (P skin erythema and pressure ulcers. This fit method is currently being utilized to select best-fit masks from available options, to identify the potential areas of increased tissue pressure, and to prevent skin injuries and their complications. Improvement of mask fit is an important priority for improving respiratory outcomes. Strategies to maintain normal skin hydration are important for protecting tissue integrity. Copyright © 2015 by Daedalus Enterprises.

  3. Improving the fitness and physical activity levels of primary school children: results of the Fit-4-Fun group randomized controlled trial.

    Science.gov (United States)

    Eather, Narelle; Morgan, Philip J; Lubans, David R

    2013-01-01

    To evaluate the impact of a multi-component school-based physical activity intervention (Fit-4-Fun) on health-related fitness and objectively measured physical activity in primary school children. Four Hunter primary schools were recruited in April, 2011 and randomized by school into treatment or control conditions. Participants included 213 children (mean age = 10.72 years ± 0.6; 52.2% female) with the treatment group (n = 118) completing the 8-week Fit-4-Fun Program. Participants were assessed at baseline and 6-month follow-up, with a 91% retention rate. Cardio-respiratory fitness (CRF) (20 m shuttle run) was the primary outcome, and secondary outcomes included body composition (BMI, BMI(Z)), muscular fitness (7-stage sit-up test, push-up test, basketball throw test, Standing Jump), flexibility (sit and reach) and physical activity (7 days pedometry). After 6-months, significant treatment effects were found for CRF (adjusted mean difference, 1.14 levels, p < 0.001), body composition (BMI mean, -0.96 kg/m(2), p < 0.001 and BMI z-score mean -0.47 z-scores, p < 0.001), flexibility (sit and reach mean, 1.52 cm, p = 0.0013), muscular fitness (sit-ups) (mean 0.62 stages, p = 0.003) and physical activity (mean, 3253 steps/day, p < 0.001). There were no group by time effects for the other muscular fitness measures. A primary school-based intervention focusing on fitness education significantly improved health-related fitness and physical activity levels in children. Copyright © 2012 Elsevier Inc. All rights reserved.

  4. Classification, diagnostic criteria, and treatment recommendations for orofacial manifestations in HIV-infected pediatric patients. Collaborative Workgroup on Oral Manifestations of Pediatric HIV Infection.

    Science.gov (United States)

    Ramos-Gomez, F J; Flaitz, C; Catapano, P; Murray, P; Milnes, A R; Dorenbaum, A

    1999-01-01

    The criteria for diagnosis of HIV-related oral lesions in adults are well established, but corresponding criteria in the pediatric population are not as well defined. The Collaborative Workgroup on the Oral Manifestations of Pediatric HIV infection reached a consensus, based upon available data, as to the presumptive and definitive criteria to diagnose the oral manifestations of HIV infection in children. Presumptive criteria refer to the clinical features of the lesions, including signs and symptoms, whereas definitive criteria require specific laboratory tests. In general, it is recommended that definitive criteria be established whenever possible. Orofacial manifestations have been divided into three groups: 1) those commonly associated with pediatric HIV infection; 2) those less commonly associated with pediatric HIV infection; and 3) those strongly associated with HIV infection but rare in children. Orofacial lesions commonly associated with pediatric HIV infection include candidiasis, herpes simplex infection, linear gingival erythema, parotid enlargement, and recurrent aphthous stomatitis. In contrast, orofacial lesions strongly associated with HIV infection but rare in children include Kaposi's sarcoma, non-Hodgkin's lymphoma, and oral hairy leukoplakia. Treatment recommendations, specific for this age group, have been included for some of the more common HIV-related orofacial manifestations.

  5. Pediatric vascular access

    International Nuclear Information System (INIS)

    Donaldson, James S.

    2006-01-01

    Pediatric interventional radiologists are ideally suited to provide vascular access services to children because of inherent safety advantages and higher success from using image-guided techniques. The performance of vascular access procedures has become routine at many adult interventional radiology practices, but this service is not as widely developed at pediatric institutions. Although interventional radiologists at some children's hospitals offer full-service vascular access, there is little or none at others. Developing and maintaining a pediatric vascular access service is a challenge. Interventionalists skilled in performing such procedures are limited at pediatric institutions, and institutional support from clerical staff, nursing staff, and technologists might not be sufficiently available to fulfill the needs of such a service. There must also be a strong commitment by all members of the team to support such a demanding service. There is a slippery slope of expected services that becomes steeper and steeper as the vascular access service grows. This review is intended primarily as general education for pediatric radiologists learning vascular access techniques. Additionally, the pediatric or adult interventional radiologist seeking to expand services might find helpful tips. The article also provides education for the diagnostic radiologist who routinely interprets radiographs containing vascular access devices. (orig.)

  6. The two-week pediatric surgery rotation: is it time wasted?

    Science.gov (United States)

    Dutta, S; Wales, P W; Fecteau, A

    2004-05-01

    With increasing medical school emphasis on generalist training and decreasing enrollment in surgical residency, the authors assessed the adequacy of a 2-week pediatric surgery rotation on meeting the learning and competency objectives outlined in The Canadian Association of Pediatric Surgeons' Self-Directed Evaluation Tool. A prospective survey was conducted of 39 clinical clerks. An anonymous self-assessment scale measuring competency objectives (medical and psychosocial) was administered pre-and postrotation. Also, exposure to pediatric surgical conditions from a list of "essential" and "nonessential" learning objectives was measured. Statistical analysis was performed using paired t test with significance at.05 level. Response rate was 77% and 54% for the competency and learning objectives, respectively. Students reported improvement in medical (P awareness of the breadth of pediatric surgical practice (P <.0001; 95% CI 2.06, 3.18). A 2-week rotation in pediatric surgery appears adequate in fulfilling most competency and learning objectives, but discussion is needed about how to best assess student competency, which topics are considered essential, and the long-term effect on recruitment to the profession.

  7. The association between dog ownership or dog walking and fitness or weight status in childhood.

    Science.gov (United States)

    Westgarth, C; Boddy, L M; Stratton, G; German, A J; Gaskell, R M; Coyne, K P; Bundred, P; McCune, S; Dawson, S

    2017-12-01

    Health benefits of dog walking are established in adults: dog owners are on average more physically active, and those walking their dogs regularly have lower weight status than those who do not. However, there has been little research on children. This study aimed to examine the association between dog ownership or dog walking and childhood fitness or weight status. A survey of pet ownership and involvement in dog walking was combined with fitness and weight status measurements of 1021 9 to 10-year-old children in the Liverpool SportsLinx study. We found little evidence to support that children who live with, or walk with, dogs are any fitter or less likely to be obese than those who do not. This is an important finding, as it suggests that the activity that children currently do with dogs is not sufficient enough to impact weight status or fitness. © 2016 The Authors. Pediatric Obesity published by John Wiley & Sons Ltd on behalf of World Obesity Federation.

  8. Nuclear imaging in pediatrics

    International Nuclear Information System (INIS)

    Siddiqui, A.R.

    1985-01-01

    The author's intent is to familiarize practicing radiologists with the technical aspects and interpretation of nuclear medicine procedures in children and to illustrate the indications for nuclear medicine procedures in pediatric problems. Pediatric doses, dosimetry, sedation, and injection techniques, organ systems, oncology and infection, testicular scanning and nuclear crystography, pediatric endocrine and skeletal systems, ventilation and perfusion imaging of both congenital and acquired pediatric disorders, cardiovascular problems, gastrointestinal, hepatobiliary, reticuloendothelial studies, and central nervous system are all topics which are included and discussed

  9. Development and content validity testing of a comprehensive classification of diagnoses for pediatric nurse practitioners.

    Science.gov (United States)

    Burns, C

    1991-01-01

    Pediatric nurse practitioners (PNPs) need an integrated, comprehensive classification that includes nursing, disease, and developmental diagnoses to effectively describe their practice. No such classification exists. Further, methodologic studies to help evaluate the content validity of any nursing taxonomy are unavailable. A conceptual framework was derived. Then 178 diagnoses from the North American Nursing Diagnosis Association (NANDA) 1986 list, selected diagnoses from the International Classification of Diseases, the Diagnostic and Statistical Manual, Third Revision, and others were selected. This framework identified and listed, with definitions, three domains of diagnoses: Developmental Problems, Diseases, and Daily Living Problems. The diagnoses were ranked using a 4-point scale (4 = highly related to 1 = not related) and were placed into the three domains. The rating scale was assigned by a panel of eight expert pediatric nurses. Diagnoses that were assigned to the Daily Living Problems domain were then sorted into the 11 Functional Health patterns described by Gordon (1987). Reliability was measured using proportions of agreement and Kappas. Content validity of the groups created was measured using indices of content validity and average congruency percentages. The experts used a new method to sort the diagnoses in a new way that decreased overlaps among the domains. The Developmental and Disease domains were judged reliable and valid. The Daily Living domain of nursing diagnoses showed marginally acceptable validity with acceptable reliability. Six Functional Health Patterns were judged reliable and valid, mixed results were determined for four categories, and the Coping/Stress Tolerance category was judged reliable but not valid using either test. There were considerable differences between the panel's, Gordon's (1987), and NANDA's clustering of NANDA diagnoses. This study defines the diagnostic practice of nurses from a holistic, patient

  10. Correlates of Pediatric CPAP Adherence

    Science.gov (United States)

    Hawkins, Stephen M.M.; Jensen, Emily L.; Simon, Stacey L.; Friedman, Norman R.

    2016-01-01

    Study Objectives: Obstructive sleep apnea (OSA) is a common pediatric condition characterized by recurrent partial or complete cessation of airflow during sleep, typically due to inadequate upper airway patency. Continuous positive airway pressure (CPAP) is a therapeutic option that reduces morbidity. Despite efforts to promote use, CPAP adherence is poor in both pediatric and adult populations. We sought to determine whether demographics, insurance status, OSA severity, therapeutic pressure, or comorbid conditions were associated with pediatric CPAP adherence. Methods: A retrospective review of adherence download data was performed on all pediatric patients with initiation or adjustment of CPAP treatment over a one-year period with documented in-laboratory CPAP titration. Patients were grouped as CPAP adherent or non-adherent, where adherence was defined as > 70% nightly use and average usage ≥ 4 hours per night. Differences between the groups were analyzed by χ2 test. Results: Overall, nearly half of participants were CPAP adherent (49%, 69/140). Of the demographic data collected (age, ethnicity, sex, insurance status), only female sex was associated with better adherence (60.9% vs 39.5% of males adherent; odds ratio [OR] = 2.41, 95%CI = 1.20–4.85; p = 0.01). Severity of OSA (diagnostic apnea-hypopnea index [AHI] and degree of hypoxemia), therapeutic pressure, and residual AHI did not impact CPAP adherence (p > 0.05). Patients with developmental delay (DD) were more likely to be adherent with CPAP than those without a DD diagnosis (OR = 2.55, 95%CI = 1.27–5.13; p = 0.007). Female patients with trisomy 21 tended to be more adherent, but this did not reach significance or account for the overall increased adherence associated with female sex. Conclusions: Our study demonstrates that adherence to CPAP therapy is poor but suggests that female sex and developmental delay are associated with better adherence. These findings support efforts to understand the

  11. Scintigraphic test of the vitality and functional fitness of organs conserved for transplantation

    International Nuclear Information System (INIS)

    Bozduganov, A.; Marinov, V.

    1976-01-01

    Having reviewed critically present-day methods of testing the vitality of isolated perfused organs, the authors propose their own. It is founded in the principles of colour scintigraphy after introduction of short-lived nuclides. The method was applied in testing 57 isolated preserved organs (5 kidneys, 12 livers, 5 hearts and 4 spleens from dogs; 2 kidneys and 27 livers from rabbits; 1 kidney and 1 liver from young pigs). Moreover, compararive scintigraphic and biochemical investigations were conducted on 2 dogs and 4 young pigs (A. Bozduganov, E. Simeonov, N. Bogdanova). The techniques of isolation and perfusion of the organ have been given a detailed description. Sup(113m)In was used as tracer. Areas of radioactivity deposits were visualized more or less intensely, depending on the degree of vitality and functional fitness still present actually; else, blanks were seen. Orthotransplantation and heterotransplantation with subsequent scintigraphic examination in vivo served, in scattered instances, the purpose of confirming or of rejecting ambiguous vitality findings in preserved organs. Advantages of the method are a general and specified evaluation of the organ in all of its areas; anatomical integrity of the object under test; applicability to various organs; possibility of conducting dynamic tests; accurate reproduction of vitality and functional findings, etc

  12. Describing pediatric dysphonia with nonlinear dynamic parameters

    Science.gov (United States)

    Meredith, Morgan L.; Theis, Shannon M.; McMurray, J. Scott; Zhang, Yu; Jiang, Jack J.

    2008-01-01

    Objective Nonlinear dynamic analysis has emerged as a reliable and objective tool for assessing voice disorders. However, it has only been tested on adult populations. In the present study, nonlinear dynamic analysis was applied to normal and dysphonic pediatric populations with the goal of collecting normative data. Jitter analysis was also applied in order to compare nonlinear dynamic and perturbation measures. This study’s findings will be useful in creating standards for the use of nonlinear dynamic analysis as a tool to describe dysphonia in the pediatric population. Methods The study included 38 pediatric subjects (23 children with dysphonia and 15 without). Recordings of sustained vowels were obtained from each subject and underwent nonlinear dynamic analysis and percent jitter analysis. The resulting correlation dimension (D2) and percent jitter values were compared across the two groups using t-tests set at a significance level of p = 0.05. Results It was shown that D2 values covary with the presence of pathology in children. D2 values were significantly higher in dysphonic children than in normal children (p = 0.002). Standard deviations indicated a higher level of variation in normal children’s D2 values than in dysphonic children’s D2 values. Jitter analysis showed markedly higher percent jitter in dysphonic children than in normal children (p = 0.025) and large standard deviations for both groups. Conclusion This study indicates that nonlinear dynamic analysis could be a viable tool for the detection and assessment of dysphonia in children. Further investigations and more normative data are needed to create standards for using nonlinear dynamic parameters for the clinical evaluation of pediatric dysphonia. PMID:18947887

  13. Increased pediatric sub-specialization is associated with decreased surgical complication rates for inpatient pediatric urology procedures

    Science.gov (United States)

    Tejwani, R.; Wang, H-H. S.; Young, B. J.; Greene, N. H.; Wolf, S.; Wiener, J. S.; Routh, J. C.

    2016-01-01

    Summary Introduction Increased case volumes and training are associated with better surgical outcomes. However, the impact of pediatric urology sub-specialization on perioperative complication rates is unknown. Objectives To determine the presence and magnitude of difference in rates of common postoperative complications for elective pediatric urology procedures between specialization levels of urologic surgeons. The Nationwide Inpatient Sample (NIS), a nationally representative administrative database, was used. Study Design The NIS (1998–2009) was retrospectively reviewed for pediatric (≤18 years) admissions, using ICD-9-CM codes to identify urologic surgeries and National Surgical Quality Improvement Program (NSQIP) inpatient postoperative complications. Degree of pediatric sub-specialization was calculated using a Pediatric Proportion Index (PPI), defined as the ratio of children to total patients operated on by each provider. The providers were grouped into PPI quartiles: Q1, 0–25% specialization; Q2, 25–50%; Q3, 50–75%; Q4, 75–100%. Weighted multivariate analysis was performed to test for associations between PPI and surgical complications. Results A total of 71,479 weighted inpatient admissions were identified. Patient age decreased with increasing specialization: Q1, 7.9 vs Q2, 4.8 vs Q3, 4.8 vs Q4, 4.6 years, PSpecialization was not associated with race (P>0.20), gender (P>0.50), or comorbidity scores (P=0.10). Mortality (1.5% vs 0.2% vs 0.3% vs 0.4%, Pspecialization. Patients treated by more highly specialized surgeons incurred slightly higher costs (Q2, +4%; Q3, +1%; Q4 + 2%) but experienced shorter length of hospital stay (Q2, –5%; Q3, –10%; Q4, –3%) compared with the least specialized providers. A greater proportion of patients treated by Q1 and Q3 specialized urologists had CCS ≥2 than those seen by Q2 or Q4 urologists (12.5% and 12.2%, respectively vs 8.4% and 10.9%, respectively, P=0.04). Adjusting for confounding effects

  14. Fitness

    Science.gov (United States)

    ... gov home http://www.girlshealth.gov/ Home Fitness Fitness Want to look and feel your best? Physical ... are? Check out this info: What is physical fitness? top Physical fitness means you can do everyday ...

  15. Reliability and Usefulness of the 30-15 Intermittent Fitness Test in Male and Female Professional Futsal Players

    Directory of Open Access Journals (Sweden)

    Valladares-Rodríguez Santiago

    2017-12-01

    Full Text Available The purpose of this study was to determine the reliability and usefulness of the 30-15 Intermittent Fitness Test (30-15IFT in professional male and female futsal players. Thirteen male (24.4 ± 5.6 years; 174.5 ± 10.3 cm; 70.3 ± 9.9 kg and fourteen female (23.3 ± 4.5 years; 165.8 ± 6.2 cm; 61.7 ± 5.5 kg professional futsal players performed the 30-15IFT on two occasions, separated by 5 days. Maximal intermittent running velocity (VIFT and heart rate at exhaustion (HRpeak data were collected for both tests. Reliability was assessed by the intraclass correlation coefficient (ICC, typical error (TE expressed as a coefficient of variation (CV, and smallest worthwhile change (SWC. VIFT demonstrated very good reliability between sessions, both for male (ICC = 0.92 and female (ICC = 0.96 players. As the TE for VIFT and HRpeak was similar to the calculated SWC for both male and female players, the usefulness of the test was rated as “medium”. A change in performance of at least 2 stages in male players, or a change of more than 1 stage in female players could be interpreted as a meaningful change in aerobic futsal fitness. The results of this study demonstrate that the 30-15IFT is both a reliable and useful test for male and female professional futsal players.

  16. Discovery and identification of potential biomarkers of pediatric Acute Lymphoblastic Leukemia

    Directory of Open Access Journals (Sweden)

    Cui Ziyou

    2009-03-01

    Full Text Available Abstract Background Acute lymphoblastic leukemia (ALL is a common form of cancer in children. Currently, bone marrow biopsy is used for diagnosis. Noninvasive biomarkers for the early diagnosis of pediatric ALL are urgently needed. The aim of this study was to discover potential protein biomarkers for pediatric ALL. Methods Ninety-four pediatric ALL patients and 84 controls were randomly divided into a "training" set (45 ALL patients, 34 healthy controls and a test set (49 ALL patients, 30 healthy controls and 30 pediatric acute myeloid leukemia (AML patients. Serum proteomic profiles were measured using surface-enhanced laser desorption/ionization-time-of-flight mass spectroscopy (SELDI-TOF-MS. A classification model was established by Biomarker Pattern Software (BPS. Candidate protein biomarkers were purified by HPLC, identified by LC-MS/MS and validated using ProteinChip immunoassays. Results A total of 7 protein peaks (9290 m/z, 7769 m/z, 15110 m/z, 7564 m/z, 4469 m/z, 8937 m/z, 8137 m/z were found with differential expression levels in the sera of pediatric ALL patients and controls using SELDI-TOF-MS and then analyzed by BPS to construct a classification model in the "training" set. The sensitivity and specificity of the model were found to be 91.8%, and 90.0%, respectively, in the test set. Two candidate protein peaks (7769 and 9290 m/z were found to be down-regulated in ALL patients, where these were identified as platelet factor 4 (PF4 and pro-platelet basic protein precursor (PBP. Two other candidate protein peaks (8137 and 8937 m/z were found up-regulated in the sera of ALL patients, and these were identified as fragments of the complement component 3a (C3a. Conclusion Platelet factor (PF4, connective tissue activating peptide III (CTAP-III and two fragments of C3a may be potential protein biomarkers of pediatric ALL and used to distinguish pediatric ALL patients from healthy controls and pediatric AML patients. Further studies with

  17. Discovery and identification of potential biomarkers of pediatric Acute Lymphoblastic Leukemia

    Science.gov (United States)

    Shi, Linan; Zhang, Jun; Wu, Peng; Feng, Kai; Li, Jing; Xie, Zhensheng; Xue, Peng; Cai, Tanxi; Cui, Ziyou; Chen, Xiulan; Hou, Junjie; Zhang, Jianzhong; Yang, Fuquan

    2009-01-01

    Background Acute lymphoblastic leukemia (ALL) is a common form of cancer in children. Currently, bone marrow biopsy is used for diagnosis. Noninvasive biomarkers for the early diagnosis of pediatric ALL are urgently needed. The aim of this study was to discover potential protein biomarkers for pediatric ALL. Methods Ninety-four pediatric ALL patients and 84 controls were randomly divided into a "training" set (45 ALL patients, 34 healthy controls) and a test set (49 ALL patients, 30 healthy controls and 30 pediatric acute myeloid leukemia (AML) patients). Serum proteomic profiles were measured using surface-enhanced laser desorption/ionization-time-of-flight mass spectroscopy (SELDI-TOF-MS). A classification model was established by Biomarker Pattern Software (BPS). Candidate protein biomarkers were purified by HPLC, identified by LC-MS/MS and validated using ProteinChip immunoassays. Results A total of 7 protein peaks (9290 m/z, 7769 m/z, 15110 m/z, 7564 m/z, 4469 m/z, 8937 m/z, 8137 m/z) were found with differential expression levels in the sera of pediatric ALL patients and controls using SELDI-TOF-MS and then analyzed by BPS to construct a classification model in the "training" set. The sensitivity and specificity of the model were found to be 91.8%, and 90.0%, respectively, in the test set. Two candidate protein peaks (7769 and 9290 m/z) were found to be down-regulated in ALL patients, where these were identified as platelet factor 4 (PF4) and pro-platelet basic protein precursor (PBP). Two other candidate protein peaks (8137 and 8937 m/z) were found up-regulated in the sera of ALL patients, and these were identified as fragments of the complement component 3a (C3a). Conclusion Platelet factor (PF4), connective tissue activating peptide III (CTAP-III) and two fragments of C3a may be potential protein biomarkers of pediatric ALL and used to distinguish pediatric ALL patients from healthy controls and pediatric AML patients. Further studies with additional

  18. Psychosocial functioning in pediatric heart transplant recipients and their families.

    Science.gov (United States)

    Cousino, Melissa K; Schumacher, Kurt R; Rea, Kelly E; Eder, Sally; Zamberlan, Mary; Jordan, Jessica; Fredericks, Emily M

    2018-03-01

    Across pediatric organ transplant populations, patient and family psychosocial functioning is associated with important health-related outcomes. Research has suggested that pediatric heart transplant recipients and their families are at increased risk for adverse psychosocial outcomes; however, recent investigation of psychosocial functioning in this population is lacking. This study aimed to provide a contemporary characterization of psychosocial functioning in pediatric heart transplant recipients and their families. Associations between psychosocial function, demographic variables, and transplant-related variables were investigated. Fifty-six parents/guardians of pediatric heart transplant recipients completed a comprehensive psychosocial screening measure during transplant follow-up clinic visits. Descriptive statistics, correlational analyses, and independent samples t tests were performed. Forty percent of pediatric heart transplant recipients and their families endorsed clinically meaningful levels of total psychosocial risk. One-third of patients presented with clinically significant psychological problems per parent report. Psychosocial risk was unassociated with demographic or transplant-related factors. Despite notable improvements in the survival of pediatric heart transplant recipients over the past decade, patients and families present with sustained psychosocial risks well beyond the immediate post-transplant period, necessitating mental health intervention to mitigate adverse impact on health-related outcomes. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  19. Privacy and Ethics in Pediatric Environmental Health Research—Part II: Protecting Families and Communities

    Science.gov (United States)

    Fisher, Celia B.

    2006-01-01

    Background In pediatric environmental health research, information about family members is often directly sought or indirectly obtained in the process of identifying child risk factors and helping to tease apart and identify interactions between genetic and environmental factors. However, federal regulations governing human subjects research do not directly address ethical issues associated with protections for family members who are not identified as the primary “research participant.” Ethical concerns related to family consent and privacy become paramount as pediatric environmental health research increasingly turns to questions of gene–environment interactions. Objectives In this article I identify issues arising from and potential solutions for the privacy and informed consent challenges of pediatric environmental health research intended to adequately protect the rights and welfare of children, family members, and communities. Discussion I first discuss family members as secondary research participants and then the specific ethical challenges of longitudinal research on late-onset environmental effects and gene–environment interactions. I conclude with a discussion of the confidentiality and social risks of recruitment and data collection of research conducted within small or unique communities, ethnic minority populations, and low-income families. Conclusions The responsible conduct of pediatric environmental health research must be conceptualized as a goodness of fit between the specific research context and the unique characteristics of subjects and other family stakeholders. PMID:17035154

  20. Is Exercise Stress Testing a Cost-Saving Strategy For Risk Assessment of Pediatric Wolff-Parkinson-White Syndrome Patients?

    Science.gov (United States)

    Moltedo, Jose M.; Iyer, Ramesh V.; Forman, Howard; Fahey, John; Rosenthal, Geoffrey; Snyder, Christopher S.

    2006-01-01

    Background: In Wolff-Parkinson-White syndrome (WPW) patients the loss of pre-excitation in a single heartbeat during exercise stress testing (EST) is a predictor of low risk of sudden death. The purpose of this study was to: 1) assess the frequency of loss of pre-excitation in a single heartbeat during exercise testing, and 2) compare the cost of EST versus trans-catheter electrophysiology study (EPS) in the risk assessment of WPW patients. Methods: A retrospective review of 50 cases of patients with WPW who underwent EST was conducted including demographics, history of supraventricular tachycardia, associated congenital heart disease, maximum heart rate achieved, and loss of pre-excitation in a single heartbeat. Hospital costs of EST and EPS were compared. Results: Of the 50 patients who underwent EST, 4 (8%), lost pre-excitation in a single heartbeat during EST. No differences were found regarding gender, age at diagnosis or EST, history of supraventricular tachycardia, presence of congenital heart disease or maximal heart rate. A cost comparison, utilizing the cost data: EST ($62.75) and EPS ($5,597) found EST to be a cost-saving approach in WPW patients. With 4 patients losing pre-excitation during EST, the cost saving of EST was $22,388 for this population of WPW patients. Conclusions: A frequency of 8% loss of pre-excitation was found in a pediatric sample that underwent EST. Additionally, EST was shown to be a cost-saving strategy in risk assessment of pediatric WPW patients. PMID:21845141

  1. Are eating habits associated with physical fitness in primary school children?

    Science.gov (United States)

    Thivel, David; David, Thivel; Aucouturier, Julien; Julien, Aucouturier; Isacco, Laurie; Laurie, Isacco; Lazaar, Nordine; Nordine, Lazaar; Ratel, Sébastien; Sébastien, Ratel; Doré, Eric; Eric, Doré; Meyer, Martine; Martine, Meyer; Duché, Pascale; Pascale, Duché

    2013-01-01

    Children's eating habits have mainly been related to anthropometric characteristics but less is known about their association with physical fitness. 278 French school children (131 boys and 147 girls) filled in eating habit questionnaires and completed anthropometric measurement (weight, height, skinfolds) and physical fitness tests. The 20-m Shuttle run test and the Squat Jump test were used to assess aerobic fitness and anaerobic (lower limb muscle power) fitness respectively. Breakfast consumption was associated with both aerobic fitness (ppower (phabits was negatively associated with CRF stages and lower limb muscle power performances (phabits and decreases with the number of unhealthy eating behaviors cumulated. Copyright © 2012 Elsevier Ltd. All rights reserved.

  2. Pediatric Voiding Cystourethrogram

    Science.gov (United States)

    Scan for mobile link. Children's (Pediatric) Voiding Cystourethrogram A children’s (pediatric) voiding cystourethrogram uses fluoroscopy – a form of real-time x-ray – to examine a child’s bladder ...

  3. Pediatric Cardiology Boot Camp: Description and Evaluation of a Novel Intensive Training Program for Pediatric Cardiology Trainees.

    Science.gov (United States)

    Ceresnak, Scott R; Axelrod, David M; Motonaga, Kara S; Johnson, Emily R; Krawczeski, Catherine D

    2016-06-01

    The transition from residency to subspecialty fellowship in a procedurally driven field such as pediatric cardiology is challenging for trainees. We describe and assess the educational value of a pediatric cardiology "boot camp" educational tool designed to help prepare trainees for cardiology fellowship. A two-day intensive training program was provided for pediatric cardiology fellows in July 2015 at a large fellowship training program. Hands-on experiences and simulations were provided in: anatomy, auscultation, echocardiography, catheterization, cardiovascular intensive care (CVICU), electrophysiology (EP), heart failure, and cardiac surgery. Knowledge-based exams as well as surveys were completed by each participant pre-training and post-training. Pre- and post-exam results were compared via paired t tests, and survey results were compared via Wilcoxon rank sum. A total of eight participants were included. After boot camp, there was a significant improvement between pre- and post-exam scores (PRE 54 ± 9 % vs. POST 85 ± 8 %; p ≤ 0.001). On pre-training survey, the most common concerns about starting fellowship included: CVICU emergencies, technical aspects of the catheterization/EP labs, using temporary and permanent pacemakers/implantable cardiac defibrillators (ICDs), and ECG interpretation. Comparing pre- and post-surveys, there was a statistically significant improvement in the participants comfort level in 33 of 36 (92 %) areas of assessment. All participants (8/8, 100 %) strongly agreed that the boot camp was a valuable learning experience and helped to alleviate anxieties about the start of fellowship. A pediatric cardiology boot camp experience at the start of cardiology fellowship can provide a strong foundation and serve as an educational springboard for pediatric cardiology fellows.

  4. Crosscheck Principle in Pediatric Audiology Today: A 40-Year Perspective.

    Science.gov (United States)

    Hall, James W

    2016-09-01

    The crosscheck principle is just as important in pediatric audiology as it was when first described 40 years ago. That is, no auditory test result should be accepted and used in the diagnosis of hearing loss until it is confirmed or crosschecked by one or more independent measures. Exclusive reliance on only one or two tests, even objective auditory measures, may result in a auditory diagnosis that is not clear or perhaps incorrect. On the other hand, close and careful analysis of findings for a test battery consisting of objective procedures and behavioral tests whenever feasible usually leads to prompt and accurate diagnosis of auditory dysfunction. This paper provides a concise review of the crosscheck principle from its introduction to its clinical application today. The review concludes with a description of a modern test battery for pediatric hearing assessment that supplements traditional behavioral tests with a variety of independent objective procedures including aural immittance measures, otoacoustic emissions, and auditory evoked responses.

  5. Crosscheck Principle in Pediatric Audiology Today: A 40-Year Perspective

    Science.gov (United States)

    2016-01-01

    The crosscheck principle is just as important in pediatric audiology as it was when first described 40 years ago. That is, no auditory test result should be accepted and used in the diagnosis of hearing loss until it is confirmed or crosschecked by one or more independent measures. Exclusive reliance on only one or two tests, even objective auditory measures, may result in a auditory diagnosis that is not clear or perhaps incorrect. On the other hand, close and careful analysis of findings for a test battery consisting of objective procedures and behavioral tests whenever feasible usually leads to prompt and accurate diagnosis of auditory dysfunction. This paper provides a concise review of the crosscheck principle from its introduction to its clinical application today. The review concludes with a description of a modern test battery for pediatric hearing assessment that supplements traditional behavioral tests with a variety of independent objective procedures including aural immittance measures, otoacoustic emissions, and auditory evoked responses. PMID:27626077

  6. The Many Null Distributions of Person Fit Indices.

    Science.gov (United States)

    Molenaar, Ivo W.; Hoijtink, Herbert

    1990-01-01

    Statistical properties of person fit indices are reviewed as indicators of the extent to which a person's score pattern is in agreement with a measurement model. Distribution of a fit index and ability-free fit evaluation are discussed. The null distribution was simulated for a test of 20 items. (SLD)

  7. Reliability and Model Fit

    Science.gov (United States)

    Stanley, Leanne M.; Edwards, Michael C.

    2016-01-01

    The purpose of this article is to highlight the distinction between the reliability of test scores and the fit of psychometric measurement models, reminding readers why it is important to consider both when evaluating whether test scores are valid for a proposed interpretation and/or use. It is often the case that an investigator judges both the…

  8. Hamiltonian inclusive fitness: a fitter fitness concept.

    Science.gov (United States)

    Costa, James T

    2013-01-01

    In 1963-1964 W. D. Hamilton introduced the concept of inclusive fitness, the only significant elaboration of Darwinian fitness since the nineteenth century. I discuss the origin of the modern fitness concept, providing context for Hamilton's discovery of inclusive fitness in relation to the puzzle of altruism. While fitness conceptually originates with Darwin, the term itself stems from Spencer and crystallized quantitatively in the early twentieth century. Hamiltonian inclusive fitness, with Price's reformulation, provided the solution to Darwin's 'special difficulty'-the evolution of caste polymorphism and sterility in social insects. Hamilton further explored the roles of inclusive fitness and reciprocation to tackle Darwin's other difficulty, the evolution of human altruism. The heuristically powerful inclusive fitness concept ramified over the past 50 years: the number and diversity of 'offspring ideas' that it has engendered render it a fitter fitness concept, one that Darwin would have appreciated.

  9. Enhancing the Pediatric Drug Development Framework to Deliver Better Pediatric Therapies Tomorrow.

    Science.gov (United States)

    Bucci-Rechtweg, Christina

    2017-10-01

    Health care professionals involved in the clinical management of children have long appreciated the limited number of therapies suitably evaluated for their optimal use in the pediatric population. In the past century, advances in regulatory policy significantly evolved adult drug evaluation. The scarcity of available patient populations, practical complexities of drug development research, and minimal financial returns have hampered pharmaceutical investment in the study of therapies for children. More recently, pediatric policy and legislation in the United States and Europe have instituted a system of obligations and incentives to stimulate investment in pediatric drug development. These initiatives, in conjunction with a more sophisticated process of drug discovery and development, have led to significant advancements in the labeling of drugs for pediatric use. Facilitated by the emergence of new targets, precision medicine, and innovations in regulatory science, there is now a subtle shift in focus toward drug development research for children rather than simply in children. Although there has been an increase in pediatric studies of investigational agents and labeling of pediatric information for use, there have been unintended consequences of existing policies. As a result, limited progress has been made in certain therapeutic areas and for off-patent therapies. Future policy reform to enhance the availability and accessibility of pediatric medicines should not only reflect an understanding not only of the successes of existing policy and legislative initiatives but also constructively address failures and unintended consequences. Taken together, policy reform, global cooperation, and innovation in regulatory science will more ably deliver better pediatric therapies tomorrow. Copyright © 2017 Elsevier HS Journals, Inc. All rights reserved.

  10. A closer look at the effect of preliminary goodness-of-fit testing for normality for the one-sample t-test.

    Science.gov (United States)

    Rochon, Justine; Kieser, Meinhard

    2011-11-01

    Student's one-sample t-test is a commonly used method when inference about the population mean is made. As advocated in textbooks and articles, the assumption of normality is often checked by a preliminary goodness-of-fit (GOF) test. In a paper recently published by Schucany and Ng it was shown that, for the uniform distribution, screening of samples by a pretest for normality leads to a more conservative conditional Type I error rate than application of the one-sample t-test without preliminary GOF test. In contrast, for the exponential distribution, the conditional level is even more elevated than the Type I error rate of the t-test without pretest. We examine the reasons behind these characteristics. In a simulation study, samples drawn from the exponential, lognormal, uniform, Student's t-distribution with 2 degrees of freedom (t(2) ) and the standard normal distribution that had passed normality screening, as well as the ingredients of the test statistics calculated from these samples, are investigated. For non-normal distributions, we found that preliminary testing for normality may change the distribution of means and standard deviations of the selected samples as well as the correlation between them (if the underlying distribution is non-symmetric), thus leading to altered distributions of the resulting test statistics. It is shown that for skewed distributions the excess in Type I error rate may be even more pronounced when testing one-sided hypotheses. ©2010 The British Psychological Society.

  11. Pediatric Celiac Disease

    Science.gov (United States)

    ... a protein found in wheat, rye, and barley. Pediatric Celiac Disease If your child has celiac disease, ... physician. Established by the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) Celiac Disease Eosinophilic ...

  12. A psychometric evaluation of the Pediatric Anesthesia Emergence Delirium scale.

    Science.gov (United States)

    Ringblom, Jenny; Wåhlin, Ingrid; Proczkowska, Marie

    2018-04-01

    Emergence delirium and emergence agitation have been a subject of interest since the early 1960s. This behavior has been associated with increased risk of injury in children and dissatisfaction with anesthesia care in their parents. The Pediatric Anesthesia Emergence Delirium Scale is a commonly used instrument for codifying and recording this behavior. The aim of this study was to psychometrically evaluate the Pediatric Anesthesia Emergence Delirium scale, focusing on the factor structure, in a sample of children recovering from anesthesia after surgery or diagnostic procedures. The reliability of the Pediatric Anesthesia Emergence Delirium scale was also tested. One hundred and twenty-two children younger than seven years were observed at postoperative care units during recovery from anesthesia. Two or 3 observers independently assessed the children using the Pediatric Anesthesia Emergence Delirium scale. The factor analysis clearly revealed a one-factor solution, which accounted for 82% of the variation in the data. Internal consistency, calculated with Cronbach's alpha, was good (0.96). The Intraclass Correlation Coefficient, which was used to assess interrater reliability for the Pediatric Anesthesia Emergence Delirium scale sum score, was 0.97 (P Pediatric Anesthesia Emergence Delirium scale for assessing emergence delirium in children recovering from anesthesia after surgery or diagnostic procedures. The kappa statistics for the Pediatric Anesthesia Emergence Delirium scale items essentially indicated good agreement between independent raters, supporting interrater reliability. © 2018 John Wiley & Sons Ltd.

  13. Diagnostic Dilemma of Cardiac Syncope in Pediatric Patients

    Directory of Open Access Journals (Sweden)

    Ranya A Hegazy

    2008-02-01

    Full Text Available Aims Syncope is defined as temporary loss of consciousness and postural tone resulting from an abrupt transient decrease in cerebral blood flow. The present work aimed at determining how diagnostic tests are used in the evaluation of pediatric syncope at a tertiary pediatric referral center and to report on the utility and the yield of these tests.Settings and Design Retrospective study conducted at a tertiary referral arrhythmolology serviceMethods and Material The clinical charts of 234 pediatric patients presenting with a primary complaint of syncope with an average age of 7.48 ± 3.82(3.5-16 years were reviewed by the investigators.Statistical analysis used Statistical Package of social science (SPSS version 9,0 was used for analysis of data.Results The commonest trigger for syncope in the study population was early following exercise (n=65 and the commonest prodrome was palpitation, noted in 25 patients. A murmur was present in 19 of our patients (8.3% while 10.7% (n=25 had abnormal ECGs. Of the 106 echocardiograms done, 14 (13.2% were abnormal. Only two of them were missed by ECG. All patients were offered ambulatory 24 hour ECG. One patient with sick sinus syndrome was diagnosed only with Holter.Conclusions Clues to the presence of cardiac syncope may include acute onset of syncope, frequent episodes, low difference between blood pressure readings in supine and erect positions (after standing for 2 minutes and most importantly an abnormal 12 lead ECG. Transthoracic echo and Holter monitoring have low yield in pediatric syncope.

  14. Pediatric Primary Care Providers' Relationships with Mental Health Care Providers: Survey Results

    Science.gov (United States)

    Pidano, Anne E.; Honigfeld, Lisa; Bar-Halpern, Miri; Vivian, James E.

    2014-01-01

    Background: As many as 20 % of children have diagnosable mental health conditions and nearly all of them receive pediatric primary health care. However, most children with serious mental health concerns do not receive mental health services. This study tested hypotheses that pediatric primary care providers (PPCPs) in relationships with mental…

  15. Validity of a Newly-Designed Rectilinear Stepping Ergometer Submaximal Exercise Test to Assess Cardiorespiratory Fitness.

    Science.gov (United States)

    Zhang, Rubin; Zhan, Likui; Sun, Shaoming; Peng, Wei; Sun, Yining

    2017-09-01

    The maximum oxygen uptake (V̇O 2 max), determined from graded maximal or submaximal exercise tests, is used to classify the cardiorespiratory fitness level of individuals. The purpose of this study was to examine the validity and reliability of the YMCA submaximal exercise test protocol performed on a newly-designed rectilinear stepping ergometer (RSE) that used up and down reciprocating vertical motion in place of conventional circular motion and giving precise measurement of workload, to determine V̇O 2 max in young healthy male adults. Thirty-two young healthy male adults (32 males; age range: 20-35 years; height: 1.75 ± 0.05 m; weight: 67.5 ± 8.6 kg) firstly participated in a maximal-effort graded exercise test using a cycle ergometer (CE) to directly obtain measured V̇O 2 max. Subjects then completed the progressive multistage test on the RSE beginning at 50W and including additional stages of 70, 90, 110, 130, and 150W, and the RSE YMCA submaximal test consisting of a workload increase every 3 minutes until the termination criterion was reached. A metabolic equation was derived from the RSE multistage exercise test to predict oxygen consumption (V̇O 2 ) from power output (W) during the submaximal exercise test (V̇O 2 (mL·min -1 )=12.4 ×W(watts)+3.5 mL·kg -1 ·min -1 ×M+160mL·min -1 , R 2 = 0.91, standard error of the estimate (SEE) = 134.8mL·min -1 ). A high correlation was observed between the RSE YMCA estimated V̇O 2 max and the CE measured V̇O 2 max (r=0.87). The mean difference between estimated and measured V̇O 2 max was 2.5 mL·kg -1 ·min -1 , with an SEE of 3.55 mL·kg -1 ·min -1 . The data suggest that the RSE YMCA submaximal exercise test is valid for predicting V̇O 2 max in young healthy male adults. The findings show that the rectilinear stepping exercise is an effective submaximal exercise for predicting V̇O 2 max. The newly-designed RSE may be potentially further developed as an alternative ergometer for assessing

  16. Annals of Pediatric Surgery

    African Journals Online (AJOL)

    The Annals of Pediatric Surgery is striving to fill an important niche that provides focus to clinical care, technical innovation and clinical research. The Annals of Pediatric Surgery has the responsibility to serve not only pediatric surgeons in the Middle East and North Africa but also should be an important conduit for scientific ...

  17. Cerebral imaging in pediatrics

    Energy Technology Data Exchange (ETDEWEB)

    Gordon, I [London, Great Ormond Street Hospital for Children (United Kingdom)

    1998-06-01

    Radioisotope brain imaging has focused mainly on regional cerebral blood flow (rCBF). However the use of ligand which go to specific receptor sites is being introduced in pediatrics, mainly psychiatry. rCBF is potentially available in many institutions, especially with the availability of multi-headed gamma cameras. The use of this technique in pediatrics requires special attention to detail in the manner of data acquisition and handling the child. The interpretation of the rCBF study in a child requires knowledge of normal brain maturation. The major clinical use in pediatrics is epilepsy because of the advances in surgery and the frequency of complex partial seizures. Other indications in pediatric neurology include brain death, acute neurological loss including stroke, language disorders, cerebral palsy, hypertension due to renovascular disease, traumatic brain injury and migraine. There are pediatric physiological conditions in which rCBF has been undertaken, these include anorexia nervosa, autism, Gilles de la Tourette syndrome (GTS) and attention deficit disorder-hyperactivity (ADHD). Research using different ligands to specific receptor sites will also be reviewed in pediatrics.

  18. Cerebral imaging in pediatrics

    International Nuclear Information System (INIS)

    Gordon, I.

    1998-01-01

    Radioisotope brain imaging has focused mainly on regional cerebral blood flow (rCBF). However the use of ligand which go to specific receptor sites is being introduced in pediatrics, mainly psychiatry. rCBF is potentially available in many institutions, especially with the availability of multi-headed gamma cameras. The use of this technique in pediatrics requires special attention to detail in the manner of data acquisition and handling the child. The interpretation of the rCBF study in a child requires knowledge of normal brain maturation. The major clinical use in pediatrics is epilepsy because of the advances in surgery and the frequency of complex partial seizures. Other indications in pediatric neurology include brain death, acute neurological loss including stroke, language disorders, cerebral palsy, hypertension due to renovascular disease, traumatic brain injury and migraine. There are pediatric physiological conditions in which rCBF has been undertaken, these include anorexia nervosa, autism, Gilles de la Tourette syndrome (GTS) and attention deficit disorder-hyperactivity (ADHD). Research using different ligands to specific receptor sites will also be reviewed in pediatrics

  19. Comparisons between Full-time and Part-time Pediatric Emergency Physicians in Pediatric Emergency Department.

    Science.gov (United States)

    Huang, I-Anne; Tuan, Pao-Lan; Jaing, Tang-Her; Wu, Chang-Teng; Chao, Minston; Wang, Hui-Hsuan; Hsia, Shao-Hsuan; Hsiao, Hsiang-Ju; Chang, Yu-Ching

    2016-10-01

    Pediatric emergency medicine is a young field that has established itself in recent decades. Many unanswered questions remain regarding how to deliver better pediatric emergency care. The implementation of full-time pediatric emergency physicians is a quality improvement strategy for child care in Taiwan. The aim of this study is to evaluate the quality of care under different physician coverage models in the pediatric emergency department (ED). The medical records of 132,398 patients visiting the pediatric ED of a tertiary care university hospital during January 2004 to December 2006 were retrospectively reviewed. Full-time pediatric emergency physicians are the group specializing in the pediatric emergency medicine, and they only work in the pediatric ED. Part-time pediatricians specializing in other subspecialties also can work an extra shift in the pediatric ED, with the majority working in their inpatient and outpatient services. We compared quality performance indicators, including: mortality rate, the 72-hour return visit rate, length of stay, admission rate, and the rate of being kept for observation between full-time and part-time pediatric emergency physicians. An average of 3678 ± 125 [mean ± standard error (SE)] visits per month (with a range of 2487-6646) were observed. The trends in quality of care, observed monthly, indicated that the 72-hour return rate was 2-6% and length of stay in the ED decreased from 11.5 hours to 3.2 hours over the study period. The annual mortality rate within 48 hours of admission to the ED increased from 0.04% to 0.05% and then decreased to 0.02%, and the overall mortality rate dropped from 0.13% to 0.07%. Multivariate analyses indicated that there was no change in the 72-hour return visit rate for full-time pediatric emergency physicians; they were more likely to admit and keep patients for observation [odds ratio = 1.43 and odds ratio = 1.71, respectively], and these results were similar to those of senior

  20. ASSESSMENT OF KNOWLEDGE & ATTITUDE OF THE PEDIATRIC RESIDENT ABOUT NEONATAL & PEDIATRIC CARDIOPULMONARY RESUSCITATION

    Directory of Open Access Journals (Sweden)

    M KADIAVAR

    2003-09-01

    Full Text Available Introduction: A high leve of skill & knowledge is required in circumstances of cardiopulmonary resucitation which represents the most urgent clinical situations. The difficulties for pediatric residents who are fronted with the most cases of pediatric & neonatal resucitation are due to different causes of cardiorespiratory arrest in camparison to adults. This study aimed to assess the knowledge & their personal attitude toward the neonatal & pediatric cardiopulmonary resuscitatin. Methods: By cross - sectional multicenter study between the pediatric residents who were studied in the teaching hospitals in Tehran (1378-90. Data were gathered among 140 residents by self-completed questionnaires which were included three parts as. demographic information assessment of their attitude by summation of score via ranking list questions and total score from assessment to their knowledge by different scenarios which were formatted in the multiple choice questions. Results: 35.7% of the residents studied in the first year of residency 35.0% in the second year and the remainder (29/3% in the third year More than 90% of them considered their knowledge about neonatal and pediatric cardiopulmonary resuscitation low & less than average. Net only 80% of the residents self - assessed their actual ability about this issue low but also declaired the insufficient education during the medical training. The total score of knowledge assessment was 14.7 + 1_0.54 from 30 without any significant relations among the residents in different hospitals or various levels of pediatric residency. (P value= 0.1 , 0.7 There was not significant correlation between the total score from their attitude & their knowledge. Conclusion: Pediatric residents as the key personnel in the management of cardiopulmonary resuscitation of the neonates and children should have enough knowledge and skills about this topic. This survey demonstrates a low level of the pediatric & neonatal

  1. Pediatric Thyroid Cancer

    Science.gov (United States)

    ... Marketplace Find an ENT Doctor Near You Pediatric Thyroid Cancer Pediatric Thyroid Cancer Patient Health Information News media ... and neck issues, should be consulted. Types of thyroid cancer in children: Papillary : This form of thyroid cancer ...

  2. Health-related fitness in very long-term survivors of childhood cancer: A cross-sectional study.

    Science.gov (United States)

    Hartman, Annelies; Pluijm, Saskia M F; Wijnen, Mark; Neggers, Sebastian J C M M; Clemens, Eva; Pieters, Rob; van den Heuvel-Eibrink, Marry M

    2018-04-01

    Impairment of health-related physical fitness (HRPF) in survivors of acute lymphoblastic leukemia has been shown. However, evidence of impairment in survivors of other pediatric malignancies and possible risk factors is limited. HRPF of 17 survivors of pediatric acute myeloid leukemia (AML), 26 survivors of neuroblastoma (NBL), 28 survivors of Wilms tumor (WT) (median age 28.8 [18.8-62.6] years) after a median follow-up time of 24.5 (6.5-43.6) years, and 74 healthy controls (median age 26.9 [17.9-61.7] years). Risk factors were investigated. Testing included submaximal cardiovascular endurance (6-Minute Walk Test (6 MWT), flexibility, and muscle strength. Results are expressed as mean (standard error). Survivors scored significantly lower than controls on the 6 MWT (588 ± 6.1 m vs. controls 611 ± 6.0 m; P = 0.008), on side flexion of the trunk (20.1 ± 0.4 cm vs. controls 22.4 ±0.4 cm; P < 0.001), and on vertical jump (39.7 ± 0.8 cm vs. controls 43.8 ± 0.8 cm; P < 0.001). Survivors of AML had lower scores on the 6 MWT (563 ± 12.4 m) than survivors of NBL (585 ± 9.9 m) and survivors of WT (606 ± 9.6 m), P = 0.046. Being a survivor, higher body mass index (BMI) and no participation in sports were independently associated with lower scores on the 6 MWT. Survivors of NBL, WT, and especially AML have impaired HRPF. Higher BMI and physical inactivity at adult age appeared prominent risk factors for impaired HRPF in these survivors. © 2017 Wiley Periodicals, Inc.

  3. Radiodiagnosis in pediatrics today

    International Nuclear Information System (INIS)

    Baklanova, V.F.

    1982-01-01

    The fields of radiodiagnosis application in pediatrics are considered. The improvement of roentgenologic methods and application of various contrast proparations enable to study and precisely differentiate congenital and acquired diseases. The scope of roentgenology application in pediatrics extends due to differentiation of pediatric specialities. New methods of investigation with decreasing radiation exposure to minimal are realized [ru

  4. The University of Western Ontario Pediatric Audiological Monitoring Protocol (UWO PedAMP)

    Science.gov (United States)

    Moodie, Sheila T.; Malandrino, April C.; Richert, Frances M.; Clench, Debbie A.; Scollie, Susan D.

    2011-01-01

    This study proposed and evaluated a guideline for outcome evaluation for infants and children with hearing loss who wear hearing aids. The University of Western Ontario Pediatric Audiological Monitoring Protocol (UWO PedAMP) was developed following a critical review of pediatric outcome evaluation tools and was systematically examined by the Network of Pediatric Audiologists of Canada. It consists of tools to gather clinical process outcomes as well as functional caregiver reports. The UWO PedAMP was administered to a clinical population of infants and children with hearing aids. Sixty-eight children were administered the functional outcome evaluation tools (i.e., caregiver reports) a total of 133 times. Clinical process outcomes of hearing aid verification (e.g., real-ear-to-coupler difference) revealed typical aided audibility (e.g., Speech Intelligibility Index). Results for the LittlEARS® questionnaire revealed that typically developing children with hearing loss who wear hearing aids are meeting auditory development milestones. Children with mild to moderate comorbidities displayed typical auditory development during the 1st year of life after which development began to decline. Children with complex factors related to hearing aid use had lower scores on the LittlEARS, but auditory development was in parallel to norms. Parents’ Evaluation of Aural/Oral Performance (PEACH) results indicated no age effect on scoring for children above 2 years of age; however, the effect of degree of hearing loss was significant. This work provides clinicians with a systematic, evidence-based outcome evaluation protocol to implement as part of a complete pediatric hearing aid fitting. PMID:22194316

  5. Residual stresses and stress corrosion cracking in pipe fittings

    International Nuclear Information System (INIS)

    Parrington, R.J.; Scott, J.J.; Torres, F.

    1994-06-01

    Residual stresses can play a key role in the SCC performance of susceptible materials in PWR primary water applications. Residual stresses are stresses stored within the metal that develop during deformation and persist in the absence of external forces or temperature gradients. Sources of residual stresses in pipe fittings include fabrication processes, installation and welding. There are a number of methods to characterize the magnitude and orientation of residual stresses. These include numerical analysis, chemical cracking tests, and measurement (e.g., X-ray diffraction, neutron diffraction, strain gage/hole drilling, strain gage/trepanning, strain gage/section and layer removal, and acoustics). This paper presents 400 C steam SCC test results demonstrating that residual stresses in as-fabricated Alloy 600 pipe fittings are sufficient to induce SCC. Residual stresses present in as-fabricated pipe fittings are characterized by chemical cracking tests (stainless steel fittings tested in boiling magnesium chloride solution) and by the sectioning and layer removal (SLR) technique

  6. Pediatric Melanoma and Drug Development

    Directory of Open Access Journals (Sweden)

    Klaus Rose

    2018-03-01

    Full Text Available Importance—Pediatric melanoma occurs, albeit rarely. Should patients be treated by today’s medical standards, or be subjected to medically unnecessary clinical studies? Observations—We identified international, industry-sponsored pediatric melanoma studies triggered by regulatory demands in www.clinicaltrials.gov and further pediatric melanoma studies demanded by European Union pediatric investigation plans. We retrieved related regulatory documents from the internet. We analyzed these studies for rationale and medical beneficence on the basis of physiology, pediatric clinical pharmacology and rationale. Regulatory authorities define children by chronological age, not physiologically. Newborns’ organs are immature but they develop and mature rapidly. Separate proof of efficacy in underage patients is justified formally/regulatorily but lacks medical sense. Children—especially post-puberty—and adults vis-a-vis medications are physiologically very similar. Two adolescent melanoma studies were terminated in 2016 because of waning recruitment, while five studies in pediatric melanoma and other solid tumors, triggered by European Union pediatric investigation plans, continue recruiting worldwide. Conclusions and Relevance—Regulatory-demanded pediatric melanoma studies are medically superfluous. Melanoma patients of all ages should be treated with effective combination treatment. Babies need special attention. Children need dose-finding and pharmacokinetic studies but adolescents metabolize and respond to drugs similarly to adults. Institutional Review Boards/ethics committees should suspend ongoing questionable pediatric melanoma studies and reject newly submitted questionable studies.

  7. Pediatric cardiology. Clinical and practical experiences with heart diseases of children, juveniles and young adults

    International Nuclear Information System (INIS)

    Haas, Nikolaus A.

    2011-01-01

    The book on pediatric cardiology covers the following chapters: (I) Fundamentals and diagnostics: pediatric cardiologic anamnesis, electrocardiograms, thorax X-radiography, MRT and CT of the heart, nuclear medical diagnostics, exercise tests, heart catheter examination, electrophysiological tests. (II) Leading symptoms: Cyanosis, cardiac murmur, thorax pain, palpitation, syncopes. (III) Disease pictures: congenital heart defects, acquired heart defects, cardiomyopathies, heart rhythm disturbances, heart insufficiency, arterial hypertension, pulmonary hypertension, other heart involving syndromes. (IV) Therapy: Catheter interventional therapy, post-surgical pediatric cardiac therapy, surgery involving the life-support machine, mechanical cardiovascular support systems, initial treatment of newborns with critical heart defects, heart transplantation, vaccination of children with heart diseases, medicinal therapy.

  8. Health-related physical fitness and physical activity in elementary school students.

    Science.gov (United States)

    Chen, Weiyun; Hammond-Bennett, Austin; Hypnar, Andrew; Mason, Steve

    2018-01-30

    This study examined associations between students' physical fitness and physical activity (PA), as well as what specific physical fitness components were more significant correlates to being physically active in different settings for boys and girls. A total of 265 fifth-grade students with an average age of 11 voluntarily participated in this study. The students' physical fitness was assessed using four FitnessGram tests, including Progressive Aerobic Cardiovascular Endurance Run (PACER), curl-up, push-up, and trunk lift tests. The students' daily PA was assessed in various settings using a daily PA log for 7 days. Data was analyzed with descriptive statistics, univariate analyses, and multiple R-squared liner regression methods. Performance on the four physical fitness tests was significantly associated with the PA minutes spent in physical education (PE) class and recess for the total sample and for girls, but not for boys. Performance on the four fitness tests was significantly linked to participation in sports/dances outside school and the total weekly PA minutes for the total sample, boys, and girls. Further, boys and girls who were the most physically fit spent significantly more time engaging in sports/dances and had greater total weekly PA than boys and girls who were not physically fit. In addition, the physically fit girls were more physically active in recess than girls who were not physically fit. Overall, students' performance on the four physical fitness tests was significantly associated with them being physically active during PE and in recess and engaging in sports/dances, as well as with their total weekly PA minutes, but not with their participation in non-organized physical play outside school. ClinicalTrials.gov ID: NCT03015337 , registered date: 1/09/2017, as "retrospectively registered".

  9. Performance studies of GooFit on GPUs vs RooFit on CPUs while estimating the statistical significance of a new physical signal

    Science.gov (United States)

    Di Florio, Adriano

    2017-10-01

    In order to test the computing capabilities of GPUs with respect to traditional CPU cores a high-statistics toy Monte Carlo technique has been implemented both in ROOT/RooFit and GooFit frameworks with the purpose to estimate the statistical significance of the structure observed by CMS close to the kinematical boundary of the J/ψϕ invariant mass in the three-body decay B + → J/ψϕK +. GooFit is a data analysis open tool under development that interfaces ROOT/RooFit to CUDA platform on nVidia GPU. The optimized GooFit application running on GPUs hosted by servers in the Bari Tier2 provides striking speed-up performances with respect to the RooFit application parallelised on multiple CPUs by means of PROOF-Lite tool. The considerable resulting speed-up, evident when comparing concurrent GooFit processes allowed by CUDA Multi Process Service and a RooFit/PROOF-Lite process with multiple CPU workers, is presented and discussed in detail. By means of GooFit it has also been possible to explore the behaviour of a likelihood ratio test statistic in different situations in which the Wilks Theorem may or may not apply because its regularity conditions are not satisfied.

  10. Management of natural health products in pediatrics: a provider-focused quality improvement project.

    Science.gov (United States)

    Gutierrez, Emily; Silbert-Flagg, JoAnne; Vohra, Sunita

    2015-01-01

    The use of natural health products by pediatric patients is common, yet health care providers often do not provide management guidance. The purpose of this project was to improve management of natural health products by pediatric nurse practitioners. Pediatric nurse practitioners from large metropolitan city were recruited (n = 32). A paired pretest-posttest design was used. Study participants were engaged to improve knowledge of natural health products, and a management toolkit was created and tested. Mean knowledge scores increased from 59.19 to 76.3 (p improved with regard to patient guidance (p product use (p = .51) and drug/herb interactions (p = .35) were not significant. This investigation is the first known study to improve knowledge and management of natural health products in pediatric clinical practice. Copyright © 2015 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

  11. Pediatrics Residents' Confidence and Performance Following a Longitudinal Quality Improvement Curriculum.

    Science.gov (United States)

    Courtlandt, Cheryl; Noonan, Laura; Koricke, Maureen Walsh; Zeskind, Philip Sanford; Mabus, Sarah; Feld, Leonard

    2016-02-01

    Quality improvement (QI) training is an integral part of residents' education. Understanding the educational value of a QI curriculum facilitates understanding of its impact. The purpose of this study was to evaluate the effects of a longitudinal QI curriculum on pediatrics residents' confidence and competence in the acquisition and application of QI knowledge and skills. Three successive cohorts of pediatrics residents (N = 36) participated in a longitudinal curriculum designed to increase resident confidence in QI knowledge and skills. Key components were a succession of progressive experiential projects, QI coaching, and resident team membership culminating in leadership of the project. Residents completed precurricular and postcurricular surveys and demonstrated QI competence by performance on the pediatric QI assessment scenario. Residents participating in the Center for Advancing Pediatric Excellence QI curriculum showed significant increases in pre-post measures of confidence in QI knowledge and skills. Coaching and team leadership were ranked by resident participants as having the most educational value among curriculum components. A pediatric QI assessment scenario, which correlated with resident-perceived confidence in acquisition of QI skills but not QI knowledge, is a tool available to test pediatrics residents' QI knowledge. A 3-year longitudinal, multimodal, experiential QI curriculum increased pediatrics residents' confidence in QI knowledge and skills, was feasible with faculty support, and was well-accepted by residents.

  12. The Functional Fitness MOT Test Battery for Older Adults: Protocol for a Mixed-Method Feasibility Study.

    Science.gov (United States)

    de Jong, Lex D; Peters, Andy; Hooper, Julie; Chalmers, Nina; Henderson, Claire; Laventure, Robert Me; Skelton, Dawn A

    2016-06-20

    Increasing physical activity (PA) brings many health benefits, but engaging people in higher levels of PA after their 60s is not straightforward. The Functional Fitness MOT (FFMOT) is a new approach which aims to raise awareness about the importance of components of fitness (strength, balance, flexibility), highlight benefits of PA, engages older people in health behavior change discussions, and directs them to local activity resources. This battery of tests combined with a brief motivational interview has not been tested in terms of feasibility or effectiveness. To assess whether the FFMOT, provided in a health care setting, is appealing to older patients of a community physiotherapy service and to understand the views and perceptions of the older people undergoing the FFMOT regarding the intervention, as well as the views of the physiotherapy staff delivering the intervention. Secondary aims are to assess the feasibility of carrying out a phase 2 pilot randomized controlled trial of the FFMOT, in the context of a community physiotherapy service, by establishing whether enough patients can be recruited and retained in the study, and enough outcome data can be generated. A mixed-methods feasibility study will be conducted in two physiotherapy outpatient clinics in the United Kingdom. A total of 30 physically inactive, medically stable older adults over the age of 60 will be provided with an individual FFMOT, comprising a set of six standardized, validated, age-appropriate tests aimed at raising awareness of the different components of fitness. The results of these tests will be used to provide the participants with feedback on performance in comparison to sex and age-referenced norms. This will be followed by tailored advice on how to become more active and improve fitness, including advice on local opportunities to be more active. Subsequently, participants will be invited to attend a focus group to discuss barriers and motivators to being more active, health

  13. Enhancing the emergency department approach to pediatric sexual assault care: implementation of a pediatric sexual assault response team program.

    Science.gov (United States)

    Goyal, Monika K; Mollen, Cynthia J; Hayes, Katie L; Molnar, Jennifer; Christian, Cindy W; Scribano, Philip V; Lavelle, Jane

    2013-09-01

    The objectives of this study were to describe the experience of a novel pediatric sexual assault response team (SART) program in the first 3 years of implementation and compare patient characteristics, evaluation, and treatment among subpopulations of patients. This was a retrospective chart review of a consecutive sample of patients evaluated at a pediatric emergency department (ED) who met institutional criteria for a SART evaluation. Associations of evaluation and treatment with sex, menarchal status, and presence of injuries were measured using logistic regression. One hundred eighty-four patients met criteria for SART evaluation, of whom 87.5% were female; mean age was 10.1 (SD, 4.6) years. The majority of patients underwent forensic evidence collection (89.1%), which varied by menarchal status among girls (P < 0.01), but not by sex. Evidence of acute anogenital injury on physical examination was found in 20.6% of patients. As per the Centers for Disease Control and Prevention guidelines for acute sexual assault evaluations in pediatric patients, menarchal girls were more likely to undergo testing for sexually transmitted infections and pregnancy (P < 0.01) and to be offered pregnancy, sexually transmitted infection, and HIV prophylaxis (P < 0.01). In an effort to improve quality and consistency of acute sexual assault examinations in a pediatric ED, development of a SART program supported the majority of eligible patients undergoing forensic evidence collection. Furthermore, a substantial number of patients had evidence of injury on examination. These findings underscore the importance of having properly trained personnel to support ED care for pediatric victims of acute sexual assault.

  14. What Is a Pediatric Gastroenterologist?

    Science.gov (United States)

    ... Text Size Email Print Share What is a Pediatric Gastroenterologist? Page Content Article Body If your child ... children, and teens. What Kind of Training Do Pediatric Gastroenterologists Have? Pediatric gastroenterologists are medical doctors who ...

  15. What Is a Pediatric Endocrinologist?

    Science.gov (United States)

    ... Text Size Email Print Share What is a Pediatric Endocrinologist? Page Content Article Body If your child ... the teen years. What Kind of Training Do Pediatric Endocrinologists Have? Pediatric endocrinologists are medical doctors who ...

  16. What Is a Pediatric Geneticist?

    Science.gov (United States)

    ... Text Size Email Print Share What is a Pediatric Geneticist? Page Content Article Body Fortunately, most children ... with similar problems. What Kind of Training Do Pediatric Geneticists Have? Pediatric geneticists are medical doctors who ...

  17. What Is a Pediatric Urologist?

    Science.gov (United States)

    ... Text Size Email Print Share What is a Pediatric Urologist? Page Content Article Body If your child ... treat your child. What Kind of Training Do Pediatric Urologists Have? Pediatric urologists are medical doctors who ...

  18. Translation and cultural adaptation of the Pediatric Eosinophilic Esophagitis Symptom Score (PEESS v2.0).

    Science.gov (United States)

    Santos, Maria Fernanda Oliveira; Barros, Cristina Palmer; Silva, Carlos Henrique Martins da; Paro, Helena Borges Martins da Silva

    2017-11-04

    To translate and culturally adapt the Pediatric Eosinophilic Esophagitis Symptom Score (version 2.0), a tool used to assess pediatric eosinophilic esophagitis symptoms reported by patients and/or their parents/caregivers. The Pediatric Eosinophilic Esophagitis Symptom Score was translated through the following stages: initial translation, back-translation, and consensus of independent reviewers through the Delphi technique. The pre-final version of the Pediatric Eosinophilic Esophagitis Symptom Score was applied to five 8-to-18-year-old patients and to ten parents of two-to-18-year-old patients from an outpatient pediatric gastroenterology service (pre-test). During the translation process, no translations presenting with difficult consensus in the review process or grammar inconsistencies were observed. During the pre-test, difficulties in comprehension of some unconventional terms, e.g., "náusea", were observed. Adverbs of frequency, such as "quase nunca" were also identified as being of difficult understanding by patients and parents, and the substitution by the term "raramente" was suggested. Such difficulties may be inherent to the pediatric age group. Age 8 years or above should be considered adequate for the self-reporting of symptoms. The study presents the Brazilian version of the Pediatric Eosinophilic Esophagitis Symptom Score, which is adapted to the Brazilian culture. This version may be introduced as a clinical and research tool for the assessment of patients with esophagic disease symptoms. The Pediatric Eosinophilic Esophagitis Symptom Score is a breakthrough in the evaluation of symptoms of pediatric eosinophilic esophagitis, since it reinforces the importance of self-reporting by patients who experience this disease. Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  19. Comparison between chloral hydrate and propofol-ketamine as sedation regimens for pediatric auditory brainstem response testing.

    Science.gov (United States)

    Abulebda, Kamal; Patel, Vinit J; Ahmed, Sheikh S; Tori, Alvaro J; Lutfi, Riad; Abu-Sultaneh, Samer

    2017-10-28

    The use of diagnostic auditory brainstem response testing under sedation is currently the "gold standard" in infants and young children who are not developmentally capable of completing the test. The aim of the study is to compare a propofol-ketamine regimen to an oral chloral hydrate regimen for sedating children undergoing auditory brainstem response testing. Patients between 4 months and 6 years who required sedation for auditory brainstem response testing were included in this retrospective study. Drugs doses, adverse effects, sedation times, and the effectiveness of the sedative regimens were reviewed. 73 patients underwent oral chloral hydrate sedation, while 117 received propofol-ketamine sedation. 12% of the patients in the chloral hydrate group failed to achieve desired sedation level. The average procedure, recovery and total nursing times were significantly lower in the propofol-ketamine group. Propofol-ketamine group experienced higher incidence of transient hypoxemia. Both sedation regimens can be successfully used for sedating children undergoing auditory brainstem response testing. While deep sedation using propofol-ketamine regimen offers more efficiency than moderate sedation using chloral hydrate, it does carry a higher incidence of transient hypoxemia, which warrants the use of a highly skilled team trained in pediatric cardio-respiratory monitoring and airway management. Copyright © 2017 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  20. Effects of Various Warm Up Protocol on Special Judo Fitness Test Performance.

    Science.gov (United States)

    Lum, Danny

    2017-02-13

    The purposed of this study was to compare the effects of postactivation potentiation (PAP) on Special Judo Fitness Test (SJFT) performance using explosive exercises that activates upper and lower limbs muscles. Eleven male judo athletes (mean ± SD, age, 16 - 29 years; height, 170 ± 7 cm; body mass, 73 ± 16 kg) attended four separate sessions. The first session was used to familiarise the subjects to the experimental procedure, the SJFT, the high pull test (HPT) and the two explosive exercises including resistance band pull and standing broad jump. Subsequently, subjects were randomly assigned in a counterbalanced manner to either perform the upper and lower body PAP (ULB), lower body PAP (LB) or usual competition (CON) warm up routine prior to performing the HPT and SJFT. The following variables were quantified: throws performed during series A, B, and C; total number of throws; heart rate immediately and 1 minute after the test; test index; peak power; and RPE after warm up. During series 1, number of throws performed in LB and ULB were significantly greater than CON (p < 0.05). Only ULB resulted in significantly greater number of total throws (p < 0.01) and higher peak power (p < 0.01) than CON. The RPE for both LB and ULB were significantly lower than CON (p < 0.01). Peak power was moderately correlated to total number of throws performed (r=0.4, p < 0.05). This study suggest that performing ULB before SJFT can result in improved performance and peak power.

  1. The US pediatric nephrology workforce: a report commissioned by the American Academy of Pediatrics.

    Science.gov (United States)

    Primack, William A; Meyers, Kevin E; Kirkwood, Suzanne J; Ruch-Ross, Holly S; Radabaugh, Carrie L; Greenbaum, Larry A

    2015-07-01

    The US pediatric nephrology workforce is poorly characterized. This report describes clinical and nonclinical activities, motivations and disincentives to a career in pediatric nephrology, future workforce needs, trainee recruitment, and possible explanations for personnel shortages. An e-mail survey was sent in 2013 to all identified US-trained or -practicing pediatric nephrologists. Of 504 respondents, 51% are men, 66% are US graduates, and 73% work in an academic setting. About 20% of trained pediatric nephrologists no longer practice pediatric nephrology. Among the 384 respondents practicing pediatric nephrology full or part-time in the United States, the mean work week was 56.1±14.3 hours, with time divided between patient care (59%), administration (13%), teaching (10%), clinical research (9%), basic research (6%), and other medical activities (3%). Most (>85%) care for dialysis and transplantation patients. The median number of weeks annually on call is 16, and 29% work with one or no partner. One-third of US pediatric nephrologists (n=126) plan to reduce or stop clinical nephrology practice in the next 5 years, and 53% plan to fully or partially retire. Almost half the division chiefs (47%) report inadequate physician staffing. Ongoing efforts to monitor and address pediatric nephrology workforce issues are needed. Copyright © 2015 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  2. Acute renal failure in pediatric patients: Etiology and predictors of outcome

    Directory of Open Access Journals (Sweden)

    Ghani Amal

    2009-01-01

    Full Text Available Acute renal failure (ARF is the acute loss of kidney function over hours or days, the etiology of which varies in different countries. The data on the etiology and outcome of ARF in Arab children is limited. Our objective was to define the causes and predictors of outcome of ARF in Kuwaiti children, and the variables determining their fitness for dialysis. A total of 32 children with ARF were evaluated regarding their demographic and clinical data, the cause of ARF and the co-morbidities. Data were analyzed to find the independent variables determining fitness for dia-lysis and outcome. Males comprised 62.5% of the study children; 46.9% of ARF cases were due to sepsis and 56.2% underwent renal replacement therapy (RRT. Univariate analysis showed that age, hemodynamic instability, use of vasopressors, multi-organ failure (MOF, and mechanical venti-lation contributed to fitness for dialysis. However, MOF was the only independent variable affecting fitness for dialysis. The overall mortality was 43.8%. Univariate analysis showed that age below 24-months, hemodynamic instability, use of vasopressors, fluid overload, need for mecha-nical ventilation, MOF and late referral to the nephrologist were associated with poor outcome. However, multivariate analysis documented MOF, and the time of nephrologists′ intervention as independent prognostic indicators. Our study suggests that sepsis was the major cause of pediatric ARF. RRT is the optimal treatment, and the only factor determining child′s fitness for dialysis is MOF.

  3. Physical fitness reference standards in fibromyalgia: The al-Ándalus project.

    Science.gov (United States)

    Álvarez-Gallardo, I C; Carbonell-Baeza, A; Segura-Jiménez, V; Soriano-Maldonado, A; Intemann, T; Aparicio, V A; Estévez-López, F; Camiletti-Moirón, D; Herrador-Colmenero, M; Ruiz, J R; Delgado-Fernández, M; Ortega, F B

    2017-11-01

    We aimed (1) to report age-specific physical fitness levels in people with fibromyalgia of a representative sample from Andalusia; and (2) to compare the fitness levels of people with fibromyalgia with non-fibromyalgia controls. This cross-sectional study included 468 (21 men) patients with fibromyalgia and 360 (55 men) controls. The fibromyalgia sample was geographically representative from southern Spain. Physical fitness was assessed with the Senior Fitness Test battery plus the handgrip test. We applied the Generalized Additive Model for Location, Scale and Shape to calculate percentile curves for women and fitted mean curves using a linear regression for men. Our results show that people with fibromyalgia reached worse performance in all fitness tests than controls (P fitness levels among patients with fibromyalgia and controls in a large sample of patients with fibromyalgia from southern of Spain. Physical fitness levels of people with fibromyalgia from Andalusia are very low in comparison with age-matched healthy controls. This information could be useful to correctly interpret physical fitness assessments and helping health care providers to identify individuals at risk for losing physical independence. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  4. Seminar Pediatrics. Medical and Technical Applications

    International Nuclear Information System (INIS)

    Montivero, M.; Nespral, D.O.; Alak, Maria del Carmen

    2012-01-01

    The Association of Biology and Nuclear Medicine has organized the 'Seminar Pediatrics - Medical and Technical Applications', held in Buenos Aires in May 2012, in order to collaborate with the scientific growth of nuclear medicine in pediatrics. The main topics covered were: management of pediatric patients and medical application in childhood, dosimetry in pediatric nuclear medicine, scope of radioisotope - studies in nephrourological pathologies, PET in pediatrics, among others.

  5. Improvement of Skills in Cardiopulmonary Resuscitation of Pediatric Residents by Recorded Video Feedbacks.

    Science.gov (United States)

    Anantasit, Nattachai; Vaewpanich, Jarin; Kuptanon, Teeradej; Kamalaporn, Haruitai; Khositseth, Anant

    2016-11-01

    To evaluate the pediatric residents' cardiopulmonary resuscitation (CPR) skills, and their improvements after recorded video feedbacks. Pediatric residents from a university hospital were enrolled. The authors surveyed the level of pediatric resuscitation skill confidence by a questionnaire. Eight psychomotor skills were evaluated individually, including airway, bag-mask ventilation, pulse check, prompt starting and technique of chest compression, high quality CPR, tracheal intubation, intraosseous, and defibrillation. The mock code skills were also evaluated as a team using a high-fidelity mannequin simulator. All the participants attended a concise Pediatric Advanced Life Support (PALS) lecture, and received video-recorded feedback for one hour. They were re-evaluated 6 wk later in the same manner. Thirty-eight residents were enrolled. All the participants had a moderate to high level of confidence in their CPR skills. Over 50 % of participants had passed psychomotor skills, except the bag-mask ventilation and intraosseous skills. There was poor correlation between their confidence and passing the psychomotor skills test. After course feedback, the percentage of high quality CPR skill in the second course test was significantly improved (46 % to 92 %, p = 0.008). The pediatric resuscitation course should still remain in the pediatric resident curriculum and should be re-evaluated frequently. Video-recorded feedback on the pitfalls during individual CPR skills and mock code case scenarios could improve short-term psychomotor CPR skills and lead to higher quality CPR performance.

  6. What is Pediatric Palliative Care?

    Science.gov (United States)

    ... FAQ Handout for Patients and Families What Is Pediatric Palliative Care? Pediatric Palliative care (pronounced pal-lee-uh-tiv) is ... life for both the child and the family. Pediatric palliative care is provided by a team of ...

  7. The fitness landscape of HIV-1 gag: advanced modeling approaches and validation of model predictions by in vitro testing.

    Directory of Open Access Journals (Sweden)

    Jaclyn K Mann

    2014-08-01

    Full Text Available Viral immune evasion by sequence variation is a major hindrance to HIV-1 vaccine design. To address this challenge, our group has developed a computational model, rooted in physics, that aims to predict the fitness landscape of HIV-1 proteins in order to design vaccine immunogens that lead to impaired viral fitness, thus blocking viable escape routes. Here, we advance the computational models to address previous limitations, and directly test model predictions against in vitro fitness measurements of HIV-1 strains containing multiple Gag mutations. We incorporated regularization into the model fitting procedure to address finite sampling. Further, we developed a model that accounts for the specific identity of mutant amino acids (Potts model, generalizing our previous approach (Ising model that is unable to distinguish between different mutant amino acids. Gag mutation combinations (17 pairs, 1 triple and 25 single mutations within these predicted to be either harmful to HIV-1 viability or fitness-neutral were introduced into HIV-1 NL4-3 by site-directed mutagenesis and replication capacities of these mutants were assayed in vitro. The predicted and measured fitness of the corresponding mutants for the original Ising model (r = -0.74, p = 3.6×10-6 are strongly correlated, and this was further strengthened in the regularized Ising model (r = -0.83, p = 3.7×10-12. Performance of the Potts model (r = -0.73, p = 9.7×10-9 was similar to that of the Ising model, indicating that the binary approximation is sufficient for capturing fitness effects of common mutants at sites of low amino acid diversity. However, we show that the Potts model is expected to improve predictive power for more variable proteins. Overall, our results support the ability of the computational models to robustly predict the relative fitness of mutant viral strains, and indicate the potential value of this approach for understanding viral immune evasion

  8. Pediatric contact dermatitis

    Directory of Open Access Journals (Sweden)

    Sharma Vinod

    2010-01-01

    Full Text Available Allergic contact dermatitis (ACD in children, until recently, was considered rare. ACD was considered as a disorder of the adult population and children were thought to be spared due to a lack of exposure to potential allergens and an immature immune system. Prevalence of ACD to even the most common allergens in children, like poison ivy and parthenium, is relatively rare as compared to adults. However, there is now growing evidence of contact sensitization of the pediatric population, and it begins right from early childhood, including 1-week-old neonates. Vaccinations, piercing, topical medicaments and cosmetics in younger patients are potential exposures for sensitization. Nickel is the most common sensitizer in almost all studies pertaining to pediatric contact dermatitis. Other common allergens reported are cobalt, fragrance mix, rubber, lanolin, thiomersol, neomycin, gold, mercapto mix, balsum of Peru and colophony. Different factors like age, sex, atopy, social and cultural practices, habit of parents and caregivers and geographic changes affect the patterns of ACD and their variable clinical presentation. Patch testing should be considered not only in children with lesions of a morphology suggestive of ACD, but in any child with dermatitis that is difficult to control.

  9. Children's (Pediatric) Magnetic Resonance Imaging

    Science.gov (United States)

    ... Physician Resources Professions Site Index A-Z Children’s (Pediatric) Magnetic Resonance Imaging Children’s magnetic resonance imaging (MRI) ... limitations of Children’s (Pediatric) MRI? What is Children’s (Pediatric) MRI? Magnetic resonance imaging (MRI) is a noninvasive ...

  10. PET imaging in pediatric oncology

    International Nuclear Information System (INIS)

    Shulkin, B.L.

    2004-01-01

    High-quality PET imaging of pediatric patients is challenging and requires attention to issues commonly encountered in the practice of pediatric nuclear medicine, but uncommon to the imaging of adult patients. These include intravenous access, fasting, sedation, consent, and clearance of activity from the urinary tract. This paper discusses some technical differences involved in pediatric PET to enhance the quality of scans and assure the safety and comfort of pediatric patients. (orig.)

  11. Pediatric Palliative Care at a Glance

    Science.gov (United States)

    ® ™ ® Pediatric Palliative Care at a Glance A child’s serious illness affects the entire family. Pediatric palliative (pal-lee-uh-tiv) care can support ... extra support, palliative care can help. What is pediatric palliative care? Pediatric palliative care is supportive care ...

  12. Pediatric neurocysticercosis: current challenges and future prospects

    Directory of Open Access Journals (Sweden)

    Singhi P

    2016-03-01

    Full Text Available Pratibha Singhi, Arushi Gahlot SainiDepartment of Pediatrics, Pediatric Neurology and Neurodevelopment Unit, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, IndiaAbstract: Neurocysticercosis (NCC is an acquired infection of the nervous system caused by encysted larvae of Taenia solium. It is a major cause of epilepsy in the tropics and the commonest cause of focal seizures in North Indian children. T. solium teniasis-cysticercosis is considered a parasitic “Neglected Tropical Diseases” endemic throughout Southeast Asia. NCC in children has pleomorphic manifestations depending on the location, number and viability of the cysts, and host response. Even with advancing knowledge of the disease manifestations, many aspects related to diagnosis and treatment, particularly in children, still remain controversial and pose challenges to clinical practice. There is no gold standard test to diagnose NCC and the management recommendations are still emerging. This review provides an overview of diagnosis of NCC in children and its management with special focus on current challenges and future prospects.Keywords: neurocysticercosis, children, epilepsy, ring enhancing lesions, pigs

  13. Understanding psychological distress among pediatric cancer caregivers.

    Science.gov (United States)

    Nam, Gina E; Warner, Echo L; Morreall, Deborah K; Kirchhoff, Anne C; Kinney, Anita Y; Fluchel, Mark

    2016-07-01

    Few studies have examined distress in caregivers of pediatric cancer patients. We evaluated the association of socioeconomic, demographic, and patient clinical factors on caregivers' self-reported psychological distress associated with having a child with cancer. N = 366 pediatric cancer caregivers completed a self-administered questionnaire from July 2010 to July 2012. The Impact of Event Scale (IES), along with two subscales "intrusion" and "avoidance" measured caregiver cancer-specific distress, with higher scores indicating greater distress. Multivariable linear regression models were used to calculate coefficients (β) and 95 % confidence intervals (95 % CI) of IES by socioeconomic, demographic, and clinical factors. Average caregiver IES score was 31.2 (standard deviation (SD) = 16.9, range 0-75). Mean intrusion score was 18.1 (SD 9.8, range 0-35) and avoidance score was 12.8 (SD 9.0, range 0-40). Caregivers with household incomes psychological distress for caregivers of pediatric oncology patients. These findings underscore the importance of developing and testing interventions aimed at evaluating and addressing the psychosocial needs for high-risk caregivers in addition to those of patients.

  14. Assessment of senior pupils’ physical fitness considering physical condition indicators

    Directory of Open Access Journals (Sweden)

    I.R. Bodnar

    2016-12-01

    Full Text Available Consideration of physical condition indicators in assessment pupils’ physical fitness permits to differentiate training and health restoration processes at physical culture lessons. Purpose: to substantiate criteria for pupils’ physical fitness assessment, considering their physical condition indicators. Material: in the research 10-11 form pupils (n=406; 211boys and 195 girls participated. After physical fitness testing by requirement of acting programs we carried out diagnostic of pupils’ psycho-emotional state. Results: by results of physical; fitness we observed substantial deviation from universal law of normal distribution. It was found that physical condition indicators of most pupils are beyond normal. It was also determined that the most informative indicators are body length, chest circumference and body relative mass. We substantiated that it is necessary to consider physical condition indicators, when determining physical fitness level. We also substantiated and worked out differentiated normative for assessment pupils’ physical fitness. Conclusions: testing without consideration physical condition indicators does not facilitate pupils’ motivation for further physical self-perfection. Such testing results in high situational anxiety and unfavorable psycho-emotional state of pupils.

  15. Children's (Pediatric) Magnetic Resonance Imaging

    Medline Plus

    Full Text Available ... Physician Resources Professions Site Index A-Z Children’s (Pediatric) Magnetic Resonance Imaging Children’s magnetic resonance imaging (MRI) ... limitations of Children’s (Pediatric) MRI? What is Children’s (Pediatric) MRI? Magnetic resonance imaging (MRI) is a noninvasive ...

  16. Children's (Pediatric) Magnetic Resonance Imaging

    Medline Plus

    Full Text Available ... News Physician Resources Professions Site Index A-Z Children’s (Pediatric) Magnetic Resonance Imaging Children’s magnetic resonance imaging ( ... the limitations of Children’s (Pediatric) MRI? What is Children’s (Pediatric) MRI? Magnetic resonance imaging (MRI) is a ...

  17. Pediatric emergence delirium: Canadian Pediatric Anesthesiologists' experience.

    Science.gov (United States)

    Rosen, H David; Mervitz, Deborah; Cravero, Joseph P

    2016-02-01

    Pediatric emergence agitation/delirium (ED) is a cluster of behaviors seen in the early postanesthetic period with negative emotional consequences for families and increased utilization of healthcare resources. Many studies have looked at identifying risk factors for ED and at pharmacologic regimens to prevent ED. There are few published reports on treatment options and efficacy for established ED episodes, and essentially no data concerning current practice in the treatment of ED. We sought to elicit the experience and opinions of Canadian Pediatric Anesthesiologists on the incidence of ED in their practice, definitions and diagnostic criteria, preventative strategies, treatments, and their perceived efficacy. A web-based survey was sent to pediatric anesthesiologists working at academic health science centers across Canada. The participants were selected based on being members of the Canadian Pediatric Anesthesia Society (CPAS), which represents the subspecialty in Canada. All members of CPAS who had e-mail contact information available in the membership database were invited to participate. A total of 209 members out of the total of 211 fulfilled these criteria and were included in the study population. The response rate was 51% (106/209). Of respondents, 42% felt that ED was a significant problem at their institutions, with 45% giving medication before or during anesthesia to prevent the development of ED. Propofol was the most common medication given to prevent ED (68%) and to treat ED (42%). Total intravenous anesthesia (TIVA) was considered by 38% of respondents as a technique used to prevent ED. Medications used for treatment included propofol (42%), midazolam (31%), fentanyl (10%), morphine (7%), and dexmedetomidine (5%), with 87% of respondents rating effectiveness of treatment as 'usually works quickly with one dose'. We present information on current practice patterns with respect to prophylaxis and treatment of ED among a specialized group of pediatric

  18. Kerala Pioneering Pediatric Surgery in India

    Directory of Open Access Journals (Sweden)

    TP Joseph

    2014-04-01

    Full Text Available Pediatric surgeons of Kerala are very proud to have led the development of superspeciality in any branch of medicine in Kerala and also superspeciality of Pediatric surgery in whole of India. Late Prof. Raman Nair returned in 1954 after training under Dr. Everett Koop in US. Same year, in his far-sighted vision for future development of the speciality, he moved to SATH, Medical College, Trivandrum and started Pediatric surgery as a speciality attached to Paediatrics department; this was the beginning of Pediatric surgery in India. He opted for Pediatric surgery as a full time job and did not do any general surgery work in adults. He was the first full time Pediatric surgeon of India; during the next few years, 2 surgeons, one in Calcutta, Prof. UC Chakraboty and Prof. D Anjaneyulu in Hyderabad started working as full time Pediatric surgeons. In Mumbai, Delhi and Chennai, Pediatric surgery developed much later and then all over the country.

  19. Detection of Brain Reorganization in Pediatric Multiple Sclerosis Using Functional MRI

    Science.gov (United States)

    2014-10-01

    7.5 years). Pediatric temporal lobe epilepsy patients who undergo clinically-indicated Wada test and/or implantation of subdural electrodes with...cohort. 2.6. Validation of fMRI in temporal lobe epilepsy patients: The validation of passive language fMRI was carried out on patient cohort 1...made up of 15 pediatric-onset temporal lobe epilepsy surgical patients all of whom had some form of invasive mapping for comparisons against fMRI

  20. Pediatric Electrocardiographic Imaging (ECGI) Applications

    Science.gov (United States)

    Silva, Jennifer N. A.

    2014-01-01

    Summary Noninvasive electrocardiographic imaging (ECGI) has been used in pediatric and congenital heart patients to better understand their electrophysiologic substrates. In this article we focus on the 4 subjects related to pediatric ECGI: 1) ECGI in patients with congenital heart disease and Wolff-Parkinson-White syndrome, 2) ECGI in patients with hypertrophic cardiomyopathy and pre-excitation, 3) ECGI in pediatric patients with Wolff-Parkinson-White syndrome, and 4) ECGI for pediatric cardiac resynchronization therapy. PMID:25722754

  1. Pediatric imaging. Rapid fire questions and answers

    International Nuclear Information System (INIS)

    Quattromani, F.; Lampe, R.

    2008-01-01

    The book contains the following contributions: Airway, head, neck; allergy, immunology rheumatology; pediatric cardiac imaging; child abuse; chromosomal abnormalities; conscious sedation; contrast agents and radiation protection; pediatric gastrointestinal imaging; genetic disorders in infants and children; pediatric genitourinary imaging; pediatric hematology, oncology imaging; pediatric intenrventional radiology; metabolic and vitamin disorders; muscoskeletal disorders (osteoradiology); neonatology imaging; pediatric neuroimaging; imaging of the respiratory tract in infants and children; vascular anomalies

  2. Pediatric imaging. Rapid fire questions and answers

    Energy Technology Data Exchange (ETDEWEB)

    Quattromani, F.; Lampe, R. (eds.) [Texas Tech Univ. Health Sciences Center, School of Medicine, Lubbock, TX (United States); Handal, G.A. [Texas Tech Univ. Health Sciences Center, School of Medicine, El Paso, TX (United States)

    2008-07-01

    The book contains the following contributions: Airway, head, neck; allergy, immunology rheumatology; pediatric cardiac imaging; child abuse; chromosomal abnormalities; conscious sedation; contrast agents and radiation protection; pediatric gastrointestinal imaging; genetic disorders in infants and children; pediatric genitourinary imaging; pediatric hematology, oncology imaging; pediatric intenrventional radiology; metabolic and vitamin disorders; muscoskeletal disorders (osteoradiology); neonatology imaging; pediatric neuroimaging; imaging of the respiratory tract in infants and children; vascular anomalies.

  3. Quality control of pediatric chest X-rays in diagnostic centers with and without pediatric competence

    International Nuclear Information System (INIS)

    Alt, C.D.; Engelmann, D.; Schenk, J.P.; Troeger, J.

    2006-01-01

    Purpose: Radiation protection in pediatric radiology is very important because of the particular sensitivity of radiosensitive organs in younger patients. Optimized image quality supports radiation protection and should be targeted. In our study we examined the quality of pediatric chest X-rays at diagnostic centers (university hospitals and other large clinics). We then evaluated differences in image quality in departments without pediatric competence (R) and departments with pediatric competence (PR). Materials and Methods: Our study was based on 313 conventional chest X-rays from 207 patients (192 p.a./a.p. and 121 lateral, 43 from R, 258 from PR and 12 neither from R nor KR) and 38 digital chest X-rays from 26 patients (25 p.a./a.p. and 13 lateral, 1 from R and 37 from PR). All patients (age 0 - 18 years) are from Nephroblastoma-Study SIOP-93/01-GPOH. We examined all initial chest X-rays, which were sent to us for evaluation upon request between 4/3/2002 and 6/14/2002. The examined parameters were: exposure, centering of the X-rays/patient positioning, collimation and sharpness. The X-rays were evaluated on a scale from 1 (best result) to 5 (worst result), resulting in an overall score of A = optimum, B = minor problems, C = major problems, or D = unusable. The optical density, the center of the image and the relative field size were also measured. Statistical tests (Mann-Whitney-U and log regression) were carried out on the conventional images. The study was performed retrospectively. The exposure, sharpness and optical density of the digital X-rays were not analyzed. Results: In the case of all conventional X-rays, the quality of the centering of the X-rays/patient positioning and collimation was moderate (average scale value: 2.4 and 2.8), and the quality of the exposure and sharpness was good and very good (average scale value: 1.9 and 1.5). The quality of the chest X-rays in departments with additional pediatric radiological expertise was better mainly in

  4. Safety and usefulness of outreach clinic conducted by pediatric echosonographers

    International Nuclear Information System (INIS)

    Al Harbi, Badr; Al Akhfash, Ali A.; Al Ghamdi, Abdullah; Al-Mesned, Abdulrahman

    2012-01-01

    Outreach echocardiographic services led by cardiac sonographers may help district level hospitals in the management of patients suspected to have cardiac anomalies. However, the safety and utility of such an approach is not tested. We retrospectively reviewed our experience of patients seen in the outreach visits by the echocardiographers alone and subsequently reviewed in the pediatric cardiology clinic. Comparison between the diagnosis made by the echocardiographer and the consultant pediatric cardiologist were done. We defined safety as no change in patient management plan between the outreach evaluation and the pediatric cardiology clinic evaluation, and we defined usefulness as being beneficial, serviceable and of practical use. Two senior echocardiographic technicians did 41 clinic visits and over a period of 17 months, 623 patients were seen. Patients less than 3 months of age constitute 63% of the total patients seen. Normal echocardiographic examinations were found in 342 (55%) of patients. These patients were not seen in our cardiology clinic. Abnormal echocardiographic examinations were found in 281 (45%) of patients. Among the 281 patients with abnormal echos in the outreach visits, 251 patients (89.3%) were seen in the pediatric cardiology clinic. Comparing the results of the outreach clinic evaluation to that of the pediatric cardiology clinic, 73 patients (29%) diagnosed to have a minor CHD turned to have normal echocardiographic examinations. In all patients seen in both the outreach clinics and the pediatric tertiary cardiac clinics there was no change in patient's management plan. Outreach clinic conducted by pediatric echo sonographers could be useful and safe. It may help in reducing unnecessary visits to pediatric cardiology clinics, provide parental reassurance, and help in narrowing the differential diagnosis in critically ill patient unable to be transferred to tertiary cardiac centers provided it is done by experienced echosonographers

  5. Psychological issues in pediatric obesity

    Directory of Open Access Journals (Sweden)

    Gurvinder Kalra

    2012-01-01

    Full Text Available Pediatric obesity is a major health problem and has reached epidemiological proportions today. The present paper reviews major psychological issues in pediatric obesity from a developmental perspective. Research and literature has shown that a number of developmental, family, maternal and child factors are responsible in the genesis of pediatric obesity. Family food habits, early developmental lifestyle of the child, parenting, early family relationships and harmony all contribute towards the growth and development of a child. The present review focuses on the role of developmental psychological factors in the pathogenesis of pediatric obesity and highlights the developmental factors that must be kept in mind when evaluating a case of pediatric obesity.

  6. Find a Pediatric Dentist

    Science.gov (United States)

    ... AAPD AAPD Publications Advertising Brochures Journals & Publications Full Journal Archives Access Pediatric Dentistry Today Practice Management and Marketing Newsletter Pediatric Dentistry Journal Open Access Articles Oral ...

  7. Reducing Overutilization of Testing for Clostridium difficile Infection in a Pediatric Hospital System: A Quality Improvement Initiative.

    Science.gov (United States)

    Klatte, J Michael; Selvarangan, Rangaraj; Jackson, Mary Anne; Myers, Angela L

    2016-01-01

    Study objectives included addressing overuse of Clostridium difficile laboratory testing by decreasing submission rates of nondiarrheal stool specimens and specimens from children ≤12 months of age and determining resultant patient and laboratory cost savings associated with decreased testing. A multifaceted initiative was developed, and components included multiple provider education methods, computerized order entry modifications, and automatic declination from laboratory on testing stool specimens of nondiarrheal consistency and from children ≤12 months old. A run chart, demonstrating numbers of nondiarrheal plus infant stool specimens submitted over time, was developed to analyze the initiative's impact on clinicians' test-ordering practices. A p-chart was generated to evaluate the percentage of these submitted specimens tested biweekly over a 12-month period. Cost savings for patients and the laboratory were assessed at the study period's conclusion. Run chart analysis revealed an initial shift after the interventions, suggesting a temporary decrease in testing submission; however, no sustained differences in numbers of specimens submitted biweekly were observed over time. On the p-chart, the mean percentage of specimens tested before the intervention was 100%. After the intervention, the average percentage of specimens tested dropped to 53.8%. Resultant laboratory cost savings totaled nearly $3600, and patient savings on testing charges were ∼$32 000. Automatic laboratory declination of nondiarrheal stools submitted for CDI testing resulted in a sustained decrease in the number of specimens tested, resulting in significant laboratory and patient cost savings. Despite multiple educational efforts, no sustained changes in physician ordering practices were observed. Copyright © 2016 by the American Academy of Pediatrics.

  8. Trends in U.S. Pediatric Otolaryngology Fellowship Training.

    Science.gov (United States)

    Espinel, Ali; Poley, Marian; Zalzal, George H; Chan, Kenny; Preciado, Diego

    2015-10-01

    Interest in pediatric otolaryngology fellowship training is growing. The workforce implications of this growing interest are unclear and understudied. To analyze trends in pediatric otolaryngology training, determine where fellows who graduated over the past 10 years are currently practicing, and test the hypothesis that graduates from Accreditation Council for Graduate Medical Education (ACGME)–accredited programs were more likely to have academic tertiary positions with faculty appointments. We conducted a web-based analysis of pediatric otolaryngology fellowship graduates. The names of all 274 applicants who were matched to pediatric otolaryngology fellowships from May 31, 2003, to May 31, 2014, were obtained from the SF Match website. Accreditation status of each program for each match year was obtained from the ACGME website. We then performed an Internet search for the current practice location of each matched applicant. Analysis was conducted from January 1, 2015, to May 1, 2015. Practice setting per year of fellowship match and accreditation status of program. For the 2003 to the 2014 match years, there was an increase from 5 to 22 accredited pediatric otolaryngology fellowship programs overall; simultaneously, the number of yearly matched applicants increased from 14 to 35. More graduates with ACGME accreditation practice at academic settings compared with graduates without ACGME accreditation although the difference was not statistically significant (67.1% vs. 50.7%; P = .15). Graduates from accredited programs, however, were significantly more likely to practice at a hospital-based setting compared with those from nonaccredited programs (81.7% vs. 65.5%; P = .003). Fellows trained in the last 10 years are relatively well distributed across the country. The number of pediatric otolaryngology fellowship applicants as well as total number of matched applicants and ACGME-accredited positions has risen in the last 10 years. It appears that a higher

  9. Facepiece leakage and fitting of respirators

    International Nuclear Information System (INIS)

    White, J.M.

    1978-05-01

    The ways in which airborne contaminants can penetrate respirators and the factors which affect the fit of respirators are discussed. The fit of the respirator to the face is shown to be the most critical factor affecting the protection achieved by the user. Qualitative and quantitative fit testing techniques are described and their application to industrial respirator programs is examined. Quantitative measurement of the leakage of a respirator while worn can be used to numerically indicate the protection achieved. These numbers, often referred to as protection factors, are sometimes used as the basis for selecting suitable respirators and this practice is reviewed. (author)

  10. Physical Activity Enhances Metabolic Fitness Independently of Cardiorespiratory Fitness in Marathon Runners

    Directory of Open Access Journals (Sweden)

    M. J. Laye

    2015-01-01

    Full Text Available High levels of cardiovascular fitness (CRF and physical activity (PA are associated with decreased mortality and risk to develop metabolic diseases. The independent contributions of CRF and PA to metabolic disease risk factors are unknown. We tested the hypothesis that runners who run consistently >50 km/wk and/or >2 marathons/yr for the last 5 years have superior metabolic fitness compared to matched sedentary subjects (CRF, age, gender, and BMI. Case-control recruitment of 31 pairs of runner-sedentary subjects identified 10 matched pairs with similar VO2max (mL/min/kg (similar-VO2max. The similar-VO2max group was compared with a group of age, gender, and BMI matched pairs who had the largest difference in VO2max (different-VO2max. Primary outcomes that defined metabolic fitness including insulin response to an oral glucose tolerance test, fasting lipids, and fasting insulin were superior in runners versus sedentary controls despite similar VO2max. Furthermore, performance (velocity at VO2max, running economy, improved exercise metabolism (lactate threshold, and skeletal muscle levels of mitochondrial proteins were superior in runners versus sedentary controls with similar VO2max. In conclusion subjects with a high amount of PA have more positive metabolic health parameters independent of CRF. PA is thus a good marker against metabolic diseases.

  11. Analysis of an In-Service Examination for Core Pediatric Craniofacial Surgery Knowledge.

    Science.gov (United States)

    Silvestre, Jason; Chang, Benjamin; Taylor, Jesse A

    2016-01-01

    Little is known about designing an effective residency curriculum for pediatric craniofacial surgery. This study elucidates the pediatric craniofacial curriculum of the Plastic Surgery In-Service Training Examination (PSITE) to facilitate knowledge acquisition during residency. Approximately, 6 consecutive PSITEs were reviewed for pediatric craniofacial questions (2010-2015). Subjects were categorized according to topics on the American Board of Plastic Surgery written board examination. Questions were categorized using an educational taxonomy model. Answer references were categorized by source and publication lag. Of 1174 PSITE questions, 147 tested pediatric craniofacial topics (12.5%). Questions appeared predominately in the Craniomaxillofacial section (83.0%, p < 0.001). The annual representation was stable more than 6 years (range: 10.2%-14.4%, p = 0.842). Question taxonomy favored interpretation (45.6%) and decision-making (40.8%) over recall (13.6%, p < 0.001) skills, and 41 questions had an associated image (27.9%) and most were photographic (76.7%, p < 0.001). The most frequently tested categories on the American Board of Plastic Surgery written examination content outline were craniofacial anomalies (23.5%), benign and malignant tumors (17.6%), and cleft lip and palate (12.5%). Overall, 80 unique journals were cited 304 times with a mean publication lag of 9.4 ± 10.9 years. Plastic and Reconstructive Surgery (34.5%) was the most cited journal (p < 0.001). These data may assist in designating core knowledge competency in pediatric craniofacial surgery for plastic surgery residents. A further understanding of PSITE utility for core knowledge competency in pediatric craniofacial surgery would be the focus of future work. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  12. Predicting diabetes mellitus using SMOTE and ensemble machine learning approach: The Henry Ford ExercIse Testing (FIT) project.

    Science.gov (United States)

    Alghamdi, Manal; Al-Mallah, Mouaz; Keteyian, Steven; Brawner, Clinton; Ehrman, Jonathan; Sakr, Sherif

    2017-01-01

    Machine learning is becoming a popular and important approach in the field of medical research. In this study, we investigate the relative performance of various machine learning methods such as Decision Tree, Naïve Bayes, Logistic Regression, Logistic Model Tree and Random Forests for predicting incident diabetes using medical records of cardiorespiratory fitness. In addition, we apply different techniques to uncover potential predictors of diabetes. This FIT project study used data of 32,555 patients who are free of any known coronary artery disease or heart failure who underwent clinician-referred exercise treadmill stress testing at Henry Ford Health Systems between 1991 and 2009 and had a complete 5-year follow-up. At the completion of the fifth year, 5,099 of those patients have developed diabetes. The dataset contained 62 attributes classified into four categories: demographic characteristics, disease history, medication use history, and stress test vital signs. We developed an Ensembling-based predictive model using 13 attributes that were selected based on their clinical importance, Multiple Linear Regression, and Information Gain Ranking methods. The negative effect of the imbalance class of the constructed model was handled by Synthetic Minority Oversampling Technique (SMOTE). The overall performance of the predictive model classifier was improved by the Ensemble machine learning approach using the Vote method with three Decision Trees (Naïve Bayes Tree, Random Forest, and Logistic Model Tree) and achieved high accuracy of prediction (AUC = 0.92). The study shows the potential of ensembling and SMOTE approaches for predicting incident diabetes using cardiorespiratory fitness data.

  13. Predicting diabetes mellitus using SMOTE and ensemble machine learning approach: The Henry Ford ExercIse Testing (FIT project.

    Directory of Open Access Journals (Sweden)

    Manal Alghamdi

    Full Text Available Machine learning is becoming a popular and important approach in the field of medical research. In this study, we investigate the relative performance of various machine learning methods such as Decision Tree, Naïve Bayes, Logistic Regression, Logistic Model Tree and Random Forests for predicting incident diabetes using medical records of cardiorespiratory fitness. In addition, we apply different techniques to uncover potential predictors of diabetes. This FIT project study used data of 32,555 patients who are free of any known coronary artery disease or heart failure who underwent clinician-referred exercise treadmill stress testing at Henry Ford Health Systems between 1991 and 2009 and had a complete 5-year follow-up. At the completion of the fifth year, 5,099 of those patients have developed diabetes. The dataset contained 62 attributes classified into four categories: demographic characteristics, disease history, medication use history, and stress test vital signs. We developed an Ensembling-based predictive model using 13 attributes that were selected based on their clinical importance, Multiple Linear Regression, and Information Gain Ranking methods. The negative effect of the imbalance class of the constructed model was handled by Synthetic Minority Oversampling Technique (SMOTE. The overall performance of the predictive model classifier was improved by the Ensemble machine learning approach using the Vote method with three Decision Trees (Naïve Bayes Tree, Random Forest, and Logistic Model Tree and achieved high accuracy of prediction (AUC = 0.92. The study shows the potential of ensembling and SMOTE approaches for predicting incident diabetes using cardiorespiratory fitness data.

  14. Surgical management and hypermetabolic modulation of pediatric burns

    NARCIS (Netherlands)

    Barret Nerín, Juan Pedro

    2002-01-01

    The purpose of the present thesis is to test the hypothesis that immediate burn wound excision of massive pediatric burns is safe and efficacious, presenting with negligible postoperative complications and with salutary effects on the inflammatory and catabolic response after burn injury.

  15. Pediatric vasculitis.

    Science.gov (United States)

    Barut, Kenan; Sahin, Sezgin; Kasapcopur, Ozgur

    2016-01-01

    The aim of this review is to define childhood vasculitis and to highlight new causative factors and treatment modalities under the guidance of recently published studies. Childhood vasculitis is difficult to diagnose because of the wide variation in the symptoms and signs. New nomenclature and classification criteria were proposed for the diagnosis of pediatric vasculitis. Recently, progress has been made toward understanding the genetic susceptibility to pediatric vasculitis as it was in other diseases. Various radiological techniques provide great opportunities in establishing the diagnosis of pediatric vasculitis. Mild central nervous system disease can accompany Henoch-Schonlein purpura and can go unnoticed. Antineutrophilic cytoplasmic antibody-associated vasculitis is rare in children. Increased severity of the disease, subglottic stenosis, and renal disease are described more frequently among children. Biological therapies are used with success in children as in adults. Future studies, whose aims are to evaluate treatment responses, prognosis and to design guidelines for activity, and damage index of vasculitis for children are required. Henoch-Schonlein purpura and Kawasaki disease are the most frequent vasculitides of children. Experience from adult studies for treatment and prognosis are usually used because of low incidence of other vasculitides in children. Multicenter studies of pediatric vasculitis should be conducted to detail treatment responses and prognosis in children.

  16. Radiology in Medical Education: A Pediatric Radiology Elective as a Template for Other Radiology Courses.

    Science.gov (United States)

    Hilmes, Melissa A; Hyatt, Eddie; Penrod, Cody H; Fleming, Amy E; Singh, Sudha P

    2016-03-01

    Traditionally, the pediatric radiology elective for medical students and pediatric residents constituted a morning teaching session focused mainly on radiography and fluoroscopy. A more structured elective was desired to broaden the exposure to more imaging modalities, create a more uniform educational experience, and include assessment tools. In 2012, an introductory e-mail and formal syllabus, including required reading assignments, were sent to participants before the start date. A rotating weekly schedule was expanded to include cross-sectional imaging (ultrasound, CT, MR) and nuclear medicine. The schedule could accommodate specific goals of the pediatric resident or medical student, as requested. Starting in 2013, an online pre-test and post-test were developed, as well as an online end-of-rotation survey specific to the pediatric radiology elective. Taking the Image Gently pledge was required. A scavenger hunt tool, cue cards, and electronic modules were added. Pre-test and post-test scores, averaged over 2 years, showed improvement in radiology knowledge, with scores increasing by 27% for medical students and 21% for pediatric residents. Surveys at the end of the elective were overwhelmingly positive, with constructive criticism and complimentary comments. We have successfully created an elective experience in radiology that dedicates time to education while preserving the workflow of radiologists. We have developed tools to provide a customized experience with many self-directed learning opportunities. Our tools and techniques are easily translatable to a general or adult radiology elective. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  17. Physical fitness of schoolgirls with Turner syndrome

    NARCIS (Netherlands)

    Milde, K.; Tomaszewski, P.K.; Stupnicki, R.

    2013-01-01

    The aim of the study was to assess physical fitness of girls with Turner syndrome (TS) and to determine the relative contributions of age, body height, and body mass to performance in fitness tests. Girls with TS aged 10-18 years (n = 184), and age- and stature-matched healthy controls (n = 280)

  18. Pediatric renal transplant practices in India.

    Science.gov (United States)

    Sethi, Sidharth Kumar; Sinha, Rajiv; Rohatgi, Smriti; Kher, Vijay; Iyengar, Arpana; Bagga, Arvind

    2017-05-01

    Limited access to tertiary-level health care, limited trained pediatric nephrologists and transplant physicians, lack of facilities for dialysis, lack of an effective deceased donor program, non-affordability, and non-adherence to immunosuppressant drugs poses a major challenge to universal availability of pediatric transplantation in developing countries. We present the results of a survey which, to the best of our knowledge, is the first such published attempt at understanding the current state of pediatric renal transplantation in India. A designed questionnaire formulated by a group of pediatric nephrologists with the aim of understanding the current practice of pediatric renal transplantation was circulated to all adult and pediatric nephrologists of the country. Of 26 adult nephrologists who responded, 16 (61.5%) were involved in pediatric transplantation, and 10 of 15 (66.6%) pediatric nephrologists were involved in pediatric transplantation. Most of the centers doing transplants were private/trust institution with only three government institutions undertaking it. Induction therapy was varied among pediatric and adult nephrologists. There were only a few centers (n=5) in the country routinely doing >5 transplants per year. Preemptive transplants and protocol biopsies were a rarity. The results demonstrate lower incidence of undertaking pediatric transplants in children below 6 years, paucity of active cadaveric programs and lack of availability of trained pediatric nephrologists and staff. In contrast to these dissimilarities, the immunosuppressant use seems to be quite similar to Western registry data with majority favoring induction agent and triple immunosuppressant (steroid, mycophenolate mofetil and tacrolimus) for maintenance. The survey also identifies major concerns in availability of this service to all regions of India as well as to all economic segments. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  19. Simulation in pediatric anesthesiology.

    Science.gov (United States)

    Fehr, James J; Honkanen, Anita; Murray, David J

    2012-10-01

    Simulation-based training, research and quality initiatives are expanding in pediatric anesthesiology just as in other medical specialties. Various modalities are available, from task trainers to standardized patients, and from computer-based simulations to mannequins. Computer-controlled mannequins can simulate pediatric vital signs with reasonable reliability; however the fidelity of skin temperature and color change, airway reflexes and breath and heart sounds remains rudimentary. Current pediatric mannequins are utilized in simulation centers, throughout hospitals in-situ, at national meetings for continuing medical education and in research into individual and team performance. Ongoing efforts by pediatric anesthesiologists dedicated to using simulation to improve patient care and educational delivery will result in further dissemination of this technology. Health care professionals who provide complex, subspecialty care to children require a curriculum supported by an active learning environment where skills directly relevant to pediatric care can be developed. The approach is not only the most effective method to educate adult learners, but meets calls for education reform and offers the potential to guide efforts toward evaluating competence. Simulation addresses patient safety imperatives by providing a method for trainees to develop skills and experience in various management strategies, without risk to the health and life of a child. A curriculum that provides pediatric anesthesiologists with the range of skills required in clinical practice settings must include a relatively broad range of task-training devises and electromechanical mannequins. Challenges remain in defining the best integration of this modality into training and clinical practice to meet the needs of pediatric patients. © 2012 Blackwell Publishing Ltd.

  20. Injury Rate and Patterns Among CrossFit Athletes.

    Science.gov (United States)

    Weisenthal, Benjamin M; Beck, Christopher A; Maloney, Michael D; DeHaven, Kenneth E; Giordano, Brian D

    2014-04-01

    CrossFit is a type of competitive exercise program that has gained widespread recognition. To date, there have been no studies that have formally examined injury rates among CrossFit participants or factors that may contribute to injury rates. To establish an injury rate among CrossFit participants and to identify trends and associations between injury rates and demographic categories, gym characteristics, and athletic abilities among CrossFit participants. Descriptive epidemiology study. A survey was conducted, based on validated epidemiologic injury surveillance methods, to identify patterns of injury among CrossFit participants. It was sent to CrossFit gyms in Rochester, New York; New York City, New York; and Philadelphia, Pennsylvania, and made available via a posting on the main CrossFit website. Participants were encouraged to distribute it further, and as such, there were responses from a wide geographical location. Inclusion criteria included participating in CrossFit training at a CrossFit gym in the United States. Data were collected from October 2012 to February 2013. Data analysis was performed using Fisher exact tests and chi-square tests. A total of 486 CrossFit participants completed the survey, and 386 met the inclusion criteria. The overall injury rate was determined to be 19.4% (75/386). Males (53/231) were injured more frequently than females (21/150; P = .03). Across all exercises, injury rates were significantly different (P CrossFit was approximately 20%. Males were more likely to sustain an injury than females. The involvement of trainers in coaching participants on their form and guiding them through the workout correlates with a decreased injury rate. The shoulder and lower back were the most commonly injured in gymnastic and power lifting movements, respectively. Participants reported primarily acute and fairly mild injuries.

  1. Validity and reliability of Nintendo Wii Fit balance scores.

    Science.gov (United States)

    Wikstrom, Erik A

    2012-01-01

    Interactive gaming systems have the potential to help rehabilitate patients with musculoskeletal conditions. The Nintendo Wii Balance Board, which is part of the Wii Fit game, could be an effective tool to monitor progress during rehabilitation because the board and game can provide objective measures of balance. However, the validity and reliability of Wii Fit balance scores remain unknown. To determine the concurrent validity of balance scores produced by the Wii Fit game and the intrasession and intersession reliability of Wii Fit balance scores. Descriptive laboratory study. Sports medicine research laboratory. Forty-five recreationally active participants (age = 27.0 ± 9.8 years, height = 170.9 ± 9.2 cm, mass = 72.4 ± 11.8 kg) with a heterogeneous history of lower extremity injury. Participants completed a single-limb-stance task on a force plate and the Star Excursion Balance Test (SEBT) during the first test session. Twelve Wii Fit balance activities were completed during 2 test sessions separated by 1 week. Postural sway in the anteroposterior (AP) and mediolateral (ML) directions and the AP, ML, and resultant center-of-pressure (COP) excursions were calculated from the single-limb stance. The normalized reach distance was recorded for the anterior, posteromedial, and posterolateral directions of the SEBT. Wii Fit balance scores that the game software generated also were recorded. All 96 of the calculated correlation coefficients among Wii Fit activity outcomes and established balance outcomes were interpreted as poor (r Wii Fit balance activity scores ranged from good (intraclass correlation coefficient [ICC] = 0.80) to poor (ICC = 0.39), with 8 activities having poor intrasession reliability. Similarly, 11 of the 12 Wii Fit balance activity scores demonstrated poor intersession reliability, with scores ranging from fair (ICC = 0.74) to poor (ICC = 0.29). Wii Fit balance activity scores had poor concurrent validity relative to COP outcomes and SEBT

  2. Normative Values of Physical Fitness Test in the Elderly: A Community Based Study in an Urban Population in Northeast India

    Directory of Open Access Journals (Sweden)

    Prasanta Kumar Bhattacharya

    2017-10-01

    Full Text Available Introduction: Physical inactivity exposes elderly people to higher risk of diseases. Assessing their functional fitness using fitness assessment tools like Senior Fitness Test (SFT is helpful in geriatric care. Determination of normative values of SFT increases its interpretability of interindividual and intergroup performances scores and usefulness. Aim: To determine normative values of SFT in geriatric population in an urban community setting. Materials and Methods: A community based prospective study in 400 elderly participants (284 men, 116 women, aged >=65 years, selected by multistage random sampling from 60 municipal wards of Guwahati city in Northeast India. Descriptive statistics, percentiles, univariate Analysis of Variance (ANOVA and Bonferroni correction methods were used. A p-value <0.05 was considered significant. Results: Mean ages in males and females were 69.80±3.82 and 67.25±2.57 years. Mean height, weight and BMI in males and females respectively were 165.61±5.36 cm and 161.03±7.93 cm; 63.63±5.99 kg and 55.54±6.74 kg; 23.2±2.03 kg/m2 and 21.5±3.42 kg/m2. Males aged 65-69 years had highest BMI (23.4±2.11 kg/m2 while those =80 had lowest (21.8±1.30 kg/m2. Females aged 70-74 years had highest BMI (23.3±3.50 kg/m2 while 65-69 years (21.3±3.39 kg/m2 had lowest. ‘Armcurl’ test showed maximum values in 70-79 year and 65-69 year age-groups in males and females respectively (11.4±3.89; 14.5±4.63. In ‘chair-stand’ test, maximum values were in 65-69 year for both sexes (males=15.2±4.64; females=13.6±4.26 respectively. In ‘back-scratch’ and ‘chair-sit and reach’ tests, maximum values were found in age-groups 70-74 and 65-69 in males and females respectively (10.5±9.11 and 13.4±8.91; 9.8±7.28 and -8.4±6.92. In ‘8-foot up-and-go’ test, maximum time to perform in males and females were in =80 and 75-79 year groups respectively (13.9±4.11; 20.3±0. In both sexes, maximum values of ‘2-minute step up

  3. New frontiers in pediatric Allo-SCT.

    Science.gov (United States)

    Talano, J M; Pulsipher, M A; Symons, H J; Militano, O; Shereck, E B; Giller, R H; Hancock, L; Morris, E; Cairo, M S

    2014-09-01

    The inaugural meeting of 'New Frontiers in Pediatric Allogeneic Stem Cell Transplantation' organized by the Pediatric Blood and Transplant Consortium (PBMTC) was held at the American Society of Pediatric Hematology and Oncology Annual Meeting. This meeting provided an international platform for physicians and investigators active in the research and utilization of pediatric Allo-SCT in children and adolescents with malignant and non-malignant disease (NMD), to share information and develop future collaborative strategies. The primary objectives of the conference included: (1) to present advances in Allo-SCT in pediatric ALL and novel pre and post-transplant immunotherapy; (2) to highlight new strategies in alternative allogeneic stem cell donor sources for children and adolescents with non-malignant hematological disorders; (3) to discuss timing of immune reconstitution after Allo-SCT and methods of facilitating more rapid recovery of immunity; (4) to identify strategies of utilizing Allo-SCT in pediatric myeloproliferative disorders; (5) to develop diagnostic and therapeutic approaches to hematological complications post pediatric Allo-SCT; (6) to enhance the understanding of new novel cellular therapeutic approaches to pediatric malignant and non-malignant hematological disorders; and (7) to discuss optimizing drug therapy in pediatric recipients of Allo-SCT. This paper will provide a brief overview of the conference.

  4. A Multiinstitutional Simulation Boot Camp for Pediatric Cardiac Critical Care Nurse Practitioners.

    Science.gov (United States)

    Brown, Kristen M; Mudd, Shawna S; Hunt, Elizabeth A; Perretta, Julianne S; Shilkofski, Nicole A; Diddle, J Wesley; Yurasek, Gregory; Bembea, Melania; Duval-Arnould, Jordan; Nelson McMillan, Kristen

    2018-03-10

    Assess the effect of a simulation "boot camp" on the ability of pediatric nurse practitioners to identify and treat a low cardiac output state in postoperative patients with congenital heart disease. Additionally, assess the pediatric nurse practitioners' confidence and satisfaction with simulation training. Prospective pre/post interventional pilot study. University simulation center. Thirty acute care pediatric nurse practitioners from 13 academic medical centers in North America. We conducted an expert opinion survey to guide curriculum development. The curriculum included didactic sessions, case studies, and high-fidelity simulation-based on high-complexity cases, congenital heart disease benchmark procedures, and a mix of lesion-specific postoperative complications. To cover multiple, high-complexity cases, we implemented Rapid Cycle Deliberate Practice method of teaching for selected simulation scenarios using an expert driven checklist. Knowledge was assessed with a pre-/posttest format (maximum score, 100%). A paired-sample t test showed a statistically significant increase in the posttest scores (mean [SD], pre test, 36.8% [14.3%] vs post test, 56.0% [15.8%]; p simulation. Median time improved overall "time to task" across these scenarios. There was a significant increase in the proportion of clinically time-sensitive tasks completed within 5 minutes (pre, 60% [30/50] vs post, 86% [43/50]; p = 0.003] Confidence and satisfaction were evaluated with a validated tool ("Student Satisfaction and Self-Confidence in Learning"). Using a five-point Likert scale, the participants reported a high level of satisfaction (4.7 ± 0.30) and performance confidence (4.8 ± 0.31) with the simulation experience. Although simulation boot camps have been used effectively for training physicians and educating critical care providers, this was a novel approach to educating pediatric nurse practitioners from multiple academic centers. The course improved overall knowledge, and the

  5. Retention of knowledge and skills in pediatric basic life support amongst pediatricians.

    Science.gov (United States)

    Binkhorst, Mathijs; Coopmans, Michelle; Draaisma, Jos M T; Bot, Petra; Hogeveen, Marije

    2018-05-07

    Retention of resuscitation skills is usually assessed at a predefined moment, which enables participants to prepare themselves, possibly introducing bias. In this multicenter study, we evaluated the retention of knowledge and skills in pediatric basic life support (PBLS) amongst 58 pediatricians and pediatric residents with an unannounced examination. Practical PBLS skills were assessed with a validated scoring instrument, theoretical knowledge with a 10-item multiple-choice test (MCQ). Participants self-assessed their PBLS capabilities using five-point Likert scales. Background data were collected with a questionnaire. Of our participants, 21% passed the practical PBLS exam: 29% failed on compressions/ventilations, 31% on other parts of the algorithm, 19% on both. Sixty-nine percent passed the theoretical test. Participants who more recently completed a PBLS course performed significantly better on the MCQ (p = 0.03). This association was less clear-cut for performance on the practical exam (p = 0.11). Older, attending pediatricians with more years of experience in pediatrics performed less well than their younger colleagues (p basic life support (PBLS) in daily practice. Poor retention of skills supposedly accounts for this incompetence. Without regular exposure, resuscitation skills usually deteriorate within 3 to 6 months after training. • Examination of resuscitation skills usually takes place after training. Also, in most studies evaluating retention of skills, participants are tested at a predefined moment. Inasmuch as participants are able to prepare themselves, these assessments do not reflect the ad hoc resuscitation capabilities of pediatricians and residents. What is New: • In this study, pediatricians and pediatric residents had to complete an unannounced PBLS exam at variable time intervals from last certification. Retention of PBLS skills was rather poor (pass rate 21%). • The PBLS skills of older, attending pediatricians with many

  6. Simulation-based medical education in pediatrics.

    Science.gov (United States)

    Lopreiato, Joseph O; Sawyer, Taylor

    2015-01-01

    The use of simulation-based medical education (SBME) in pediatrics has grown rapidly over the past 2 decades and is expected to continue to grow. Similar to other instructional formats used in medical education, SBME is an instructional methodology that facilitates learning. Successful use of SBME in pediatrics requires attention to basic educational principles, including the incorporation of clear learning objectives. To facilitate learning during simulation the psychological safety of the participants must be ensured, and when done correctly, SBME is a powerful tool to enhance patient safety in pediatrics. Here we provide an overview of SBME in pediatrics and review key topics in the field. We first review the tools of the trade and examine various types of simulators used in pediatric SBME, including human patient simulators, task trainers, standardized patients, and virtual reality simulation. Then we explore several uses of simulation that have been shown to lead to effective learning, including curriculum integration, feedback and debriefing, deliberate practice, mastery learning, and range of difficulty and clinical variation. Examples of how these practices have been successfully used in pediatrics are provided. Finally, we discuss the future of pediatric SBME. As a community, pediatric simulation educators and researchers have been a leading force in the advancement of simulation in medicine. As the use of SBME in pediatrics expands, we hope this perspective will serve as a guide for those interested in improving the state of pediatric SBME. Published by Elsevier Inc.

  7. Figure-of-merit (FOM), an improved criterion over the normalized chi-squared test for assessing goodness-of-fit of gamma-ray spectral peaks

    International Nuclear Information System (INIS)

    Garo Balian, H.; Eddy, N.W.

    1977-01-01

    A careful experimenter knows that in order to choose the best curve fits of peaks from a gamma ray spectrum for such purposes as energy or intensity calibration, half-life determination, etc., the application of the normalized chi-squared test, [chisub(N)] 2 =chi 2 /(n-m), is insufficient. One must normally verify the goodness-of-fit with plots, detailed scans of residuals, etc. Because of different techniques of application, variations in backgrounds, in peak sizes and shapes, etc., quotation of the [chisub(N)] 2 value associated with an individual peak fit conveys very little information unless accompanied by considerable ancillary data. (This is not to say that the traditional chi 2 formula should not be used as the source of the normal equations in the least squares fitting procedure. But after the fitting, it is unreliable as a criterion for comparison with other fits.) The authors present a formula designated figure-of-merit (FOM) which greatly improves on the uncertainty and fluctuations of the [chisub(N)] 2 formula. An FOM value of less than 2.5% indicates a good fit (in the authors' judgement) irrespective of background conditions and variations in peak sizes and shapes. Furthermore, the authors feel the FOM formula is less subject to fluctuations resulting from different techniques of application. (Auth.)

  8. Applications of Genomic Sequencing in Pediatric CNS Tumors.

    Science.gov (United States)

    Bavle, Abhishek A; Lin, Frank Y; Parsons, D Williams

    2016-05-01

    Recent advances in genome-scale sequencing methods have resulted in a significant increase in our understanding of the biology of human cancers. When applied to pediatric central nervous system (CNS) tumors, these remarkable technological breakthroughs have facilitated the molecular characterization of multiple tumor types, provided new insights into the genetic basis of these cancers, and prompted innovative strategies that are changing the management paradigm in pediatric neuro-oncology. Genomic tests have begun to affect medical decision making in a number of ways, from delineating histopathologically similar tumor types into distinct molecular subgroups that correlate with clinical characteristics, to guiding the addition of novel therapeutic agents for patients with high-risk or poor-prognosis tumors, or alternatively, reducing treatment intensity for those with a favorable prognosis. Genomic sequencing has also had a significant impact on translational research strategies in pediatric CNS tumors, resulting in wide-ranging applications that have the potential to direct the rational preclinical screening of novel therapeutic agents, shed light on tumor heterogeneity and evolution, and highlight differences (or similarities) between pediatric and adult CNS tumors. Finally, in addition to allowing the identification of somatic (tumor-specific) mutations, the analysis of patient-matched constitutional (germline) DNA has facilitated the detection of pathogenic germline alterations in cancer genes in patients with CNS tumors, with critical implications for genetic counseling and tumor surveillance strategies for children with familial predisposition syndromes. As our understanding of the molecular landscape of pediatric CNS tumors continues to advance, innovative applications of genomic sequencing hold significant promise for further improving the care of children with these cancers.

  9. Management of pediatric central nervous system emergencies: a review for general radiologists.

    Science.gov (United States)

    Rebollo Polo, M

    2016-05-01

    To review the most common and most important diseases and disorders of the central nervous system (CNS) in pediatric emergencies, discussing the indications for different imaging tests in each context. In pediatric patients, acute neurologic symptoms (seizures, deteriorating level of consciousness, focal neurologic deficits, etc.) can appear in diverse clinical situations (trauma, child abuse, meningoencephalitis, ischemia…). It is important to decide on the most appropriate neuroimaging diagnostic algorithm for each situation and age group, as well as to know the signs of the most typical lesions that help us in the etiological differential diagnosis. Pediatric patients' increased vulnerability to ionizing radiation and the possible need for sedation in studies that require more time are factors that should be taken into account when indicating an imaging test. It is essential to weigh the risks and benefits for the patient and to avoid unnecessary studies. Copyright © 2016 SERAM. Published by Elsevier España, S.L.U. All rights reserved.

  10. Physical Fitness and Self-Image: An Evaluation of the Exercise Self-Schema Questionnaire Using Direct Measures of Physical Fitness.

    Science.gov (United States)

    Thomas, Jafra D; Vanness, J Mark; Cardinal, Bradley J

    2016-01-01

    The purpose of this study was to perform a construct validity assessment of Kendzierski's exercise self-schema theory questionnaire using objective measures of health-related physical fitness. This study tested the hypothesis that individuals with an exercise self-schema would possess significantly greater physical fitness than those who did not across three domains of health-related physical fitness: Body composition, cardiovascular fitness, and upper-body muscular endurance. Undergraduate student participants from one private university on the west coast of the United States completed informed consent forms and the exercise self-schema questionnaire within a classroom setting or at an on-campus outside tabling session. Participants not meeting inclusion criteria for Kendzierski's three original schema groups were categorized as "unschematic," and were included within MANCOVA/ANCOVA analyses, where gender served as the covariate. Participants underwent lab-based fitness assessments administered in accordance with the 2013 American College of Sports Medicine Guidelines for Exercise Testing and Prescription. The hypothesis of this study was partially supported. Specifically, exerciser schematics were significantly leaner than aschematics (p = .002) and they had greater levels of upper-body muscular endurance compared to both aschematic and nonexerciser schematics (p = .002). However, no differences were observed for cardiovascular fitness (i.e., predicted V02Max p = .410). The findings of this study help to establish the construct validity of Kendizerski's self-report exercise self-schema categorization scheme. Visual inspection of the data, as well as computed effect size measures suggest exercise self-schema is associated with dimensions of one's physical fitness.

  11. Physical Fitness For Futsal Referee Of Football Association In Thailand

    Science.gov (United States)

    Thaweesub Koeipakvaen Acting Sub L., t.

    2018-01-01

    The purpose of the research to study physical fitness for futsal Referee of Football Association in Thailand and Compare of the Physical Fitness for first level, second and third futsal Referee of Football Association in Thailand. The population of first level, second and third level futsal Referee of Football Association in Thailand 107 person. The sample were futsal Referee of Football Association in Thailand 97 person. First level futsal Referee 22 person. Second level futsal Referee 11 person. Third level futsal Referee 64 person. The instrument used was futsal physical fitness test of Football Association in Thailand. Endurance Test (1,000 meter), Speed Test (4x10 meter) 2 time, and Agility Test (80 meter) 2 time. The statistic for data analysis were one way Anova, Percentage, Mean, Standard Deviation and F-test. The results were as the follow: (1) the result comparing F-test first level futsal referee with level second and first level futsal referee with third level. the statically significant different at the 0.05 level, and the result comparing Endurance as the follow the Physical Fitness for first level, second and third futsal Referee. the statically significant different at the 0.05 level.

  12. Pediatric medical device development by surgeons via capstone engineering design programs.

    Science.gov (United States)

    Sack, Bryan S; Elizondo, Rodolfo A; Huang, Gene O; Janzen, Nicolette; Espinoza, Jimmy; Sanz-Cortes, Magdalena; Dietrich, Jennifer E; Hakim, Julie; Richardson, Eric S; Oden, Maria; Hanks, John; Haridas, Balakrishna; Hury, James F; Koh, Chester J

    2018-03-01

    There is a need for pediatric medical devices that accommodate the unique physiology and anatomy of pediatric patients that is increasingly receiving more attention. However, there is limited literature on the programs within children's hospitals and academia that can support pediatric device development. We describe our experience with pediatric device design utilizing collaborations between a children's hospital and two engineering schools. Utilizing the academic year as a timeline, unmet pediatric device needs were identified by surgical faculty and matched with an engineering mentor and a team of students within the Capstone Engineering Design programs at two universities. The final prototypes were showcased at the end of the academic year and if appropriate, provisional patent applications were filed. All twelve teams successfully developed device prototypes, and five teams obtained provisional patents. The prototypes that obtained provisional patents included a non-operative ureteral stent removal system, an evacuation device for small kidney stone fragments, a mechanical leech, an anchoring system of the chorio-amniotic membranes during fetal surgery, and a fetal oxygenation monitor during fetoscopic procedures. Capstone Engineering Design programs in partnership with surgical faculty at children's hospitals can play an effective role in the prototype development of novel pediatric medical devices. N/A - No clinical subjects or human testing was performed. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Critical assessment of pediatric neurosurgery patient/parent educational information obtained via the Internet.

    Science.gov (United States)

    Garcia, Michael; Daugherty, Christopher; Ben Khallouq, Bertha; Maugans, Todd

    2018-05-01

    OBJECTIVE The Internet is used frequently by patients and family members to acquire information about pediatric neurosurgical conditions. The sources, nature, accuracy, and usefulness of this information have not been examined recently. The authors analyzed the results from searches of 10 common pediatric neurosurgical terms using a novel scoring test to assess the value of the educational information obtained. METHODS Google and Bing searches were performed for 10 common pediatric neurosurgical topics (concussion, craniosynostosis, hydrocephalus, pediatric brain tumor, pediatric Chiari malformation, pediatric epilepsy surgery, pediatric neurosurgery, plagiocephaly, spina bifida, and tethered spinal cord). The first 10 "hits" obtained with each search engine were analyzed using the Currency, Relevance, Authority, Accuracy, and Purpose (CRAAP) test, which assigns a numerical score in each of 5 domains. Agreement between results was assessed for 1) concurrent searches with Google and Bing; 2) Google searches over time (6 months apart); 3) Google searches using mobile and PC platforms concurrently; and 4) searches using privacy settings. Readability was assessed with an online analytical tool. RESULTS Google and Bing searches yielded information with similar CRAAP scores (mean 72% and 75%, respectively), but with frequently differing results (58% concordance/matching results). There was a high level of agreement (72% concordance) over time for Google searches and also between searches using general and privacy settings (92% concordance). Government sources scored the best in both CRAAP score and readability. Hospitals and universities were the most prevalent sources, but these sources had the lowest CRAAP scores, due in part to an abundance of self-marketing. The CRAAP scores for mobile and desktop platforms did not differ significantly (p = 0.49). CONCLUSIONS Google and Bing searches yielded useful educational information, using either mobile or PC platforms. Most

  14. Technical study of craniospinal irradiation in pediatric patients with patient position and field matching

    Energy Technology Data Exchange (ETDEWEB)

    Itoh, Masanori; Ise, Toshihide; Umezu, Mikio [Kangawa Children' s Medical Center, Yokohama (Japan); Hioki, Minoru

    2000-05-01

    Craniospinal irradiation (CSI) in leukemia and medulloblastoma patients is usually a three-field technique that involves parallel-opposed lateral cranial fields adjacent and orthogonal to a posterior spinal field. Since sedation is often necessary for pediatric patients, the supine position is more favorable than the prone position for respiratory monitoring. We practiced CSI in the supine position in one case of leukemia and three cases of medulloblastoma. Each location of the isocenter was determined by moving the couch to fit the center of the CSI on the basis of incisura intertragica. The angles of collimator rotation and couch rotation were calculated according to each treatment field size. The junction was also moved 2 cm day by day during the course of treatment so that over- and underdose at the junction would be prevented. The supine position did not allow us to visually confirm the proper junction between the lateral cranial fields and the spinal field. However, we succeeded in practicing complete conjunction between the fields by proper collimator and couch rotations on the assessment of the film-dose method. CSI in the supine position is naturally comfortable for pediatric patients and seems effective in pediatric treatments, which often require respiratory monitoring for sedation. (author)

  15. Music distraction - its efficacy in management of anxious pediatric dental patients

    Directory of Open Access Journals (Sweden)

    Marwah N

    2005-01-01

    Full Text Available Managing the anxiety of pediatric dental patient has long been the purview of dentists over many years. Various techniques have been used with moderate and variant success rates over the last few years. The main aim of this study was to ascertain if music distraction is an effective means of managing anxiety in pediatric dental patients. Forty children aged between 4 and 8 years were selected for the study. The assessment of anxiety was done using Venham′s picture test, Venham′s anxiety rating scale, pulse rate, and oxygen saturation during different treatment visits. The values were statistically analyzed and it was concluded that audio distraction did decrease the anxiety level in pediatric dental patients, but not to a very significant level.

  16. Análise da correlação entre o protocolo Polar Fitness Test® para predição de VO2máx e ergoespirometria

    Directory of Open Access Journals (Sweden)

    Moacir Marocolo

    2012-06-01

    Full Text Available INTRODUÇÃO: A importância da mensuração do consumo máximo de oxigênio (O2máxé justificada por sua aceitação internacional como o melhor parâmetro fisiológico para avaliar a capacidade funcional do sistema cardiorrespiratório tanto em atletas como em não atletas que treinam fisicamente com objetivo de obter melhor saúde. OBJETIVO: Verificar a concordância entre os protocolos Polar Fitness Test® para a estimativa do O2máx e o teste de esforço máximo com medida direta de gases. MÉTODOS: Dezessete homens ativos (22,5 ± dois anos participaram. Em repouso, aplicou-se o protocolo Polar Fitness Test® e, em seguida, a coleta direta de gases sob o esforço máximo, em esteira, seguindo o protocolo de Bruce. RESULTADOS: Houve diferença significativa entre os valores médios dos métodos para estimativa do O2máx. O protocolo Polar Fitness Test® subestimou o O2máx, em média 15% (IC95%: 24; -53% comparado com a medida direta de gases. Os valores obtidos pelo Polar Fitness Test® não tiveram boa correlação com a medida direta em ergoespirômetro (r = 0,1. CONCLUSÃO: O protocolo Polar Fitness Test® não é válido para a estimativa do O2máx em homens jovens ativos fisicamente.

  17. Assessment of a head support system to prevent pediatric out-of-position: an observational study.

    Science.gov (United States)

    Lopez-Valdes, Francisco J; Forman, Jason L; Ash, Joseph H; Kent, Richard; Alba, Juan J; Segui-Gomez, Maria

    Head injuries are the most common severe injuries sustained by pediatric occupants in road traffic crashes. Preventing children from adopting positions that can result in an increased injury risk due to unfavorable interactions with the restraints is fundamental. The objective of this paper was to assess the effect of a head support system (SS) on the lateral position of the head, the vertical position of the sternum and the shoulder belt fit. Thirty pediatric rear-seat passengers were exposed to two 75-minute trials. Volunteers were restrained by a three-point belt and, if needed, used the appropriate child restraint system for their anthropometry (high-back booster, low-back booster, no booster). A case crossover study was designed in which the volunteers used the head support system (SS) during one of the trials, acting as their own controls (No SS) in the other. Compared to the control group, the head support reduced significantly the 90(th) percentile value of the absolute value of the relative lateral motion of the head, regardless of the restraint used. The system also reduced the maximum downward position of the sternal notch within the low-back booster group. As for the belt fit, the use of the head support improved significantly the position of the shoulder belt on the occupant in the low-back booster and in the no booster groups.

  18. The Association Between Measures of Fitness and Metabolic Health in Treatment-Seeking Youth with Obesity.

    Science.gov (United States)

    Guseman, Emily Hill; Cauffman, Samuel P; Tucker, Jared M; Smith, Lucie; Eisenmann, Joey C; Stratbucker, William

    2017-04-01

    Both cardiorespiratory fitness (CRF) and measures of muscular fitness are associated with metabolic syndrome in adults. However, limited information exists about these relationships in youth with severe obesity who are at increased risk of metabolic dysfunction. The purpose of this study was to examine the relationship between fitness and metabolic health in treatment-seeking youth with obesity. Data for this analysis were collected at the time of baseline visits at a stage 3 pediatric weight management center. Maximal voluntary contractions were obtained by using isometric hand-grip dynamometry, and CRF was obtained from a maximal treadmill test. Resting blood pressure and fasting measures of blood lipids, glucose, and insulin were used to calculate a continuous metabolic syndrome score (cMetS); homeostasis model assessment of insulin resistance (HOMA-IR) was calculated from fasting insulin and glucose. Relationships between measures of fitness and metabolic health were evaluated by using partial correlations adjusted for age. Sixty-nine participants (21 boys, 48 girls) were included in this analysis. Of these, 46% (n = 32) met the criteria for metabolic syndrome. No differences were found between boys and girls for any variable analyzed. Muscular strength was positively associated with cMetS (r = 0.35), though this association weakened after adjustment for body mass index percentile. CRF was inversely associated with homeostasis model assessment of insulin resistance (HOMA-IR) (r = -0.26) and fasting insulin (r = -0.27). Body fat percentage was positively associated with insulin (r = 0.36). No significant relationship was found between CRF and cMetS. Contrary to previous studies, CRF was not associated with metabolic syndrome in this group. Muscular strength, however, was associated with cMetS. Notably, CRF was associated with elevated HOMA-IR, which may be seen as a precursor to metabolic syndrome. These results suggest that CRF and muscular

  19. Low aerobic fitness in Brazilian adolescents

    Directory of Open Access Journals (Sweden)

    Diego Augusto Santos Silva

    2015-04-01

    Full Text Available INTRODUCTION: aerobic fitness is considered one of the most important components of health-related physical fitness, with low levels related to increased risk of premature death from all causes, especially cardiovascular diseases. OBJECTIVE: to identify the characteristics of adolescents at higher risk of low levels of aerobic fitness. METHODS: the study included 696 adolescents 15-17 years of age enrolled in public high schools of Florianópolis, southern Brazil. This cross-sectional epidemiological study was conducted in Florianópolis, Santa Catarina, Brazil. Aerobic fitness was measured using the modified Canadian Aerobic Fitness Test mCAFT. Sociodemographic gender, age, school grade, paternal and maternal schooling, socioeconomic status, and anthropometric variables body weight, height, triceps and subscapular skinfold thickness, sexual maturation, physical activity, sedentary behavior, and eating habits were collected. RESULTS: it was found that 31.5% of adolescents had low aerobic fitness levels, being higher in boys 49.2% compared to girls 20.6%. Moreover, girls with sedentary behavior, overweight and high body fat percentage were the groups most likely to have inadequate aerobic fitness. In males, the groups most likely to have inadequate aerobic fitness were those whose parents studied more than eight years, those with low levels of physical activity, and those with inadequate nutrition and excessive body fat. CONCLUSION: low aerobic fitness levels were present in one third of adolescents and was more prevalent in boys. Lifestyle changes, including replacement of sedentary behaviors by physical and sport activities , may assist in improving the aerobic fitness of Brazilian adolescents.

  20. Tissue quantification for development of pediatric phantom

    International Nuclear Information System (INIS)

    Alves, A.F.F.; Miranda, J.R.A.; Pina, D.R.

    2013-01-01

    The optimization of the risk- benefit ratio is a major concern in the pediatric radiology, due to the greater vulnerability of children to the late somatic effects and genetic effects of exposure to radiation compared to adults. In Brazil, it is estimated that the causes of death from head trauma are 18 % for the age group between 1-5 years and the radiograph is the primary diagnostic test for the detection of skull fracture . Knowing that the image quality is essential to ensure the identification of structures anatomical and minimizing errors diagnostic interpretation, this paper proposed the development and construction of homogeneous phantoms skull, for the age group 1-5 years. The construction of the phantoms homogeneous was performed using the classification and quantification of tissue present in the skull of pediatric patients. In this procedure computational algorithms were used, using Matlab, to quantify distinct biological tissues present in the anatomical regions studied , using pictures retrospective CT scans. Preliminary data obtained from measurements show that between the ages of 1-5 years, assuming an average anteroposterior diameter of the pediatric skull region of the 145.73 ± 2.97 mm, can be represented by 92.34 mm ± 5.22 of lucite and 1.75 ± 0:21 mm of aluminum plates of a provision of PEP (Pacient equivalent phantom). After its construction, the phantoms will be used for image and dose optimization in pediatric protocols process to examinations of computerized radiography

  1. Exercise videogames for physical activity and fitness: Design and rationale of the Wii Heart Fitness trial.

    Science.gov (United States)

    Bock, Beth C; Thind, Herpreet; Dunsiger, Shira I; Serber, Eva R; Ciccolo, Joseph T; Cobb, Victoria; Palmer, Kathy; Abernathy, Sean; Marcus, Bess H

    2015-05-01

    Despite numerous health benefits, less than half of American adults engage in regular physical activity. Exercise videogames (EVG) may be a practical and attractive alternative to traditional forms of exercise. However there is insufficient research to determine whether EVG play alone is sufficient to produce prolonged engagement in physical activity or improvements in cardiovascular fitness and overall health risk. The goal of the present study is to test the efficacy of exercise videogames to increase time spent in moderate to vigorous physical activity (MVPA) and to improve cardiovascular risk indices among adults. Wii Heart Fitness is a rigorous 3-arm randomized controlled trial with adults comparing three 12-week programs: (1) supervised EVGs, (2) supervised standard exercise, and (3) a control condition. Heart rate is monitored continuously throughout all exercise sessions. Assessments are conducted at baseline, end of intervention (week 12), 6 and 9 months. The primary outcome is time spent in MVPA physical activity. Secondary outcomes include changes in cardiovascular fitness, body composition, blood lipid profiles and maintenance of physical activity through six months post-treatment. Changes in cognitive and affective constructs derived from Self Determination and Social Cognitive Theories will be examined to explain the differential outcomes between the two active treatment conditions. The Wii Heart Fitness study is designed to test whether regular participation in EVGs can be an adequate source of physical activity for adults. This study will produce new data on the effect of EVGs on cardiovascular fitness indices and prolonged engagement with physical activity. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. Phantom Limb Pain in Pediatric Oncology

    Directory of Open Access Journals (Sweden)

    Patrick DeMoss

    2018-04-01

    Full Text Available Phantom limb pain (PLP is a prevalent problem for children and adolescents undergoing amputation due to cancer treatment. The symptoms are wide ranging from sharp to tingling. PLP in children typically lasts for a few minutes but can be almost constant and can be highly distressing. This focused review describes the characteristics, epidemiology, mechanisms, and evidence-based treatment of PLP in pediatric populations, focusing on pediatric cancer. In pediatric oncology, the administration of chemotherapy is a risk factor that potentially sensitizes the nervous system and predisposes pediatric cancer patients to develop PLP after amputation. Gabapentin, tricyclic antidepressants, opiates, nerve blocks, and epidural catheters have shown mixed success in adults and case reports document potential utility in pediatric patients. Non-pharmacologic treatments, such as mirror therapy, psychotherapy, and acupuncture have also been used in pediatric PLP with success. Prospective controlled trials are necessary to advance care for pediatric patients with PLP.

  3. ASSESSMENT OF PHYSICAL SKILLS TO THE STUDENT FITNESS INDEX

    Directory of Open Access Journals (Sweden)

    Ratko Pavlović

    2011-09-01

    Full Text Available A very common way of assessing the state of physical abilities is to determine on the basis of diagnostic tests, and they give us the necessary information when it comes to general skills defined population. This evaluation is usually performed diagnostic tests in the laboratory. However, reliable data are available on the performance of some field tests. Depending on field conditions, very often is done using estimates of general ability test, 2km walking UKK. To perform this test shall include data on body height, weight, BMI-in, values, heart rate, time walking. Based on the formula and application of these data are obtained fitness value of the index by which to define the overall physical condition of patients. Also based on the formula to obtain indicators on maximum oxygen consumption. The study comprised third-year students East Sarajevo, who held classes in subjects walking sports athletics, in order to determine their state of physical fitness index based on fitness.

  4. Policy challenges for the pediatric rheumatology workforce: Part I. Education and economics

    Directory of Open Access Journals (Sweden)

    Henrickson Michael

    2011-08-01

    Full Text Available Abstract For children with rheumatic conditions, the available pediatric rheumatology workforce mitigates their access to care. While the subspecialty experiences steady growth, a critical workforce shortage constrains access. This three-part review proposes both national and international interim policy solutions for the multiple causes of the existing unacceptable shortfall. Part I explores the impact of current educational deficits and economic obstacles which constrain appropriate access to care. Proposed policy solutions follow each identified barrier. Challenges consequent to obsolete, limited or unavailable exposure to pediatric rheumatology include: absent or inadequate recognition or awareness of rheumatic disease; referral patterns that commonly foster delays in timely diagnosis; and primary care providers' inappropriate or outdated perception of outcomes. Varying models of pediatric rheumatology care delivery consequent to market competition, inadequate reimbursement and uneven institutional support serve as additional barriers to care. A large proportion of pediatrics residency programs offer pediatric rheumatology rotations. However, a minority of pediatrics residents participate. The current generalist pediatrician workforce has relatively poor musculoskeletal physical examination skills, lacking basic competency in musculoskeletal medicine. To compensate, many primary care providers rely on blood tests, generating referrals that divert scarce resources away from patients who merit accelerated access to care for rheumatic disease. Pediatric rheumatology exposure could be enhanced during residency by providing a mandatory musculoskeletal medicine rotation that includes related musculoskeletal subspecialties. An important step is the progressive improvement of many providers' fixed referral and laboratory testing patterns in lieu of sound physical examination skills. Changing demographics and persistent reimbursement disparities will

  5. Optimization of a miniature Maglev ventricular assist device for pediatric circulatory support.

    Science.gov (United States)

    Zhang, Juntao; Koert, Andrew; Gellman, Barry; Gempp, Thomas M; Dasse, Kurt A; Gilbert, Richard J; Griffith, Bartley P; Wu, Zhongjun J

    2007-01-01

    A miniature Maglev blood pump based on magnetically levitated bearingless technology is being developed and optimized for pediatric patients. We performed impeller optimization by characterizing the hemodynamic and hemocompatibility performances using a combined computational and experimental approach. Both three-dimensional flow features and hemolytic characteristics were analyzed using computational fluid dynamics (CFD) modeling. Hydraulic pump performances and hemolysis levels of three different impeller designs were quantified and compared numerically. Two pump prototypes were constructed from the two impeller designs and experimentally tested. Comparison of CFD predictions with experimental results showed good agreement. The optimized impeller remarkably increased overall pump hydraulic output by more than 50% over the initial design. The CFD simulation demonstrated a clean and streamlined flow field in the main flow path. The numerical results by hemolysis model indicated no significant high shear stress regions. Through the use of CFD analysis and bench-top testing, the small pediatric pump was optimized to achieve a low level of blood damage and improved hydraulic performance and efficiency. The Maglev pediatric blood pump is innovative due to its small size, very low priming volume, excellent hemodynamic and hematologic performance, and elimination of seal-related and bearing-related failures due to adoption of magnetically levitated bearingless motor technology, making it ideal for pediatric applications.

  6. Cost of Pediatric Visceral Leishmaniasis Care in Morocco.

    Science.gov (United States)

    Tachfouti, Nabil; Najdi, Adil; Alonso, Sergi; Sicuri, Elisa; Laamrani El Idrissi, Abderahmane; Nejjari, Chakib; Picado, Albert

    2016-01-01

    Visceral leishmaniasis (VL) is a neglected parasitic disease that is fatal if left untreated. VL is endemic in Morocco and other countries in North Africa were it mainly affects children from rural areas. In Morocco, the direct observation of Leishmania parasites in bone marrow aspirates and serological tests are used to diagnose VL. Glucantime is the first line of treatment. The objective of this study was to report the costs associated to standard clinical management of pediatric VL from the provider perspective in Morocco. As a secondary objective we described the current clinical practices and the epidemiological characteristics of pediatric VL patients. From March to June 2014 we conducted a survey in eight hospitals treating pediatric VL patients in Morocco. A pro-forma was used to collect demographic, clinical and management data from medical records. We specifically collected data on VL diagnosis and treatment. We also estimated the days of hospitalization and the time to start VL treatment. Costs were estimated by multiplying the use of resources in terms of number of days in hospital, tests performed and drugs provided by the official prices. For patients receiving part of their treatment at Primary Health Centers (PHC) we estimated the cost of administering the Glucantime as outpatient. We calculated the median cost per VL patient. We also estimated the cost of managing a VL case when different treatment strategies were applied: inpatient and outpatient. We obtained data from 127 VL patients. The median total cost per pediatric VL case in Morocco is 520 US$. The cost in hospitals applying an outpatient strategy is significantly lower (307 US$) than hospitals keeping the patients for the whole treatment (636 US$). However the outpatient strategy is not yet recommended as VL treatment for children in the Moroccan guidelines. VL diagnosis and treatment regimens should be standardized following the current guidelines in Morocco.

  7. Cost of Pediatric Visceral Leishmaniasis Care in Morocco.

    Directory of Open Access Journals (Sweden)

    Nabil Tachfouti

    Full Text Available Visceral leishmaniasis (VL is a neglected parasitic disease that is fatal if left untreated. VL is endemic in Morocco and other countries in North Africa were it mainly affects children from rural areas. In Morocco, the direct observation of Leishmania parasites in bone marrow aspirates and serological tests are used to diagnose VL. Glucantime is the first line of treatment. The objective of this study was to report the costs associated to standard clinical management of pediatric VL from the provider perspective in Morocco. As a secondary objective we described the current clinical practices and the epidemiological characteristics of pediatric VL patients.From March to June 2014 we conducted a survey in eight hospitals treating pediatric VL patients in Morocco. A pro-forma was used to collect demographic, clinical and management data from medical records. We specifically collected data on VL diagnosis and treatment. We also estimated the days of hospitalization and the time to start VL treatment. Costs were estimated by multiplying the use of resources in terms of number of days in hospital, tests performed and drugs provided by the official prices. For patients receiving part of their treatment at Primary Health Centers (PHC we estimated the cost of administering the Glucantime as outpatient. We calculated the median cost per VL patient. We also estimated the cost of managing a VL case when different treatment strategies were applied: inpatient and outpatient.We obtained data from 127 VL patients. The median total cost per pediatric VL case in Morocco is 520 US$. The cost in hospitals applying an outpatient strategy is significantly lower (307 US$ than hospitals keeping the patients for the whole treatment (636 US$. However the outpatient strategy is not yet recommended as VL treatment for children in the Moroccan guidelines. VL diagnosis and treatment regimens should be standardized following the current guidelines in Morocco.

  8. Toward creating family-friendly work environments in pediatrics: baseline data from pediatric department chairs and pediatric program directors.

    Science.gov (United States)

    McPhillips, Heather A; Burke, Ann E; Sheppard, Kate; Pallant, Adam; Stapleton, F Bruder; Stanton, Bonita

    2007-03-01

    The objective was to determine baseline characteristics of pediatric residency training programs and academic departments in regard to family-friendly work environments as outlined in the Report of the Task Force on Women in Pediatrics. We conducted Web-based anonymous surveys of 147 pediatric department chairs and 203 pediatric program directors. The chair's questionnaire asked about child care, lactation facilities, family leave policies, work-life balance, and tenure and promotion policies. The program director's questionnaire asked about family leave, parenting, work-life balance, and perceptions of "family-friendliness." The response rate was 52% for program directors and 51% for chairs. Nearly 60% of chairs reported some access to child care or provided assistance locating child care; however, in half of these departments, demand almost always exceeded supply. Lactation facilities were available to breastfeeding faculty in 74% of departments, although only 57% provided access to breast pumps. A total of 78% of chairs and 90% of program directors reported written maternity leave policies with slightly fewer reporting paternity leave policies. The majority (83%) of chairs reported availability of part-time employment, whereas only 27% of program directors offered part-time residency options. Most departments offered some flexibility in promotion and tenure. Although progress has been made, change still is needed in many areas in pediatric departments and training programs, including better accessibility to quality child care; improved lactation facilities for breastfeeding mothers; clear, written parental leave policies; and flexible work schedules to accommodate changing demands of family life.

  9. Utilizing a Pediatric Disaster Coalition Model to Increase Pediatric Critical Care Surge Capacity in New York City.

    Science.gov (United States)

    Frogel, Michael; Flamm, Avram; Sagy, Mayer; Uraneck, Katharine; Conway, Edward; Ushay, Michael; Greenwald, Bruce M; Pierre, Louisdon; Shah, Vikas; Gaffoor, Mohamed; Cooper, Arthur; Foltin, George

    2017-08-01

    A mass casualty event can result in an overwhelming number of critically injured pediatric victims that exceeds the available capacity of pediatric critical care (PCC) units, both locally and regionally. To address these gaps, the New York City (NYC) Pediatric Disaster Coalition (PDC) was established. The PDC includes experts in emergency preparedness, critical care, surgery, and emergency medicine from 18 of 25 major NYC PCC-capable hospitals. A PCC surge committee created recommendations for making additional PCC beds available with an emphasis on space, staff, stuff (equipment), and systems. The PDC assisted 15 hospitals in creating PCC surge plans by utilizing template plans and site visits. These plans created an additional 153 potential PCC surge beds. Seven hospitals tested their plans through drills. The purpose of this article was to demonstrate the need for planning for disasters involving children and to provide a stepwise, replicable model for establishing a PDC, with one of its primary goals focused on facilitating PCC surge planning. The process we describe for developing a PDC can be replicated to communities of any size, setting, or location. We offer our model as an example for other cities. (Disaster Med Public Health Preparedness. 2017;11:473-478).

  10. Pediatric Brain Tumor Foundation

    Science.gov (United States)

    ... navigate their brain tumor diagnosis. WATCH AND SHARE Brain tumors and their treatment can be deadly so ... Pediatric Central Nervous System Cancers Read more >> Pediatric Brain Tumor Foundation 302 Ridgefield Court, Asheville, NC 28806 ...

  11. Pediatric advanced life support and sedation of pediatric dental patients.

    Science.gov (United States)

    Kim, Jongbin

    2016-03-01

    Programs provided by the Korea Association of Cardiopulmonary Resuscitation include Basic Life Support (BLS), Advanced Cardiac Life Support (ACLS), Pediatric Advanced Life Support (PALS), and Korean Advanced Life Support (KALS). However, programs pertinent to dental care are lacking. Since 2015, related organizations have been attempting to develop a Dental Advanced Life Support (DALS) program, which can meet the needs of the dental environment. Generally, for initial management of emergency situations, basic life support is most important. However, emergencies in young children mostly involve breathing. Therefore, physicians who treat pediatric dental patients should learn PALS. It is necessary for the physician to regularly renew training every two years to be able to immediately implement professional skills in emergency situations. In order to manage emergency situations in the pediatric dental clinic, respiratory support is most important. Therefore, mastering professional PALS, which includes respiratory care and core cases, particularly upper airway obstruction and respiratory depression caused by a respiratory control problem, would be highly desirable for a physician who treats pediatric dental patients. Regular training and renewal training every two years is absolutely necessary to be able to immediately implement professional skills in emergency situations.

  12. Pediatric Nephrolithiasis: A Review.

    Science.gov (United States)

    Miah, Tayaba; Kamat, Deepak

    2017-06-01

    The incidence of pediatric nephrolithiasis is on the rise. The composition of kidney stones in children is different than in adults, as most stones in children have a composition of calcium oxalate and calcium phosphate mixed with a small amount of uric acid. The symptoms of pediatric nephrolithiasis are nonspecific. Computed tomography (CT) is the gold standard for diagnosis; however, because of radiation exposure associated with a CT scan, ultrasonography is also an accepted modality for the diagnosis. Extensive metabolic evaluation is important to rule out an underlying metabolic disorder. Urinary decompression, medical expulsion therapy, and surgical interventions such as ureteroscopy and extracorporeal shockwave lithotripsy are some of the options available for treating pediatric nephrolithiasis. [Pediatr Ann. 2017;46(6):e242-e244.]. Copyright 2017, SLACK Incorporated.

  13. Music distraction - its efficacy in management of anxious pediatric dental patients

    OpenAIRE

    Marwah N; Prabhakar A; Raju O

    2005-01-01

    Managing the anxiety of pediatric dental patient has long been the purview of dentists over many years. Various techniques have been used with moderate and variant success rates over the last few years. The main aim of this study was to ascertain if music distraction is an effective means of managing anxiety in pediatric dental patients. Forty children aged between 4 and 8 years were selected for the study. The assessment of anxiety was done using Venham′s picture test, Venham′s...

  14. Competency Testing for Pediatric Cardiology Fellows Learning Transthoracic Echocardiography: Implementation, Fellow Experience, and Lessons Learned.

    Science.gov (United States)

    Levine, Jami C; Geva, Tal; Brown, David W

    2015-12-01

    There is currently great interest in measuring trainee competency at all levels of medical education. In 2007, we implemented a system for assessing cardiology fellows' progress in attaining imaging skills. This paradigm could be adapted for use by other cardiology programs. Evaluation consisted of a two-part exercise performed after years 1 and 2 of pediatric cardiology training. Part 1: a directly observed evaluation of technical skills as fellows imaged a normal subject (year 1) and a patient with complex heart disease (year 2). Part 2: fellows interpreted and wrote reports for two echocardiograms illustrating congenital heart disease. These were graded for accuracy and facility with communicating pertinent data. After 5 years of testing, fellows were surveyed about their experience. In 5 years, 40 fellows were tested at least once. Testing identified four fellows who underperformed on the technical portion and four on the interpretive portion. Surveys were completed by 33 fellows (83 %). Most (67 %) felt that intermittent observation by faculty was inadequate for assessing skills and that procedural volume was a poor surrogate for competency (58 %). Posttest feedback was constructive and valuable for 90, and 70 % felt the process helped them set goals for skill improvement. Overall, fellows felt this testing was fair and should continue. Fellow performance and responses identified programmatic issues that were creating barriers to learning. We describe a practical test to assess competency for cardiology fellows learning echocardiography. This paradigm is feasible, has excellent acceptance among trainees, and identifies trainees who need support. Materials developed could be easily adapted to help track upcoming ACGME-mandated metrics.

  15. Obesity and Pediatric Drug Development.

    Science.gov (United States)

    Vaughns, Janelle D; Conklin, Laurie S; Long, Ying; Zheng, Panli; Faruque, Fahim; Green, Dionna J; van den Anker, John N; Burckart, Gilbert J

    2018-05-01

    There is a lack of dosing guidelines for use in obese children. Moreover, the impact of obesity on drug safety and clinical outcomes is poorly defined. The paucity of information needed for the safe and effective use of drugs in obese patients remains a problem, even after drug approval. To assess the current incorporation of obesity as a covariate in pediatric drug development, the pediatric medical and clinical pharmacology reviews under the Food and Drug Administration (FDA) Amendments Act of 2007 and the FDA Safety and Innovation Act (FDASIA) of 2012 were reviewed for obesity studies. FDA labels were also reviewed for statements addressing obesity in pediatric patients. Forty-five drugs studied in pediatric patients under the FDA Amendments Act were found to have statements and key words in the medical and clinical pharmacology reviews and labels related to obesity. Forty-four products were identified similarly with pediatric studies under FDASIA. Of the 89 product labels identified, none provided dosing information related to obesity. The effect of body mass index on drug pharmacokinetics was mentioned in only 4 labels. We conclude that there is little information presently available to provide guidance related to dosing in obese pediatric patients. Moving forward, regulators, clinicians, and the pharmaceutical industry should consider situations in drug development in which the inclusion of obese patients in pediatric trials is necessary to facilitate the safe and effective use of new drug products in the obese pediatric population. © 2018, The American College of Clinical Pharmacology.

  16. Maternal fitness at the onset of the second trimester of pregnancy: correlates and relationship with infant birth weight.

    Science.gov (United States)

    Bisson, M; Alméras, N; Plaisance, J; Rhéaume, C; Bujold, E; Tremblay, A; Marc, I

    2013-12-01

    What is already known about this subject A healthy life begins in utero and a healthy pregnancy requires a fit and healthy mother. Physical activity during pregnancy provides a stimulation that is essential for promoting optimal body oxygenation and composition as well as metabolic fitness during pregnancy. Although a higher maternal fitness is expected to provide a beneficial fetal environment, it is still unclear whether physical fitness during pregnancy contributes to perinatal health. What this study adds Participation in sports and exercise previously and at the beginning of pregnancy can benefit maternal health by improving cardiorespiratory fitness during pregnancy, irrespective of maternal body mass index. Maternal strength, an indicator of muscular fitness, is an independent determinant of infant fetal growth and can positively influence birth weight. It is still unclear whether maternal physical activity and fitness during pregnancy contributes to perinatal health. The aims of this study were to characterize maternal physical fitness at 16 weeks of pregnancy and to examine its effects on infant birth weight. Maternal anthropometry (body mass index [BMI] and skin-folds), physical activity, cardiorespiratory fitness (VO2 peak) and muscular fitness (handgrip strength) were assessed at 16 weeks of gestation in 65 healthy pregnant women. Offspring birth weight was collected from maternal charts after delivery. A higher VO2 peak was associated with physical activity spent at sports and exercise before and in early pregnancy (P = 0.0005). Maternal BMI was negatively associated with cardiorespiratory fitness (P pregnancy as a new determinant of infant birth weight. © 2012 The Authors. Pediatric Obesity © 2012 International Association for the Study of Obesity.

  17. What Is a Pediatric Allergist / Immunologist?

    Science.gov (United States)

    ... Text Size Email Print Share What is a Pediatric Allergist/Immunologist? Page Content Article Body If your ... immune system problems. What Kind of Training Do Pediatric Allergists/Immunologists Have? Pediatric allergists/immunologists are medical ...

  18. What Is a Pediatric Heart Surgeon?

    Science.gov (United States)

    ... Text Size Email Print Share What is a Pediatric Heart Surgeon? Page Content Article Body If your ... require heart surgery. What Kind of Training Do Pediatric Heart Surgeons Have? Pediatric heart surgeons are medical ...

  19. Pediatric ureteropelvic junction obstruction: can magnetic resonance urography identify crossing vessels?

    Energy Technology Data Exchange (ETDEWEB)

    Parikh, Kushal R.; Kraft, Kate H.; Ivancic, Vesna; Smith, Ethan A.; Dillman, Jonathan R. [Section of Pediatric Radiology, Mott Children' s Hospital, Department of Radiology, University of Michigan Health System, Ann Arbor, MI (United States); Hammer, Matthew R. [University of Texas Southwestern, Department of Radiology, Dallas, TX (United States)

    2015-11-15

    MR Urography (MRU) is an increasingly used imaging modality for the evaluation of pediatric genitourinary obstruction. To determine whether pediatric MR urography (MRU) reliably detects crossing vessels in the setting of suspected ureteropelvic junction (UPJ) obstruction. The clinical significance of these vessels was also evaluated. We identified pediatric patients diagnosed with UPJ obstruction by MRU between May 2009 and June 2014. MRU studies were evaluated by two pediatric radiologists for the presence or absence of crossing vessels. Ancillary imaging findings such as laterality, parenchymal thinning/scarring, trapped fluid in the proximal ureter, and presence of renal parenchymal edema were also evaluated. Imaging findings were compared to surgical findings. We used the Mann-Whitney U test to compare continuous data and the Fisher exact test to compare proportions. Twenty-four of 25 (96%) UPJ obstructions identified by MRU were surgically confirmed. MRU identified crossing vessels in 10 of these cases, with 9 cases confirmed intraoperatively (κ = 0.92 [95% CI: 0.75, 1.0]). Crossing vessels were determined to be the primary cause of UPJ obstruction in 7/9 children intraoperatively, while in two children the vessels were deemed incidental and noncontributory to the urinary tract obstruction. There was no significant difference in age or the proportions of ancillary findings when comparing children without and with obstructing vessels. MRU allows detection of crossing vessels in pediatric UPJ obstruction. Although these vessels are the primary cause of obstruction in some children, they are incidental and non-contributory in others. Our study failed to convincingly identify any significant predictors (e.g., age or presence of renal parenchymal edema) that indicate when a crossing vessel is the primary cause of obstruction. (orig.)

  20. Pediatric Endocrinology Nurses Society

    Science.gov (United States)

    ... Join Now International Welcome to PENS The Pediatric Endocrinology Nursing Society (PENS) is committed to the development ... nurses in the art and science of pediatric endocrinology nursing. Learn More Text1 2018 PENS Call for ...