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Sample records for preparticipation physical examinations

  1. Pre-Participation Physical Examinations

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    ... live longer, healthier lives. Research shows that moderate physical activity – such as 30 minutes a day of brisk walking – significantly contributes to longevity. Even a person with risk factors like high ...

  2. PREPARTICIPATION SCREENING – THE SPORTS PHYSICAL THERAPY PERSPECTIVE

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    Blackburn, Turner A.; Boucher, Brenda

    2013-01-01

    Background and Purpose: The sports physical therapist (SPT) is uniquely qualified to participate in the provision of preparticipation physical examinations (PPE). The PPE is recommended prior to athletic participation and required by many jurisdictions. There is little research to support the process and components; however, a number of professional organizations have recommendations that direct the PPE process. Description of Topic and Related Evidence: This clinical commentary highlights the role of the sports physical therapist and current evidence related to the preparticipation physical examination process. Data sources were limited to include professional positions and peer reviewed publications from 1988 through January 2013. Relation to Clinical Practice: Preparticipation physicals should be useful, comprehensive, and cost effective for the athlete and the health care team. Additional research is indicated in many of the areas of the PPE. The SPT is a valuable member of the health care team and can be a primary facilitator of the PPE in concert with the physician, athletic trainer, athletic organization administrators, and others. Well‐designed and inclusive PPEs can be provided to meet the major objectives of identification of athletes at risk. Controversy continues over the extent of the cardiac screening component as well as other sport or athlete specific components. Level of Evidence: 5 PMID:23593556

  3. Use of Electrocardiogram as Part of the Preparticipation Examination.

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    Chain, Kelly; Gregory, Andrew

    2016-01-01

    A sudden cardiac event or death in a young athlete is a traumatic and memorable event. These tragic events have long-lasting and widespread influences that not only affect the person's immediate family, but also have profound effects on the team, school, and entire community. Over the past several decades there has been a significant research effort in the area of sudden cardiac death (SCD) in athletes in hopes of decreasing preventable deaths. One area of research and discussion that has emerged is the use of electrocardiograms (EKGs) in preparticipation screening examinations as a tool to help identify athletes at risk for SCD. The use of an EKG in addition to a detailed history and physical examination is a controversial and frequently debated topic. To help sort through some of the controversy, this article discusses some of the pros and cons of incorporating the EKG as a screening modality in the preparticipation evaluation for clearance to participate in sports. Copyright 2016, SLACK Incorporated.

  4. Is there evidence for mandating electrocardiogram as part of the pre-participation examination?

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    Borjesson, Mats; Dellborg, Mikael

    2011-01-01

    The risk of sudden cardiac death may be increased up to 2.8 times in competitive athletes compared with nonathletes. The majority of sudden cardiac death cases are caused by an underlying abnormality that potentially may be identified on cardiovascular screening, depending on the specific abnormality and the content of the cardiovascular screening applied. Indeed, today, cardiac screening is universally recommended by the cardiac societies [European Society of Cardiology (ESC) and American Heart Association (AHA)] and required by the sporting bodies [Fédération Internationale de Football Association (FIFA) and Union of European Football Associations (UEFA)]. Pre-participation examination is by consensus understood to include personal history and physical examination; controversy exists regarding the usefulness and appropriateness of screening using resting 12-lead electrocardiogram (ECG), with an apparent transatlantic difference. The ESC recommends screening consisting of personal history, physical examination, and 12-lead resting ECG, whereas recommendations from the AHA includes only personal history and physical examination. There is firm scientific ground to state that the sensitivity of screening with ECG is vastly superior to, and the cost-effectiveness significantly better than, screening without ECG. Cardiac screening of elite athletes with personal history, physical examination, and ECG is cost-effective also in comparison with other well-accepted procedures of modern health care, such as dialysis and implantable cardiac defibrillators. Newly published recommendations for the interpretation of the ECG in athletes (ESC) and future studies on ECGs in athletes of different ethnicity, gender, and age may further increase the specificity of ECG in cardiac screening, refining the screening procedure and lowering the costs for additional follow-up testing. Cardiac screening without ECG is not cost-effective and may be only marginally better than no screening

  5. Applying the ACSM Preparticipation Screening Algorithm to U.S. Adults: National Health and Nutrition Examination Survey 2001-2004.

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    Whitfield, Geoffrey P; Riebe, Deborah; Magal, Meir; Liguori, Gary

    2017-10-01

    For most people, the benefits of physical activity far outweigh the risks. Research has suggested that exercise preparticipation questionnaires might refer an unwarranted number of adults for medical evaluation before exercise initiation, creating a potential barrier to adoption. The new American College of Sports Medicine (ACSM) prescreening algorithm relies on current exercise participation; history and symptoms of cardiovascular, metabolic, or renal disease; and desired exercise intensity to determine referral status. Our purpose was to compare the referral proportion of the ACSM algorithm to that of previous screening tools using a representative sample of U.S. adults. On the basis of responses to health questionnaires from the 2001-2004 National Health and Nutrition Examination Survey, we calculated the proportion of adults 40 yr or older who would be referred for medical clearance before exercise participation based on the ACSM algorithm. Results were stratified by age and sex and compared with previous results for the ACSM/American Heart Association Preparticipation Questionnaire and the Physical Activity Readiness Questionnaire. On the basis of the ACSM algorithm, 2.6% of adults would be referred only before beginning vigorous exercise and 54.2% of respondents would be referred before beginning any exercise. Men were more frequently referred before vigorous exercise, and women were more frequently referred before any exercise. Referral was more common with increasing age. The ACSM algorithm referred a smaller proportion of adults for preparticipation medical clearance than the previously examined questionnaires. Although additional validation is needed to determine whether the algorithm correctly identifies those at risk for cardiovascular complications, the revised ACSM algorithm referred fewer respondents than other screening tools. A lower referral proportion may mitigate an important barrier of medical clearance from exercise participation.

  6. Pre-participation examination of competitive athletes: role of the ECG.

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    Hirzinger, Corinna; Froelicher, Victor F; Niebauer, Josef

    2010-08-01

    Sudden cardiac death in athletes is rare but has a wide social impact because it confronts the general population with the paradox that athletes perceived and admired as the fittest and healthiest suddenly drop dead during their sport. Mass media coverage is guaranteed in the case of sudden cardiac death of a top athlete, while other competitive and noncompetitive athletes of all ages, team members, sponsors, as well as huge parts of society remain puzzled and frightened. Therefore, debate is ongoing regarding how to minimize the number of fatalities, and the search continues for a cost-effective preparticipation screening for competitive athletes. Despite the fact that routine ECG screening would be widely available and rather inexpensive, debate continues regarding whether this should be part of initial screening for every athlete before starting to train at high intensity as well as during annual checkups. The role of ECGs in preparticipation examinations of competitive athletes is intensively discussed because there is a lack of strict criteria for which ECG findings should generate further workup. In this article, we analyze the main publications on sudden cardiac death, focusing on the benefit of ECG screening in preparticipation examination as it has been shown to be feasible and effective in identifying athletes at risk of sudden cardiac death. Copyright © 2010 Elsevier Inc. All rights reserved.

  7. Addition of the electrocardiogram to the preparticipation examination of college athletes.

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    Le, Vy-Van; Wheeler, Matthew T; Mandic, Sandra; Dewey, Frederick; Fonda, Holly; Perez, Marco; Sungar, Gannon; Garza, Daniel; Ashley, Euan A; Matheson, Gordon; Froelicher, Victor

    2010-03-01

    Although the use of standardized cardiovascular (CV) system-focused history and physical examination is recommended for the preparticipation examination (PPE) of athletes, the addition of the electrocardiogram (ECG) has been controversial. Because the impact of ECG screening on college athletes has rarely been reported, we analyzed the findings of adding the ECG to the PPE of Stanford athletes. For the past 15 years, the Stanford Sports Medicine program has mandated a PPE questionnaire and physical examination by Stanford physicians for participation in intercollegiate athletics. In 2007, computerized ECGs with digital measurements were recorded on athletes and entered into a database. Although the use of standardized CV-focused history and physical examination are recommended for the PPE of athletes, the addition of the ECG has been controversial. Because the feasibility and outcomes of ECG screening on college athletes have rarely been reported, we present findings derived from the addition of the ECG to the PPE of Stanford athletes. For the past 15 years, the Stanford Sports Medicine program has mandated a PPE questionnaire and physical examination by Stanford physicians for participation in intercollegiate athletics. In 2007, computerized ECGs with digital measurements were recorded on athletes and entered into a database. Six hundred fifty-eight recordings were obtained (54% men, 10% African-American, mean age 20 years) representing 24 sports. Although 68% of the women had normal ECGs, only 38% of the men did so. Incomplete right bundle branch block (RBBB) (13%), right axis deviation (RAD) (10%), and atrial abnormalities (3%) were the 3 most common minor abnormalities. Sokolow-Lyon criteria for left ventricular hypertrophy (LVH) were found in 49%; however, only 27% had a Romhilt-Estes score of >or=4. T-wave inversion in V2 to V3 occurred in 7%, and only 5 men had abnormal Q-waves. Sixty-three athletes (10%) were judged to have distinctly abnormal ECG findings

  8. The American Chiropractic Board of Sports Physicians Position Statement on Pre-Participation Examinations: An Expert Consensus

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    Moreau, William J.; Nabhan, Dustin C.; Roecker, Christopher; Kimura, Melissa Nagare; Klein, Andrew; Guimard, Brett; Pierce, Kevin; Helma, Patrick; Nelson, Robert; Bahr, Kelly Shockley; Nelson, Laney; Williams, Perry

    2015-01-01

    Objective The purpose of this paper is to present a position statement of best practices for the provision of a safe and high-quality pre-participation examination (PPE) and to provide recommendations on education requirements for doctors of chiropractic providing the PPE. Methods In 2014, the American Chiropractic Board of Sports Physicians (ACBSP) Board of Directors identified a need to review and update the ACBSP position statements and practice guidelines in order to be current with evolving best practices. Twelve ACBSP certificants, 10 Diplomates of the ACBSP, and 2 Certified Chiropractic Sports Physicians, met in April 2015 to author a pre-participation position statement using an expert consensus process. Panel members excluded anyone with commercial conflicts of interest and included individuals with expertise in clinical sports medicine and the performance of PPEs. A literature review was performed and circulated in advance for use by the panel in addressing the topic. The position statement was written through a consensus process and accepted by the ACBSP Board of Directors in May of 2015. Results The ACBSP Position Statement on Pre-participation Examinations identifies the qualifications and best practices for doctors of chiropractic to perform a PPE. Conclusion This position statement states that doctors of chiropractic with post graduate education and current Diplomates of the ACBSP or Certified Chiropractic Sports Physicians certification have the prerequisite education and qualifying skills to perform PPEs. PMID:26778931

  9. The American Chiropractic Board of Sports Physicians Position Statement on Pre-Participation Examinations: An Expert Consensus.

    Science.gov (United States)

    Moreau, William J; Nabhan, Dustin C; Roecker, Christopher; Kimura, Melissa Nagare; Klein, Andrew; Guimard, Brett; Pierce, Kevin; Helma, Patrick; Nelson, Robert; Bahr, Kelly Shockley; Nelson, Laney; Williams, Perry

    2015-09-01

    The purpose of this paper is to present a position statement of best practices for the provision of a safe and high-quality pre-participation examination (PPE) and to provide recommendations on education requirements for doctors of chiropractic providing the PPE. In 2014, the American Chiropractic Board of Sports Physicians (ACBSP) Board of Directors identified a need to review and update the ACBSP position statements and practice guidelines in order to be current with evolving best practices. Twelve ACBSP certificants, 10 Diplomates of the ACBSP, and 2 Certified Chiropractic Sports Physicians, met in April 2015 to author a pre-participation position statement using an expert consensus process. Panel members excluded anyone with commercial conflicts of interest and included individuals with expertise in clinical sports medicine and the performance of PPEs. A literature review was performed and circulated in advance for use by the panel in addressing the topic. The position statement was written through a consensus process and accepted by the ACBSP Board of Directors in May of 2015. The ACBSP Position Statement on Pre-participation Examinations identifies the qualifications and best practices for doctors of chiropractic to perform a PPE. This position statement states that doctors of chiropractic with post graduate education and current Diplomates of the ACBSP or Certified Chiropractic Sports Physicians certification have the prerequisite education and qualifying skills to perform PPEs.

  10. Selected Musculoskeletal and Performance Characteristics of Members of a Women's Professional Football Team: Application of a Pre-participation Examination.

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    Nett, Beth; Brosky, Joseph A; Velarde, Lynnuel; Pariser, David P; Boyce, David A

    2010-02-01

    Although it is common practice to administer pre-participation examinations (PPE) of athletes prior to training, there are no clearly established formats. Elements integral to the PPE fall within the scope of physical therapist practice, and are often categorized as a form of primary prevention for musculoskeletal disorders as defined in the Guide to Physical Therapist Practice. The purpose of this study is to describe the design and implementation of a PPE for a women's professional (gridiron) football team. The results and findings from this PPE provide one of the first musculoskeletal profiles and information about selected physical characteristics from members of a female professional football team. Players from the Kentucky Karma women's football team, a member of the National Women's Football League (NWFA), volunteered to participate in a PPE. Of twenty-five eligible team members, thirteen consented to participate. The PPE consisted of a health history questionnaire, a musculoskeletal screening, and a series of physical performance and agility tests. The players' average (± SD) age, height, weight, body mass index (BMI), and body fat percentage were 29.6 (± 5.6) yrs., 1.66 (± .05) m, 66.8 (± 12.6) kg, 24.1 (± 3.7), and 27.4 (± 6.6) %, respectively. Commonly reported injuries were similar to those reported in men's collegiate football. This is one of the first papers to report on a model PPE for a women's professional football team. Future research is needed to establish a standard PPE, recognize common injuries, and develop prevention strategies unique to women's professional football.

  11. Pre-Participation Physical Fitness does not Influence Adherence to a Supervised Exercise Program

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    Fábio Akio Nishijuka

    2017-08-01

    Full Text Available Abstract Background: Exercise-based cardiac rehabilitation tends to reduce mortality. However, it requires medium/long-term adherence to regular physical exercise. It is relevant to identify the variables that affect adherence to an supervised exercise program (SEP. Objective: To evaluate the influence of pre-participation levels of aerobic and non-aerobic physical fitness components in medium-term adherence to SEP. Methods: A total of 567 SEP participants (65 ± 12 years (68% men were studied. Participants adherent to the program for less than 6 months (48% (non-adherent - NAD were compared with 52% of participants who were adherent for 6 months or more (adherents - AD. In the non-aerobic fitness, flexibility (FLX (Flexitest and muscle power (MPW/body weight in standing rowing (watts/kg were evaluated while aerobic fitness was obtained by direct measure of VO2max/body weight (VO2. These measurements were normatized for sex and age based on percentiles (P (P-FLX/P-MPW of reference data or percentages of predicted (P-VO2. Additionally, AD and NAD with extreme results (tertiles were simultaneously compared for the three variables. Results: There was no difference between AD and NAD for non-aerobic results, in median [P25-P75], P-FLX: 30 [13-56] and 31 [9-52], respectively, (p = 0.69 and P-MPW: 34 [17-58] and 36 [16-62], respectively (p = 0.96, and for aerobic results (mean ± standard error P-VO2 (75.9 ± 1.3% and 75.0 ± 1.3%, respectively (p = 0.83. When comparing extreme tertiles, a difference was found for P-MPW in the lower tertile only, with a slight advantage of AD over NAD- 9 [5-16] versus 4 [1-11] (p = 0.04. Conclusion: Although awareness of the pre-participation levels of aerobic and non-aerobic physical fitness components is useful for individualized exercise prescription, these variables do not seem to influence medium-term adherence to SEP.

  12. Cardiovascular screening in adolescents and young adults: a prospective study comparing the Pre-participation Physical Evaluation Monograph 4th Edition and ECG.

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    Fudge, Jessie; Harmon, Kimberly G; Owens, David S; Prutkin, Jordan M; Salerno, Jack C; Asif, Irfan M; Haruta, Alison; Pelto, Hank; Rao, Ashwin L; Toresdahl, Brett G; Drezner, Jonathan A

    2014-08-01

    This study compares the accuracy of cardiovascular screening in active adolescents and young adults using a standardised history, physical examination and resting 12-lead ECG. Participants were prospectively screened using a standardised questionnaire based on the Pre-participation Physical Evaluation Monograph 4th Edition (PPE-4), physical examination and ECG interpreted using modern standards. Participants with abnormal findings had focused echocardiography and further evaluation. Primary outcomes included disorders associated with sudden cardiac arrest (SCA). From September 2010 to July 2011, 1339 participants underwent screening: age 13-24 (mean 16) years, 49% male, 68% Caucasian, 17% African-American and 1071 (80%) participating in organised sports. Abnormal history responses were reported on 916 (68%) questionnaires. After physician review, 495/916 (54%) participants with positive questionnaires were thought to have non-cardiac symptoms and/or a benign family history and did not warrant additional evaluation. Physical examination was abnormal in 124 (9.3%) participants, and 72 (5.4%) had ECG abnormalities. Echocardiograms were performed in 586 (44%) participants for abnormal history (31%), physical examination (8%) or ECG (5%). Five participants (0.4%) were identified with a disorder associated with SCA, all with ECG-detected Wolff-Parkinson-White. The false-positive rates for history, physical examination and ECG were 31.3%, 9.3% and 5%, respectively. A standardised history and physical examination using the PPE-4 yields a high false-positive rate in a young active population with limited sensitivity to identify those at risk for SCA. ECG screening has a low false-positive rate using modern interpretation standards and improves detection of primary electrical disease at risk of SCA. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  13. Wilderness Preparticipation Evaluation and Considerations for Special Populations.

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    Joy, Elizabeth; Van Baak, Karin; Dec, Katherine L; Semakula, Barbara; Cardin, Ashlea D; Lemery, Jay; Wortley, George C; Yaron, Michael; Madden, Christopher

    2015-12-01

    Children, older adults, disabled and special needs athletes, and female athletes who participate in outdoor and wilderness sports and activities each face unique risks. For children and adolescents traveling to high altitude, the preparticipation physical evaluation should focus on risk assessment, prevention strategies, early recognition of altitude-related symptoms, management plans, and appropriate follow-up. As the risk and prevalence of chronic disease increases with age, both older patients and providers need to be aware of disease and medication-specific risks relative to wilderness sport and activity participation. Disabled and special needs athletes benefit from careful pre-event planning for the potential medical issues and equipment modifications that may affect their health in wilderness environments. Issues that demand special consideration for female adventurers include pregnancy, contraceptive use, menses, and ferritin levels at altitude. A careful preparticipation evaluation that factors in unique, population- specific risks will help special populations stay healthy and safe on wilderness adventures. The PubMed and SportDiscus databases were searched in 2014 using both MeSH terms and text words and include peer-reviewed English language articles from 1977 to 2014. Additional information was accessed from Web-based sources to produce this narrative review on preparticipation evaluation for special populations undertaking wilderness adventures. Key words include children, adolescent, pediatric, seniors, elderly, disabled, special needs, female, athlete, preparticipiation examination, wilderness medicine, and sports. Copyright © 2015. Published by Elsevier Inc.

  14. Preseason physical examination for the prevention of sports injuries.

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    McKeag, D B

    1985-01-01

    The importance of the preseason physical examination and preparticipation evaluation of sports candidates is highlighted because it constitutes one of the few occasions in which the physician can actively prevent sports injuries from occurring. As exercise participation continues to increase on a world-wide basis, an understanding of the goals and objectives of such a pre-exercise evaluation are important. The need is not for a standard evaluation form, but for a consistent understanding of adjusting the evaluation to the age of the candidate, the type of sport to be engaged in and the anticipated level of competition. Essentials of any evaluation are musculoskeletal, cardiovascular and psychological examinations. Examinations should have clearly defined objectives, and factors determining the type of evaluation include: prospective athlete; contemplated exercise programme; and motivation. Different types of implementation are individual examinations, locker room technique and the station technique, each with advantages and disadvantages. A pre-exercise evaluation should always occur before any anticipated change in level of school or competition with an interval or intercurrent history and physical examinations occurring at regular intervals. It is important that examinations take place before the commencement of a sports season so previous injuries and problems can be dealt with; timing is vital. Contents of a pre-exercise physical examination should include history, a physical examination, laboratory testing and additional specific screening evaluations. Finally, assessment of the pre-exercise evaluation and injury prediction will aid physicians in preparticipation evaluations.

  15. The Outpatient Physical Examination.

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    Artandi, Maja K; Stewart, Rosalyn W

    2018-05-01

    The physical examination in the outpatient setting is a valuable tool. Even in settings where there is lack of evidence, such as the annual physical examination of an asymptomatic adult, the physical examination is beneficial for the physician-patient relationship. When a patient has specific symptoms, the physical examination-in addition to a thorough history-can help narrow down, or in many cases establish, a diagnosis. In a time where imaging and laboratory tests are easily available, but are expensive and can be invasive, a skilled physical examination remains an important component of patient evaluation. Copyright © 2018 Elsevier Inc. All rights reserved.

  16. Transtelephonic Electrocardiographic Transmission in the Preparticipation Screening of Athletes

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    Theodoros Samaras

    2008-01-01

    Full Text Available Transtelephonic electrocardiographic transmission (TET is the most widespread form of telecardiology since it enables clinicians to assess patients at a distance. The purpose of this study was to assess the efficacy and effectiveness of TET either by fixed telephone line (POTS or by mobile phone in the preparticipation screening of young athletes. A total of 506 players, aged 20.5 ± 6.2 years, from 23 soccer clubs in the prefecture of Thessaloniki, Greece, were physically examined in their playfields by a general practitioner (GP and had their ECG recorded. In 142 cases, and on the judgment of the GP, the ECG was transmitted via POTS and/or global system for mobile communications (GSM to a specialised medical centre where it was evaluated by a cardiologist. The mean total time for recording, storing, and transmitting the ECG was four minutes per subject. It was found that the success rate for transmission at first attempt was similar for both fixed and mobile networks, that is, 93% and 91%, respectively. The failure rate in the GSM network was correlated to the reception level at the site of transmission. Only in about half ( = 74 of the transmitted ECGs did the cardiologist confirm “abnormal” findings, although in 16, they were considered to be clinically insignificant. Consequently, 58 athletes were referred for further medical examination. Our results indicate that TET (either by fixed telephone line or by mobile phone can ensure valid, reliable, and objective measurements, and significantly contribute to the application of medical screening in a great number of athletes. Therefore, it is recommended as an alternative diagnostic tool for the preparticipation screening of athletes living in remote areas.

  17. Physical examination of swine.

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    Masters, B J; Hamilton, M; Masters, P G

    1992-07-01

    Swine may be examined to evaluate a disease state or a lowered economic performance or as a herd health consultation. As much of the examination as possible should be performed without handling the animal. A thorough history, evaluation of herd records, environmental examination, and herd examination should be performed prior to the evaluation of an individual animal. All necessary equipment should be available when starting the individual examination. The animals is then restrained and examined, and necessary samples are taken. Post-mortem examinations or slaughter house evaluations are a very frequent part of a health examination on swine. All samples taken should be in accordance with the standards of the laboratory that you use. You should work closely with the laboratory to obtain the best results. Physical examination of swine can be rewarding for the veterinarian as well as the producer. The most important aspect to remember is to have enough information and the proper equipment available to handle the animals for the minimal amount of time to gain the maximum benefits. Vietnamese pot-bellied pigs are similar to domestic swine in terms of their diseases and health but are dissimilar in management; pot-bellied pigs are frequently brought to the veterinarian for individual examinations. History is the most valuable part of the examination, followed by observation. Pot-bellied pigs prefer to be held securely with a hand under the chin and rump. The examination is conducted similarly to the examination of any companion animal. Chemical restraint often is necessary for sampling or minor surgical procedures. Owners should be consulted prior to the use of any restraint. This will help win their approval and confidence when working on their pets. While performing the physical examination, look at the pig's overall health as well as specific breed characteristics. Try to stay abreast of swine vaccination recommendations; you may be consulted in this regard. Most

  18. Preparticipation Evaluation for Climbing Sports.

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    Campbell, Aaron D; Davis, Christopher; Paterson, Ryan; Cushing, Tracy A; Ng, Pearlly; Peterson, Charles S; Sedgwick, Peter E; McIntosh, Scott E

    2015-12-01

    Climbing is a popular wilderness sport among a wide variety of professional athletes and amateur enthusiasts, and many styles are performed across many environments. Potential risks confront climbers, including personal health or exacerbation of a chronic condition, in addition to climbing-specific risks or injuries. Although it is not common to perform a preparticipation evaluation (PPE) for climbing, a climber or a guide agency may request such an evaluation before participation. Formats from traditional sports PPEs can be drawn upon, but often do not directly apply. The purpose of this article was to incorporate findings from expert opinion from professional societies in wilderness medicine and in sports medicine, with findings from the literature of both climbing epidemiology and traditional sports PPEs, into a general PPE that would be sufficient for the broad sport of climbing. The emphasis is on low altitude climbing, and an overview of different climbing styles is included. Knowledge of climbing morbidity and mortality, and a standardized approach to the PPE that involves adequate history taking and counseling have the potential for achieving risk reduction and will facilitate further study on the evaluation of the efficacy of PPEs. Copyright © 2015. Published by Elsevier Inc.

  19. Preparticipation Evaluation for Climbing Sports.

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    Campbell, Aaron D; Davis, Christopher; Paterson, Ryan; Cushing, Tracy A; Ng, Pearlly; Peterson, Charles S; Sedgwick, Peter E; McIntosh, Scott E

    2015-09-01

    Climbing is a popular wilderness sport among a wide variety of professional athletes and amateur enthusiasts, and many styles are performed across many environments. Potential risks confront climbers, including personal health or exacerbation of a chronic condition, in addition to climbing-specific risks or injuries. Although it is not common to perform a preparticipation evaluation (PPE) for climbing, a climber or a guide agency may request such an evaluation before participation. Formats from traditional sports PPEs can be drawn upon, but often do not directly apply. The purpose of this article was to incorporate findings from expert opinion from professional societies in wilderness medicine and in sports medicine, with findings from the literature of both climbing epidemiology and traditional sports PPEs, into a general PPE that would be sufficient for the broad sport of climbing. The emphasis is on low altitude climbing, and an overview of different climbing styles is included. Knowledge of climbing morbidity and mortality, and a standardized approach to the PPE that involves adequate history taking and counseling have the potential for achieving risk reduction and will facilitate further study on the evaluation of the efficacy of PPEs.

  20. Normative Functional Performance Values in High School Athletes: The Functional Pre-Participation Evaluation Project.

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    Onate, James A; Starkel, Cambrie; Clifton, Daniel R; Best, Thomas M; Borchers, James; Chaudhari, Ajit; Comstock, R Dawn; Cortes, Nelson; Grooms, Dustin R; Hertel, Jay; Hewett, Timothy E; Miller, Meghan Maume; Pan, Xueliang; Schussler, Eric; Van Lunen, Bonnie L

    2018-01-01

      The fourth edition of the Preparticipation Physical Evaluation recommends functional testing for the musculoskeletal portion of the examination; however, normative data across sex and grade level are limited. Establishing normative data can provide clinicians reference points with which to compare their patients, potentially aiding in the development of future injury-risk assessments and injury-mitigation programs.   To establish normative functional performance and limb-symmetry data for high school-aged male and female athletes in the United States.   Cross-sectional study.   Athletic training facilities and gymnasiums across the United States.   A total of 3951 male and female athletes who participated on high school-sponsored basketball, football, lacrosse, or soccer teams enrolled in this nationwide study.   Functional performance testing consisted of 3 evaluations. Ankle-joint range of motion, balance, and lower extremity muscular power and landing control were assessed via the weight-bearing ankle-dorsiflexion-lunge, single-legged anterior-reach, and anterior single-legged hop-for-distance (SLHOP) tests, respectively. We used 2-way analyses of variance and χ 2 analyses to examine the effects of sex and grade level on ankle-dorsiflexion-lunge, single-legged anterior-reach, and SLHOP test performance and symmetry.   The SLHOP performance differed between sexes (males = 187.8% ± 33.1% of limb length, females = 157.5% ± 27.8% of limb length; t = 30.3, P performance. We observed differences for SLHOP and ankle-dorsiflexion-lunge performance among grade levels, but these differences were not clinically meaningful.   We demonstrated differences in normative data for lower extremity functional performance during preparticipation physical evaluations across sex and grade levels. The results of this study will allow clinicians to compare sex- and grade-specific functional performances and implement approaches for preventing musculoskeletal

  1. Pre-Participation Medical Evaluation for Adventure and Wilderness Watersports.

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    Nathanson, Andrew T; Young, Justin Mark J; Young, Craig

    2015-12-01

    A request for a preparticipation medical evaluation for wilderness watersports may be made by guiding agencies, instructional camps, or by patients presenting for an annual visit. Although guidelines have been published regarding preparticipation physical evaluation for traditional competitive high school and collegiate sports, little has been written about medical evaluations for those wishing to engage in wilderness and adventure watersports. in this article, we offer guidance based on literature review and expert opinion. Watersports are among the most common recreational activities in the United states and are generally safe. Drowning, however, is a significant risk, particularly in small, self-propelled craft, and among children. Medical counseling before participation in watersports should include screening for medical conditions which may impair swimming ability, including a history of seizures, heart disease, and lung disease. Physicians should also promote preventive health measures such as use of lifejackets and sun protection, as well as alcohol avoidance. Swim testing tailored to specific activities should be strongly considered for children and those with questionable swimming ability. Copyright © 2015. Published by Elsevier Inc.

  2. Analysis of Pre-participation Screening Protocols for Football Players in Europe, USA, and Libya: Possible Implications for Preventing Sudden Cardiac Death

    Directory of Open Access Journals (Sweden)

    Salaheddin Sharif

    2017-06-01

    Full Text Available Sudden cardiac death is the leading cause of death in sport participants and may result from undiagnosed cardiac diseases. It has been universally agreed upon that pre-participation screening can identify those athletes at risk of sudden cardiac death, and yet, there is no commonly accepted protocol to screen athletes. Although the European Society of Cardiology (ESC and the American Heart Association (AHA recommend the routine screening of athletes to prevent sudden death, there is significant disagreement regarding the guidelines of the protocols. The American Heart Association protocol includes a detailed medical history and a physical examination, whereas the European Society of Cardiology protocol includes 12-lead electrocardiography with a detailed medical history and a physical examination. The cost benefit of using electrocardiography is debatable, particularly if the screening is used to prevent sudden death associated with uncommon diseases. The Libyan Football Federation established a new seasonal pre-competition medical assessment protocol for Libyan football athletes during the 2013-2014 season, which includes a medical history, physical examination, 12 lead electrocardiography, echocardiography, and blood test. Regardless of cost and differences in protocol, there is a significant value in pre-participation screening for athletes in order to decrease the incidence of sudden cardiac death, and this report examines some of these different protocols as well as their potential for identifying athletes at risk for sudden cardiac death.

  3. [Diagnosis. History and physical examination].

    Science.gov (United States)

    Pérez Martín, Álvaro

    2014-01-01

    Family physicians play a key role in the diagnosis and management of patients with osteoarthritis. Diagnosis is mainly clinical and radiological. A complete history should be taken with meticulous physical examination of the joints. The history-taking should aim to detect risk factors and compatible clinical symptoms. Pain characteristics should be identified, distinguishing between mechanical and inflammatory pain, and an exhaustive examination of the joints should be performed, with evaluation of the presence of pain, deformity, mobility restrictions (both active and passive), crepitus, joint effusion, and inflammation. A differential diagnosis should be made with all diseases that affect the joints and/or produce joint stiffness. Copyright © 2014 Elsevier España, S.L. All rights reserved.

  4. Commentary Preparticipation physical evaluation: An opportunity for ...

    African Journals Online (AJOL)

    standardised procedures for carrying out PPE,7–9 its potential benefits are enormous. ... sports clubs and franchises throughout the world require that athletes ... counselling and anticipatory guidance.12 Over and above this, the PPE process ...

  5. Cost-effectiveness of pre-participation screening of athletes with ECG in Europe and Algeria.

    Science.gov (United States)

    Assanelli, Deodato; Levaggi, Rosella; Carré, François; Sharma, Sanjay; Deligiannis, Asterios; Mellwig, Klaus Peter; Tahmi, Mohamed; Vinetti, Giovanni; Aliverti, Paola

    2015-03-01

    The aim of this study is to evaluate the cost-effectiveness of ECG in combination with family and personal history and physical examination in order to detect cardiovascular diseases that might cause sudden death in athletes. The study was conducted on a cohort of 6,634, mainly young professional and recreational athletes, 1,071 from Algeria and 5,563 from Europe (France, Germany and Greece). Each athlete underwent medical history, physical examination, and resting 12-lead ECG. 293 athletes (4.4 %), 149 in Europe (2.7 %) and 144 in Algeria (13.4 %) required further tests, and 56 were diagnosed with cardiovascular disease and thus disqualified. The cost-effectiveness ratio (CER) was calculated as the ratio between the cost of screening and the number of statistical life-years saved by the intervention. The estimated reduced risk of death deriving from treatment or disqualification resulted in the saving of 79.1 statistical life-years in Europe and 136.3 in Algeria. CER of screening was 4,071 purchasing-power-parity-adjusted US dollars ($PPP) in Europe and 582 $PPP in Algeria. The results of this study strongly support the utilisation of 12-lead ECG in the pre-participation screening of young athletes, especially in countries where secondary preventive care is not highly developed.

  6. Pre-participation screening of asymptomatic athletes : "Don't do stupid stuff".

    Science.gov (United States)

    Mosterd, A

    2018-03-01

    Catastrophic events, be it traffic accidents, natural disasters or homicides, always lead to scrutiny. Could we have seen the event coming and could it have been prevented? In the case of a sudden cardiac arrest of a seemingly healthy athlete the public outcry is not any different. Despite an intrinsic appeal for screening to prevent similar events, there is no evidence that justifies routine cardiovascular pre-participation screening of athletes. On balance, cardiovascular screening in athletes will most likely do more harm than good. Fatal exercise-related cardiac arrests do not occur very often. The true diagnostic yield of the pre-participation evaluation is not known and once a cardiac condition has been identified, the most appropriate intervention is often unclear. It follows that pre-participation screening of large groups of athletes without known cardiac disease will inevitably result in many false positive findings, while at the same time providing a false sense of security to those screened negative. Except for compelling reasons (e. g. cascade screening, research settings, professional athletes), physicians should not engage in routine examination of asymptomatic athletes to prevent cardiac events.

  7. Hypothesis-driven physical examination curriculum.

    Science.gov (United States)

    Allen, Sharon; Olson, Andrew; Menk, Jeremiah; Nixon, James

    2017-12-01

    Medical students traditionally learn physical examination skills as a rote list of manoeuvres. Alternatives like hypothesis-driven physical examination (HDPE) may promote students' understanding of the contribution of physical examination to diagnostic reasoning. We sought to determine whether first-year medical students can effectively learn to perform a physical examination using an HDPE approach, and then tailor the examination to specific clinical scenarios. Medical students traditionally learn physical examination skills as a rote list of manoeuvres CONTEXT: First-year medical students at the University of Minnesota were taught both traditional and HDPE approaches during a required 17-week clinical skills course in their first semester. The end-of-course evaluation assessed HDPE skills: students were assigned one of two cardiopulmonary cases. Each case included two diagnostic hypotheses. During an interaction with a standardised patient, students were asked to select physical examination manoeuvres in order to make a final diagnosis. Items were weighted and selection order was recorded. First-year students with minimal pathophysiology performed well. All students selected the correct diagnosis. Importantly, students varied the order when selecting examination manoeuvres depending on the diagnoses under consideration, demonstrating early clinical decision-making skills. An early introduction to HDPE may reinforce physical examination skills for hypothesis generation and testing, and can foster early clinical decision-making skills. This has important implications for further research in physical examination instruction. © 2016 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

  8. Student-patient communication during physical examination

    NARCIS (Netherlands)

    Cleland, Jennifer; de la Croix, Anne; Cotton, Philip; Coull, Sharon; Skelton, John

    BACKGROUND: Communication during the physical examination has been understudied. Explicit, evidence-based guidance is not available as to the most effective content or process of communication while performing physical examination, or indeed how to teach this to medical students. The objective of

  9. AAPT/NSTA High School Physics Examination.

    Science.gov (United States)

    Nelson, James

    1983-01-01

    Discusses development of the American Association of Physics Teachers and National Science Teachers Association (AAPT/NSTA) high school physics examination. Includes sample examination questions and distribution of topics: mechanics (30 percent), waves/optics/sound (20 percent), heat/kinetic theory (10 percent), electricity/magnetism (25 percent),…

  10. The Hypothesis-Driven Physical Examination.

    Science.gov (United States)

    Garibaldi, Brian T; Olson, Andrew P J

    2018-05-01

    The physical examination remains a vital part of the clinical encounter. However, physical examination skills have declined in recent years, in part because of decreased time at the bedside. Many clinicians question the relevance of physical examinations in the age of technology. A hypothesis-driven approach to teaching and practicing the physical examination emphasizes the performance of maneuvers that can alter the likelihood of disease. Likelihood ratios are diagnostic weights that allow clinicians to estimate the post-probability of disease. This hypothesis-driven approach to the physical examination increases its value and efficiency, while preserving its cultural role in the patient-physician relationship. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. A Practical Concussion Physical Examination Toolbox.

    Science.gov (United States)

    Matuszak, Jason M; McVige, Jennifer; McPherson, Jacob; Willer, Barry; Leddy, John

    With heightened awareness of concussion, there is a need to assess and manage the concussed patient in a consistent manner. Unfortunately, concussion physical examination has not been standardized or supported by evidence. Important questions remain about the physical examination. Review of ClinicalKey, Cochrane, MEDLINE, and PubMed prior to July 2015 was performed using search terms, including concussion, mTBI, physical examination, mental status, cranial nerves, reflexes, cervical, vestibular, and oculomotor. The references of the pertinent articles were reviewed for other relevant sources. Clinical review. Level 3. The pertinent physical examination elements for concussion include evaluation of cranial nerves, manual muscle testing, and deep tendon reflexes; inspecting the head and neck for trauma or tenderness and cervical range of motion; Spurling maneuver; a static or dynamic balance assessment; screening ocular examination; and a mental status examination that includes orientation, immediate and delayed recall, concentration, mood, affect, insight, and judgment. Other examination elements to consider, based on signs, symptoms, or clinical suspicion, include testing of upper motor neurons, cervical strength and proprioception, coordination, pupillary reactivity, and visual acuity; examination of the jaw, temporomandibular joint, and thoracic spine; fundoscopic evaluation; orthostatic vital signs; assessment of dynamic visual acuity; and screening for depression, anxiety, substance abuse disorders, and preinjury psychiatric difficulties. Various elements of the physical examination, such as screening ocular examination, cervical musculoskeletal examination, static and/or dynamic balance assessment, and mental status examination, appear to have utility for evaluating concussion; however, data on validity are lacking.

  12. A Practical Concussion Physical Examination Toolbox

    Science.gov (United States)

    Matuszak, Jason M.; McVige, Jennifer; McPherson, Jacob; Willer, Barry; Leddy, John

    2016-01-01

    Context: With heightened awareness of concussion, there is a need to assess and manage the concussed patient in a consistent manner. Unfortunately, concussion physical examination has not been standardized or supported by evidence. Important questions remain about the physical examination. Evidence Acquisition: Review of ClinicalKey, Cochrane, MEDLINE, and PubMed prior to July 2015 was performed using search terms, including concussion, mTBI, physical examination, mental status, cranial nerves, reflexes, cervical, vestibular, and oculomotor. The references of the pertinent articles were reviewed for other relevant sources. Study Design: Clinical review. Level of Evidence: Level 3. Results: The pertinent physical examination elements for concussion include evaluation of cranial nerves, manual muscle testing, and deep tendon reflexes; inspecting the head and neck for trauma or tenderness and cervical range of motion; Spurling maneuver; a static or dynamic balance assessment; screening ocular examination; and a mental status examination that includes orientation, immediate and delayed recall, concentration, mood, affect, insight, and judgment. Other examination elements to consider, based on signs, symptoms, or clinical suspicion, include testing of upper motor neurons, cervical strength and proprioception, coordination, pupillary reactivity, and visual acuity; examination of the jaw, temporomandibular joint, and thoracic spine; fundoscopic evaluation; orthostatic vital signs; assessment of dynamic visual acuity; and screening for depression, anxiety, substance abuse disorders, and preinjury psychiatric difficulties. Conclusion: Various elements of the physical examination, such as screening ocular examination, cervical musculoskeletal examination, static and/or dynamic balance assessment, and mental status examination, appear to have utility for evaluating concussion; however, data on validity are lacking. PMID:27022058

  13. Preparticipation Screening of Athletic Officials: SEC Football Referees at Risk.

    Science.gov (United States)

    Turner, John L; Walters, Rod; Leski, Mark J; Saywell, Robert M; Wooldridge, J Scott

    2003-03-01

    Although preparticipation screening for athletes is commonplace, few studies have addressed the issue for those officiating at games. To review current data on physiologic stress on sports officials, to obtain prevalence data on health parameters for football officials, and to determine the outcomes when screening criteria are applied in preseason exams. A protocol was established using health history questionnaires and physical exams with laboratory screening to assess the health of all football officials working in the Southeastern Conference (SEC) from 1997 to 2000. The main outcome measure was the prevalence of cardiac risk factors as determined by American College of Sports Medicine guidelines. Initial screening of 102 football officials revealed that 10.1% of SEC referees had elevated systolic blood pressure, 13.9% had elevated diastolic blood pressure, and 3.8% had resting tachycardia. Average body mass index (BMI) was 28.6 kg/m2, with 87.3% having a BMI that exceeded 25 (overweight). About one-third (31.6%) had a BMI greater than 30 (obese). Total fasting cholesterol exceeded 200 mg/dL in 44.2%, HDL levels were below 35 mg/dL in 34.3%, and LDL levels were above 120 mg/dL in 62.3%. Compared with age-adjusted national data, there were more overweight and more obese officials, but they had lower systolic and diastolic blood pressures and lower mean total cholesterol levels. Using the Framingham Study prediction model to estimate coronary heart disease (CHD) risk, analysis revealed that referees had a lower risk than the national 10-year CHD risk but a higher risk compared with that of the low-risk population. These data reveal a greater need for graded exercise testing. The higher rates of obesity among officials will promote further screening for CHD risk factors.

  14. Distinguishing hypertrophic cardiomyopathy from athlete's heart physiological remodelling: clinical significance, diagnostic strategies and implications for preparticipation screening.

    Science.gov (United States)

    Maron, B J

    2009-09-01

    Sudden cardiac death in young competitive athletes is an important public health problem, although a relatively low-event-rate phenomenon. The single most common cardiovascular cause of these unexpected catastrophes is hypertrophic cardiomyopathy (HCM), accounting for about one-third of cases. Since the phenotypic expression of HCM is variable, and not uncommonly includes patients with mild and localised left ventricular hypertrophy, the differential diagnosis with physiological remodelling of athlete's heart not uncommonly arises. This review discusses those non-invasive strategies that are useful in distinguishing the benign consequences of systematic athletic training from pathological left ventricular hypertrophy with the potential for sudden cardiac death. Preparticipation screening in healthy general athlete populations may raise the suspicion of HCM, and ultimately lead to definitive diagnosis. However, recently controversy has arisen regarding the most effective and practical strategy for the screening of athletes. European investigators have promoted routine 12-lead ECGs as part of a national mandatory programme distinct from the customary practice in the US which is limited to history and physical examinations. Consensus criteria and recommendations for eligibility and disqualification of athletes with HCM (and other cardiovascular abnormalities) have proved useful to the practising community.

  15. Exploration of the attitudes of nursing students to peer physical examination and physical examination of patients.

    Science.gov (United States)

    Wearn, Andy M; Bhoopatkar, Harsh; Mathew, Thomas K; Stewart, Lisa

    2013-08-01

    The use of peer physical examination (PPE) in early clinical skills has been studied amongst medical students. The majority of students are comfortable with using peer physical examination, when sensitive areas are excluded. Students' attitudes are related to their personal characteristics: gender, age, religious faith, and ethnicity. There is no data on nursing students' attitudes to peer physical examination. Identify and explore: Dual cohort, cross-sectional, anonymous survey. Three-year undergraduate nursing programme, skills centre and service clinical learning. All first and third year nursing students were asked to complete a modified Examining Fellow Students questionnaire at the end of 2008. The questionnaire asked students to indicate which of 12 body areas they would not be willing to examine/have examined by a peer of the same/opposite gender. This study also asked students which of the 12 body areas they felt uncomfortable examining on patients. The response rate was 76% (128/168). The students were predominantly female (93% female; 7% male). Most students were comfortable with examining non-sensitive body regions of peers (78.2%-100% willing) and patients (92.3-100% willing). Male gender was significantly associated with willingness to examine and be examined by peers (p=0.001); Asian students were significantly less willing to engage in peer physical examination with opposite gender (pexamining patients of either gender (pexamination shows similarities and differences to other studies. Student characteristics were not related to patient examination attitudes. Copyright © 2012 Elsevier Ltd. All rights reserved.

  16. Chemical and physical quality examination: Chapter 4

    Science.gov (United States)

    Lamar, William

    1953-01-01

    In a balanced study of water pollution or water utilization a thorough chemical and physical examination is essential. This provides a basis for evaluation of stream conditions, their effects and remedies. Such information is of value to the general public who are interested in clean water and in recreation, hunting, fishing, and wildlife; to the chemist, engineer, hydrologist, and industrialist who are interested in the domestic and industrial use of water both as raw material and as a vehicle for the removal of waste materials; to the sanitarian who is interested in healthful conditions; and to the biologist who is interested in maintaining a favorable biological balance. For every living plant and animal there are optimum physical and chemical conditions and these characteristics are determining factors in the aquatic life of any body of water.

  17. The Enduring Value of the Physical Examination.

    Science.gov (United States)

    Zaman, Junaid A B

    2018-05-01

    This article focuses exclusively on physical examination (PE) in the context of clinical medicine, that is, the interaction between a health care provider and patient. In essence, there is not only benefit (value) to PE but also that it will last (endure) for some time. Both "enduring" and "value" are explored in more depth with respect to the future integration of PE into the clinical assessment of a patient and how its value extends well beyond current diagnostic/cost-based metrics. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

  18. Can Physical Examination Create a Stener Lesion?

    Science.gov (United States)

    Lankachandra, Manesha; Eggers, John P; Bogener, James W; Hutchison, Richard L

    2017-09-01

    The purpose of this study is to determine whether a Stener lesion can be created while testing stability of the ulnar collateral ligament (UCL) of the thumb. Testing was performed in a manner that reproduced clinical examination. Six fresh frozen hand and forearm specimens underwent sequential sectioning of the accessory UCL, the proper UCL, and the ulnar sagittal band. Measurements of radial deviation of the metacarpophalangeal (MCP) joint were taken with the thumb in neutral rotation, pronation and supination, both with 0 degrees and with 30 degrees of flexion of the MCP joint. Visual examination was performed to assess the presence of a Stener lesion. No Stener lesion was created in any position as long as the fascial origin of the ulnar sagittal band at the adductor pollicis longus remained intact. After creating a defect in the ulnar sagittal band, a Stener lesion was created in two specimens, but only when the thumb was flexed and supinated. Pronation provided more stability, and supination provided less stability, with one or both components cut, especially when testing at 30° of flexion. Compared to both components cut without flexion or rotation, there was a statistically significant difference in angulation with the 30 degrees of MCP joint flexion in both neutral rotation in supination. Performing a physical examination to assess the amount of instability of an ulnar collateral ligament injury did not create a Stener lesion if the exam was performed in a controlled, gentle manner with the thumb held without rotation. If the thumb is held in neutral rotation during the exam, an iatrogenic Stener lesion should not be created.

  19. Comparison of Alcohol Use Disorder Screens During College Athlete Pre-Participation Evaluations.

    Science.gov (United States)

    Majka, Erek; Graves, Travis; Diaz, Vanessa A; Player, Marty S; Dickerson, Lori M; Gavin, Jennifer K; Wessell, Andrea

    2016-05-01

    The US Preventive Services Task Force (USPSTF) recommends screening adults for alcohol misuse, a challenge among young adults who may not have regular primary care. The pre-participation evaluation (PPE) provides an opportunity for screening, but traditional screening tools require extra time in an already busy visit. The objective of this study was to compare the 10-item Alcohol Use Disorders Identification Test (AUDIT) with a single-question alcohol misuse screen in a population of college-aged athletes. This cross-sectional study was performed during an athletic PPE clinic at a college in the Southeastern United States among athletes ages 18 years and older. Written AUDIT and single-question screen "How many times in the past year have you had X or more drinks in a day?" (five for men, four for women) asked orally were administered to each participant. Sensitivity, specificity, and positive and negative predictive values for the single-question screen were compared to AUDIT. A total of 225 athletes were screened; 60% were female; 29% screened positive by AUDIT; 59% positive by single-question instrument. Males were more likely to screen positive by both methods. Compared to the AUDIT, the brief single-question screen had 92% sensitivity for alcohol misuse and 55% specificity. The negative predictive value of the single-question screen was 95% compared to AUDIT. A single-question screen for alcohol misuse in college-aged athletes had a high sensitivity and negative predictive value compared to the more extensive AUDIT screen. Ease of administration of this screening tool is ideal for use within the pre-participation physical among college-aged athletes who may not seek regular medical care.

  20. Interobserver reliability of physical examination of shoulder girdle

    NARCIS (Netherlands)

    Nomden, Jettie G.; Slagers, Anton J.; Bergman, Geert; Winters, Jan C.; Kropmans, Thomas J. B.; Dijkstra, Pieter U.

    The object of this study was to assess interobserver reliability in 23 tests concerning physical examination of the shoulder girdle. A physical therapist and a physical therapist/manual therapist independently performed a physical examination of the shoulder girdle in 91 patients with shoulder

  1. Adherence to guidelines for cardiovascular screening in current high school preparticipation evaluation forms.

    Science.gov (United States)

    Rausch, Christopher M; Phillips, George C

    2009-10-01

    We compared the content of the cardiac screening questions on US state high school athletic association preparticipation evaluation forms with current consensus recommendations. We reviewed the high school athletic association's approved, recommended, or required sports preparticipation form from each of the 50 US states and the District of Columbia, and compared the content of the personal and family history components with current recommendations for cardiac screening questions. We found that 85% of the preparticipation forms in current use contain all elements of the formerly recommended guidelines, but only 17% contain all elements of the new consensus guidelines. We conclude that although there appears to be some improvement in the content of the preparticipation forms in current use compared with previous studies, the vast majority of these forms are incomplete compared with current consensus guidelines.

  2. Examining the Gender Gap in Introductory Physics

    Science.gov (United States)

    Kost, Lauren; Pollock, Steven; Finkelstein, Noah

    2009-05-01

    Our previous research[1] showed that despite the use of interactive engagement techniques in the introductory physics course, the gap in performance between males and females on a mechanics conceptual learning survey persisted from pre- to post-test, at our institution. Such findings were counter to previously published work[2]. Follow-up studies[3] identified correlations between student performance on the conceptual learning survey and students' prior physics and math knowledge and their incoming attitudes and beliefs about physics and learning physics. The results indicate that the gender gap at our institution is predominantly associated with differences in males' and females' previous physics and math knowledge, and attitudes and beliefs. Our current work extends these results in two ways: 1) we look at the gender gap in the second semester of the introductory sequence and find results similar to those in the first semester course and 2) we identify ways in which males and females differentially experience several aspects of the introductory course. [1] Pollock, et al, Phys Rev: ST: PER 3, 010107. [2] Lorenzo, et al, Am J Phys 74, 118. [3] Kost, et al, PERC Proceedings 2008.

  3. 21 CFR 1210.12 - Physical examination of cows.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Physical examination of cows. 1210.12 Section 1210... FEDERAL IMPORT MILK ACT Inspection and Testing § 1210.12 Physical examination of cows. (a) Physical examination of any and all cows in herds producing milk or cream which is to be shipped or transported into...

  4. Lasers In Physical Evidence Examination: An Overview

    Science.gov (United States)

    Menzel, E. R.

    1987-01-01

    A recent application of fluorescence that is perhaps largely unknown outside law enforcement involves the utilization of laser excited fluorescence (LEF) in forensic science. In this overview, the focus is on LEF applicaton to development of latent fingerprints. Other areas of criminalistics, such as document examination and fiber analysis will be dealt with briefly only. To bring the technical reader, who likely has little familiarity with the fingerprint field, up to stream, a historical introduction precedes the description of current procedures for laser detection of latent fingerprints which is followed by a brief outline of current areas of research in the fingerprint area and application of lasers to other types of evidence examination. The overview concludes with an assessment of the current state and utilization growth prognosis of lasers in criminalistics.

  5. Physical examination is sufficient for the diagnosis of sprained ankles

    NARCIS (Netherlands)

    van Dijk, C. N.; Lim, L. S.; Bossuyt, P. M.; Marti, R. K.

    1996-01-01

    We studied the merits of physical examination after inversion injury of the ankle in 160 consecutive patients. They had an explanatory operation if they had a positive arthrogram and/or positive signs on a delayed physical examination. To determine the interobserver variation in delayed physical

  6. History and Physical Examination for Shoulder Instability.

    Science.gov (United States)

    Haley, Col Chad A

    2017-09-01

    Glenohumeral instability frequently occurs in young active individuals especially those engaged in athletic and military activities. With advanced imaging and arthroscopic evaluation, our understanding of the injury patterns associated with instability has significantly improved. The majority of instability results from a traumatic anterior event which presents with common findings in the history, examination, and imaging studies. As such, a comprehensive evaluation of the patient is important to correctly diagnose the instability patterns and thus provide appropriate treatment intervention. With the correct diagnosis and improved surgical techniques, the majority of patients with instability can return to preinjury levels.

  7. Evolution of physics examining 1940-2000 at Cambridge

    Science.gov (United States)

    Roberts, A.; Brown, L. M.

    2001-07-01

    Much controversy exists about the supposed changing examination standards. Emphasis has been placed on the standards of GCSE and A-level examinations. However, many large employers recruit graduates, and so university examination standards also deserve attention. Here, Cambridge University Part II (third year undergraduate) examinations in Physics are studied since 1940. Trends in prescriptiveness, choice of questions, and other variables were found.

  8. Diagnosis of thyroid disease. Anamnesis and physical examination

    International Nuclear Information System (INIS)

    Freudenberg, L.S.

    2008-01-01

    Anamnesis and physical examination rank first in the diagnostic process of thyroid disease. They provide a basis for subsequent diagnostic procedures and treatment. This article focusses on personal, medical and familial history as well as physical examination of the neck and general clinical examination with respect to signs and symptoms of hypo- or hyperthyreoidism. In addition indications for fine-needle biopsy and biopsy technique are described. (orig.)

  9. Physical activity for health: examining similarities and differences ...

    African Journals Online (AJOL)

    In the face of a rising diabetes epidemic, a target population for prevention programme is the children of patients with type 2 diabetes. This study examined physical activity of patients with type 2 diabetes and that of their adult children, and characterized the factors associated with physical inactivity among the participants.

  10. Bias in the physical examination of patients with lumbar radiculopathy

    Directory of Open Access Journals (Sweden)

    Katz Jeffrey N

    2010-11-01

    Full Text Available Abstract Background No prior studies have examined systematic bias in the musculoskeletal physical examination. The objective of this study was to assess the effects of bias due to prior knowledge of lumbar spine magnetic resonance imaging findings (MRI on perceived diagnostic accuracy of the physical examination for lumbar radiculopathy. Methods This was a cross-sectional comparison of the performance characteristics of the physical examination with blinding to MRI results (the 'independent group' with performance in the situation where the physical examination was not blinded to MRI results (the 'non-independent group'. The reference standard was the final diagnostic impression of nerve root impingement by the examining physician. Subjects were recruited from a hospital-based outpatient specialty spine clinic. All adults age 18 and older presenting with lower extremity radiating pain of duration ≤ 12 weeks were evaluated for participation. 154 consecutively recruited subjects with lumbar disk herniation confirmed by lumbar spine MRI were included in this study. Sensitivities and specificities with 95% confidence intervals were calculated in the independent and non-independent groups for the four components of the radiculopathy examination: 1 provocative testing, 2 motor strength testing, 3 pinprick sensory testing, and 4 deep tendon reflex testing. Results The perceived sensitivity of sensory testing was higher with prior knowledge of MRI results (20% vs. 36%; p = 0.05. Sensitivities and specificities for exam components otherwise showed no statistically significant differences between groups. Conclusions Prior knowledge of lumbar MRI results may introduce bias into the pinprick sensory testing component of the physical examination for lumbar radiculopathy. No statistically significant effect of bias was seen for other components of the physical examination. The effect of bias due to prior knowledge of lumbar MRI results should be considered

  11. Bias in the physical examination of patients with lumbar radiculopathy

    Science.gov (United States)

    2010-01-01

    Background No prior studies have examined systematic bias in the musculoskeletal physical examination. The objective of this study was to assess the effects of bias due to prior knowledge of lumbar spine magnetic resonance imaging findings (MRI) on perceived diagnostic accuracy of the physical examination for lumbar radiculopathy. Methods This was a cross-sectional comparison of the performance characteristics of the physical examination with blinding to MRI results (the 'independent group') with performance in the situation where the physical examination was not blinded to MRI results (the 'non-independent group'). The reference standard was the final diagnostic impression of nerve root impingement by the examining physician. Subjects were recruited from a hospital-based outpatient specialty spine clinic. All adults age 18 and older presenting with lower extremity radiating pain of duration ≤ 12 weeks were evaluated for participation. 154 consecutively recruited subjects with lumbar disk herniation confirmed by lumbar spine MRI were included in this study. Sensitivities and specificities with 95% confidence intervals were calculated in the independent and non-independent groups for the four components of the radiculopathy examination: 1) provocative testing, 2) motor strength testing, 3) pinprick sensory testing, and 4) deep tendon reflex testing. Results The perceived sensitivity of sensory testing was higher with prior knowledge of MRI results (20% vs. 36%; p = 0.05). Sensitivities and specificities for exam components otherwise showed no statistically significant differences between groups. Conclusions Prior knowledge of lumbar MRI results may introduce bias into the pinprick sensory testing component of the physical examination for lumbar radiculopathy. No statistically significant effect of bias was seen for other components of the physical examination. The effect of bias due to prior knowledge of lumbar MRI results should be considered when an isolated

  12. A comprehensive and cost-effective preparticipation exam implemented on the World Wide Web.

    Science.gov (United States)

    Peltz, J E; Haskell, W L; Matheson, G O

    1999-12-01

    Mandatory preparticipation examinations (PPE) are labor intensive, offer little routine health maintenance and are poor predictors of future injury or illness. Our objective was to develop a new PPE for the Stanford University varsity athletes that improved both quality of primary and preventive care and physician time efficiency. This PPE is based on the annual submission, by each athlete, of a comprehensive medical history questionnaire that is then summarized in a two-page report for the examining physician. The questionnaire was developed through a search of MEDLINE from 1966 to 1997, review of PPE from 11 other institutions, and discussion with two experts from each of seven main content areas: medical and musculoskeletal history, eating, menstrual and sleep disorders, stress and health risk behaviors. Content validity was assessed by 10 sports medicine physicians and four epidemiologists. It was then programmed for the World Wide Web (http:// www.stanford.edu/dept/sportsmed/). The questionnaire demonstrated a 97 +/- 2% sensitivity in detecting positive responses requiring physician attention. Sixteen physicians administered the 1997/98 PPE; using the summary reports, 15 found improvement in their ability to provide overall medical care including health issues beyond clearance; 13 noted a decrease in time needed for each athlete exam. Over 90% of athletes who used the web site found it "easy" or "moderately easy" to access and complete. Initial assessment of this new PPE format shows good athlete compliance, improved exam efficiency and a strong increase in subjective physician satisfaction with the quality of screening and medical care provided. The data indicate a need for improvement of routine health maintenance in this population. The database offers opportunities to study trends, risk factors, and results of interventions.

  13. The Physical Examination as Ritual: Social Sciences and Embodiment in the Context of the Physical Examination.

    Science.gov (United States)

    Costanzo, Cari; Verghese, Abraham

    2018-05-01

    The privilege of examining a patient is a skill of value beyond its diagnostic utility. A thorough physical examination is an important ritual that benefits patients and physicians. The concept of embodiment helps one understand how illness and pain further define and shape the lived experiences of individuals in the context of their race, gender, sexuality, and socioeconomic status. Understanding ritual in medicine, including the placebo effects of such rituals, reaffirms the centrality of the physical examination to the process of building strong physician-patient relationships. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. ACL injury: How do the physical examination tests compare?

    Science.gov (United States)

    Koster, Christiaan H; Harmsen, Annelieke Mk; Lichtenberg, Miranda C; Bloemers, Frank W

    2018-03-01

    Three physical examination tests are most commonly used to evaluate cruciate ligament injury. The best known and most frequently used technique is the anterior drawer test. The other 2 tests, the Lachman test and the pivot shift test, are more difficult to perform and are used less often, especially by physicians untrained in their use. In addition, there is a relatively new diagnostic test: the lever sign test. The aim of our article is to provide a short, clinically relevant overview of the literature and to assess the diagnostic value of physical examination for the primary care physician.

  15. Examining issues of underrepresented minority students in introductory physics

    Science.gov (United States)

    Watkins, Jessica Ellen

    In this dissertation we examine several issues related to the retention of under-represented minority students in physics and science. In the first section, we show that in calculus-based introductory physics courses, the gender gap on the FCI is diminished through the use of interactive techniques, but in lower-level introductory courses, the gap persists, similar to reports published at other institutions. We find that under-represented racial minorities perform similar to their peers with comparable academic preparation on conceptual surveys, but their average exam grades and course grades are lower. We also examine student persistence in science majors; finding a significant relationship between pedagogy in an introductory physics course and persistence in science. In the second section, we look at student end-of-semester evaluations and find that female students rate interactive teaching methods a full point lower than their male peers. Looking more deeply at student interview data, we find that female students report more social issues related to the discussions in class and both male and female students cite feeling pressure to obtain the correct answer to clicker questions. Finally, we take a look an often-cited claim for gender differences in STEM participation: cognitive differences explain achievement differences in physics. We examine specifically the role of mental rotations in physics achievement and problem-solving, viewing mental rotations as a tool that students can use on physics problems. We first look at student survey results for lower-level introductory students, finding a low, but significant correlation between performance on a mental rotations test and performance in introductory physics courses. In contrast, we did not find a significant relationship for students in the upper-level introductory course. We also examine student problem-solving interviews to investigate the role of mental rotations on introductory problems.

  16. Cardiac Limited Ultrasound Examination Techniques to Augment the Bedside Cardiac Physical Examination.

    Science.gov (United States)

    Kimura, Bruce J; Shaw, David J; Amundson, Stan A; Phan, James N; Blanchard, Daniel G; DeMaria, Anthony N

    2015-09-01

    The current practice of physical diagnosis is dependent on physician skills and biases, inductive reasoning, and time efficiency. Although the clinical utility of echocardiography is well known, few data exist on how to integrate 2-dimensional screening "quick-look" ultrasound applications into a novel, modernized cardiac physical examination. We discuss the evidence basis behind ultrasound "signs" pertinent to the cardiovascular system and elemental in synthesis of bedside diagnoses and propose the application of a brief cardiac limited ultrasound examination based on these signs. An ultrasound-augmented cardiac physical examination can be taught in traditional medical education and has the potential to improve bedside diagnosis and patient care. © 2015 by the American Institute of Ultrasound in Medicine.

  17. The value of physical examination in mental health nursing.

    Science.gov (United States)

    Martin, Carolyn T

    2016-03-01

    This article explores the use of a physical examination assignment in a mental health general nursing clinical placement course that addresses the poor physical health of people with mental illness and the barriers traditionally impeding health care provision for this population. A descriptive qualitative approach utilizes inductive content analysis to investigate 145 student survey responses. The assignment assists student nurses in understanding that physical and mental well-being are intrinsically linked. Students report increased comfort performing a physical examination on patients with mental illness post assignment. Students' initial bias towards this population was minimized post the clinical assignment. Poor physical health is common among people with mental health problems. Many view the provision of care as a major public health issue. Nurses are the front line caregivers of mental health service consumers and are well positioned to assess their physical needs. Their assessment may be the first step in recognizing health care issues in this population. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. Risk Factors, Pathobiomechanics and Physical Examination of Rotator Cuff Tears

    Science.gov (United States)

    Moulton, Samuel G.; Greenspoon, Joshua A.; Millett, Peter J.; Petri, Maximilian

    2016-01-01

    Background: It is important to appreciate the risk factors for the development of rotator cuff tears and specific physical examination maneuvers. Methods: A selective literature search was performed. Results: Numerous well-designed studies have demonstrated that common risk factors include age, occupation, and anatomic considerations such as the critical shoulder angle. Recently, research has also reported a genetic component as well. The rotator cuff axially compresses the humeral head in the glenohumeral joint and provides rotational motion and abduction. Forces are grouped into coronal and axial force couples. Rotator cuff tears are thought to occur when the force couples become imbalanced. Conclusion: Physical examination is essential to determining whether a patient has an anterosuperior or posterosuperior tear. Diagnostic accuracy increases when combining a series of examination maneuvers. PMID:27708731

  19. History and physical examination of hip injuries in elderly adults.

    Science.gov (United States)

    Hamedan Al Maqbali, Mohammed Abdullah

    2014-01-01

    Hip fracture is the most common injury occurring to elderly people and is associated with restrictions of the activities of the patients themselves. The discovery of a hip fracture can be the beginning of a complex journey of care, from initial diagnosis, through operational procedures to rehabilitation. The patient's history and physical examination form the basis of the diagnosis and monitoring of elderly patients with hip problems and dictate the appropriate treatment strategy to be implemented. The aim of this study is to discuss the different diagnoses of hip pain in a case study of an elderly woman who initially complained of pain in her right knee following a fall at home. It shows that musculoskeletal physical examination determined the management of the hip fracture that was found to be present. In addition, the aim of this article is to review diagnostic tests such as radiographs and recommend appropriate management and treatment of hip fractures in elderly patients.

  20. Physical examination prior to initiating hormonal contraception: a systematic review.

    Science.gov (United States)

    Tepper, Naomi K; Curtis, Kathryn M; Steenland, Maria W; Marchbanks, Polly A

    2013-05-01

    Provision of contraception is often linked with physical examination, including clinical breast examination (CBE) and pelvic examination. This review was conducted to evaluate the evidence regarding outcomes among women with and without physical examination prior to initiating hormonal contraceptives. The PubMed database was searched from database inception through March 2012 for all peer-reviewed articles in any language concerning CBE and pelvic examination prior to initiating hormonal contraceptives. The quality of each study was assessed using the United States Preventive Services Task Force grading system. The search did not identify any evidence regarding outcomes among women screened versus not screened with CBE prior to initiation of hormonal contraceptives. The search identified two case-control studies of fair quality which compared women who did or did not undergo pelvic examination prior to initiating oral contraceptives (OCs) or depot medroxyprogesterone acetate (DMPA). No differences in risk factors for cervical neoplasia, incidence of sexually transmitted infections, incidence of abnormal Pap smears or incidence of abnormal wet mount findings were observed. Although women with breast cancer should not use hormonal contraceptives, there is little utility in screening prior to initiation, due to the low incidence of breast cancer and uncertain value of CBE among women of reproductive age. Two fair quality studies demonstrated no differences between women who did or did not undergo pelvic examination prior to initiating OCs or DMPA with respect to risk factors or clinical outcomes. In addition, pelvic examination is not likely to detect any conditions for which hormonal contraceptives would be unsafe. Published by Elsevier Inc.

  1. Comparing Physical Examination With Sonographic Versions of the Same Examination Techniques for Splenomegaly.

    Science.gov (United States)

    Cessford, Tara; Meneilly, Graydon S; Arishenkoff, Shane; Eddy, Christopher; Chen, Luke Y C; Kim, Daniel J; Ma, Irene W Y

    2017-12-08

    To determine whether sonographic versions of physical examination techniques can accurately identify splenomegaly, Castell's method (Ann Intern Med 1967; 67:1265-1267), the sonographic Castell's method, spleen tip palpation, and the sonographic spleen tip technique were compared with reference measurements. Two clinicians trained in bedside sonography patients recruited from an urban hematology clinic. Each patient was examined for splenomegaly using conventional percussion and palpation techniques (Castell's method and spleen tip palpation, respectively), as well as the sonographic versions of these maneuvers (sonographic Castell's method and sonographic spleen tip technique). Results were compared with a reference standard based on professional sonographer measurements. The sonographic Castell's method had greater sensitivity (91.7% [95% confidence interval, 61.5% to 99.8%]) than the traditional Castell's method (83.3% [95% confidence interval, 51.6% to 97.9%]) but took longer to perform [mean ± SD, 28.8 ± 18.6 versus 18.8 ± 8.1 seconds; P = .01). Palpable and positive sonographic spleen tip results were both 100% specific, but the sonographic spleen tip method was more sensitive (58.3% [95% confidence interval, 27.7% to 84.8%] versus 33.3% [95% confidence interval, 9.9% to 65.1%]). Sonographic versions of traditional physical examination maneuvers have greater diagnostic accuracy than the physical examination maneuvers from which they are derived but may take longer to perform. We recommend a combination of traditional physical examination and sonographic techniques when evaluating for splenomegaly at the bedside. © 2017 by the American Institute of Ultrasound in Medicine.

  2. Hip Dysplasia: Clinical Signs and Physical Examination Findings.

    Science.gov (United States)

    Syrcle, Jason

    2017-07-01

    Hip dysplasia is a common developmental disorder of the dog, consisting of varying degrees of hip laxity, progressive remodeling of the structures of the hip, and subsequent development of osteoarthritis. It is a juvenile-onset condition, with clinical signs often first evident at 4 to 12 months of age. A tentative diagnosis of hip dysplasia can be made based on signalment, history, and physical examination findings. The Ortolani test is a valuable tool for identifying juvenile dogs affected with this condition. Further diagnostics can then be prioritized, contributing to prompt diagnosis and appropriate treatment. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Physical examination tests for hip dysfunction and injury.

    Science.gov (United States)

    Reiman, Michael P; Mather, Richard C; Cook, Chad E

    2015-03-01

    Physical examination tests for hip dysfunction and injury of the strongest diagnostic accuracy were identified in a recent systematic review with meta-analysis in BJSM. These tests are described in this article. A detailed description of the various different tests is given, with photographs for each test procedure. Diagnostic interpretation of each test requires careful consideration, with special attention to specific variables such as test performance and patient population. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  4. Clinical history and physical examination skills - A requirement for radiographers?

    International Nuclear Information System (INIS)

    Snaith, Beverly A.; Lancaster, Anne

    2008-01-01

    Radiographer's roles have evolved with their scope broadening over the last 20 years culminating in the development of advanced and consultant posts. Yet one development has not been embraced, despite being inherent in medicine and a common extension of nurse and other allied health professionals' roles, is that of clinical assessment. This article explores the evolving role of the radiographer and discusses whether this should include skills in clinical history taking and physical examination. Issues for education and development will be addressed together with examples of current and potential roles

  5. A Mokken scale analysis of the peer physical examination questionnaire.

    Science.gov (United States)

    Vaughan, Brett; Grace, Sandra

    2018-01-01

    Peer physical examination (PPE) is a teaching and learning strategy utilised in most health profession education programs. Perceptions of participating in PPE have been described in the literature, focusing on areas of the body students are willing, or unwilling, to examine. A small number of questionnaires exist to evaluate these perceptions, however none have described the measurement properties that may allow them to be used longitudinally. The present study undertook a Mokken scale analysis of the Peer Physical Examination Questionnaire (PPEQ) to evaluate its dimensionality and structure when used with Australian osteopathy students. Students enrolled in Year 1 of the osteopathy programs at Victoria University (Melbourne, Australia) and Southern Cross University (Lismore, Australia) were invited to complete the PPEQ prior to their first practical skills examination class. R, an open-source statistics program, was used to generate the descriptive statistics and perform a Mokken scale analysis. Mokken scale analysis is a non-parametric item response theory approach that is used to cluster items measuring a latent construct. Initial analysis suggested the PPEQ did not form a single scale. Further analysis identified three subscales: 'comfort', 'concern', and 'professionalism and education'. The properties of each subscale suggested they were unidimensional with variable internal structures. The 'comfort' subscale was the strongest of the three identified. All subscales demonstrated acceptable reliability estimation statistics (McDonald's omega > 0.75) supporting the calculation of a sum score for each subscale. The subscales identified are consistent with the literature. The 'comfort' subscale may be useful to longitudinally evaluate student perceptions of PPE. Further research is required to evaluate changes with PPE and the utility of the questionnaire with other health profession education programs.

  6. Predictors of Heavy Stethoscope Contamination Following a Physical Examination.

    Science.gov (United States)

    Tschopp, Clément; Schneider, Alexis; Longtin, Yves; Renzi, Gesuele; Schrenzel, Jacques; Pittet, Didier

    2016-06-01

    BACKGROUND The degree of bacterial contamination of stethoscopes can vary significantly following a physical examination. OBJECTIVE To conduct a prospective study to investigate the impact of various environmental and patient characteristics on stethoscope contamination. METHODS Following a standardized examination, the levels of bacterial contamination of 4 regions of the physicians' hands and 2 sections of the stethoscopes, and the presence of different pathogenic bacteria, were assessed. Predictors of heavy stethoscope contamination were identified through multivariate logistic regression. RESULTS In total, 392 surfaces were sampled following examination of 56 patients. The microorganisms most frequently recovered from hands and stethoscopes were Enterococcus spp. (29% and 20%, respectively) and Enterobacteriaceae (16% and 7%, respectively). Staphylococcus aureus (either methicillin susceptible or resistant), extended-spectrum β-lactamase-producing Enterobacteriaceae, and Acinetobacter baumannii were recovered from 4%-9% of the samples from either hands or stethoscopes. There was a correlation between the likelihood of recovering these pathogens from the stethoscopes vs from the physicians' hands (ρ=0.79; P=.04). The level of patient's skin contamination was an independent predictor of contamination of the stethoscope diaphragm (adjusted odds ratio [aOR], 1.001; P=.007) and tube (aOR, 1.001; P=.003). Male sex (aOR, 28.24; P=.01) and reception of a bed bath (aOR, 7.52; P=.048) were also independently associated with heavy tube contamination. CONCLUSIONS Stethoscope contamination following a single physical examination is not negligible and is associated with the level of contamination of the patient's skin. Prevention of pathogen dissemination is needed. Infect Control Hosp Epidemiol 2016;37:673-679.

  7. Canada's Physical Activity Guide: examining print-based material for motivating physical activity in the workplace.

    Science.gov (United States)

    Plotnikoff, Ronald C; Todosijczuk, Ivan; Johnson, Steven T; Karunamuni, Nandini

    2012-01-01

    The authors conducted a secondary analysis on 202 adults from the Physical Activity Workplace Study. The aim of this analysis was to examine demographic characteristics associated with reading Canada's Physical Activity Guide (CPAG), being motivated by the guide, and whether participants in the Physical Activity Workplace Study who read the CPAG increased their physical activity levels over 1 year. Results revealed that less than 50% of participants read the full version of CPAG, and less than 10% were motivated by it. The CPAG also appears to be more appealing to and effective for women than for men. Although the CPAG had some influence in increasing mild physical activity levels in a workplace sample, there was also a decrease in physical activity levels among some members of the group. Overall, the effectiveness of CPAG was not substantial, and the findings of this analysis could help guide future targeted intervention materials and programs.

  8. Necessity of introducing postencounter note describing history and physical examination at clinical performance examination in Korea.

    Science.gov (United States)

    Kim, Jonghoon

    2014-06-01

    Information gathering ability had been evaluated mainly via checklists in clinical performance examinations (CPX). But, it is not proved yet if students write the information correctly in postencounter note (PN), although they asked questions or performed physical examinations (PE) about the information when they interacted with standardized patients in CPX. This study addressed the necessity of introducing PN to evaluate the ability in CPX. After patient encounters, students were instructed to write the findings of history taking and physical examination that they considered as important information in approaching the patient's problems in PN. PNs were scored using answer keys selected from checklist items, which were considered to be recorded in PN by CPX experts. PNs of six CPX cases from 54 students were analyzed. Correlation coefficients between the key-checklist scores and PN scores of six cases were moderate to high (0.52 to 0.79). However, students frequently neglected some cardinal features of chief complains, pertinent findings of past/social history and PE, and pertinent negative findings of associated symptoms in PNs, which were checked as 'done' in the keys of checklists. It is necessary to introduce PN in CPX to evaluate the students' ability of synthesis and integration of patient information.

  9. Influence of the workplace on learning physical examination skills.

    Science.gov (United States)

    Duvivier, Robbert; Stalmeijer, Renée; van Dalen, Jan; van der Vleuten, Cees; Scherpbier, Albert

    2014-03-28

    Hospital clerkships are considered crucial for acquiring competencies such as diagnostic reasoning and clinical skills. The actual learning process in the hospital remains poorly understood. This study investigates how students learn clinical skills in workplaces and factors affecting this. Six focus group sessions with 32 students in Internal Medicine rotation (4-9 students per group; sessions 80-90 minutes). Verbatim transcripts were analysed by emerging themes and coded independently by three researchers followed by constant comparison and axial coding. Students report to learn the systematics of the physical examination, gain agility and become able to recognise pathological signs. The learning process combines working alongside others and working independently with increasing responsibility for patient care. Helpful behaviour includes making findings explicit through patient files or during observation, feedback by abnormal findings and taking initiative. Factors affecting the process negatively include lack of supervision, uncertainty about tasks and expectations, and social context such as hierarchy of learners and perceived learning environment. Although individual student experiences vary greatly between different hospitals, it seems that proactivity and participation are central drivers for learning. These results can improve the quality of existing programmes and help design new ways to learn physical examination skills.

  10. Influence of the workplace on learning physical examination skills

    Science.gov (United States)

    2014-01-01

    Background Hospital clerkships are considered crucial for acquiring competencies such as diagnostic reasoning and clinical skills. The actual learning process in the hospital remains poorly understood. This study investigates how students learn clinical skills in workplaces and factors affecting this. Methods Six focus group sessions with 32 students in Internal Medicine rotation (4–9 students per group; sessions 80–90 minutes). Verbatim transcripts were analysed by emerging themes and coded independently by three researchers followed by constant comparison and axial coding. Results Students report to learn the systematics of the physical examination, gain agility and become able to recognise pathological signs. The learning process combines working alongside others and working independently with increasing responsibility for patient care. Helpful behaviour includes making findings explicit through patient files or during observation, feedback by abnormal findings and taking initiative. Factors affecting the process negatively include lack of supervision, uncertainty about tasks and expectations, and social context such as hierarchy of learners and perceived learning environment. Conclusion Although individual student experiences vary greatly between different hospitals, it seems that proactivity and participation are central drivers for learning. These results can improve the quality of existing programmes and help design new ways to learn physical examination skills. PMID:24678562

  11. Psychogenic Explanations of Physical Illness: Time to Examine the Evidence.

    Science.gov (United States)

    Wilshire, Carolyn E; Ward, Tony

    2016-09-01

    In some patients with chronic physical complaints, detailed examination fails to reveal a well-recognized underlying disease process. In this situation, the physician may suspect a psychological cause. In this review, we critically evaluated the evidence for this causal claim, focusing on complaints presenting as neurological disorders. There were four main conclusions. First, patients with these complaints frequently exhibit psychopathology but not consistently more often than patients with a comparable "organic" diagnosis, so a causal role cannot be inferred. Second, these patients report a high incidence of adverse life experiences, but again, there is insufficient evidence to indicate a causal role for any particular type of experience. Third, although psychogenic illnesses are believed to be more responsive to psychological interventions than comparable "organic" illnesses, there is currently no evidence to support this claim. Finally, recent evidence suggests that biological and physical factors play a much greater causal role in these illnesses than previously believed. We conclude that there is currently little evidential support for psychogenic theories of illness in the neurological domain. In future research, researchers need to take a wider view concerning the etiology of these illnesses. © The Author(s) 2016.

  12. Examining the effects of testwiseness in conceptual physics evaluations

    Science.gov (United States)

    DeVore, Seth; Stewart, John; Stewart, Gay

    2016-12-01

    Testwiseness is defined as the set of cognitive strategies used by a student that is intended to improve his or her score on a test regardless of the test's subject matter. Questions with elements that may be affected by testwiseness are common in physics assessments, even in those which have been extensively validated and widely used as evaluation tools in physics education research. The potential effect of several elements of testwiseness were analyzed for questions in the Force Concept Inventory (FCI) and Conceptual Survey on Electricity and Magnetism that contain distractors that are predicted to be influenced by testwiseness. This analysis was performed using data sets collected between fall 2001 and spring 2014 at one midwestern U.S. university (including over 9500 students) and between Spring 2011 and Spring 2015 at a second eastern U.S. university (including over 2500 students). Student avoidance of "none of the above" or "zero" distractors was statistically significant. The effect of the position of a distractor on its likelihood to be selected was also significant. The effects of several potential positive and negative testwiseness effects on student scores were also examined by developing two modified versions of the FCI designed to include additional elements related to testwiseness; testwiseness produced little effect post-instruction in student performance on the modified instruments.

  13. Evaluation of effect of self-examination and physical examination on breast cancer.

    Science.gov (United States)

    Hassan, Lotfi Mohammad; Mahmoud, Noori; Miller, Anthony B; Iraj, Harrirchi; Mohsen, Mirzaei; Majid, Jafarizadea; Reza, Sadeghian Mohammad; Mojgan, Minosepehr

    2015-08-01

    Breast cancer is the number one cancer of women in the world. More than 90% of breast cancers can be cured with early diagnosis followed by effective multimodality treatment. The efficacy of screening by breast self-examination (BSE) and breast physical examination (BPx) is best evaluated using randomized screening trials. A total of 12,660 women aged 35-64 years, 6330 in the intervention group and 6330 in the control group, were randomly selected from four areas of Yazd city, I.R. of Iran. The number of detected cancers along with kind of cancer, staging of cancer, the route of detected cancer and the number of deaths during the first 5 years of the study were collected and analyzed. No significance difference between the two groups was seen in respect to socio-demographic and socio-economic variables (P > 0.05). Subjects in the intervention group had a response rate of 83.5% for attending the health center and 80.2% for visiting the assigned surgeon. A total of 31 and 13 new cases of breast cancer were identified in the intervention and control groups, respectively, of which 48.5% of cases in the intervention group were breast cancer in the two groups with a ratio of 2.4 was observed. BSE & BPx have a significant effect in detecting breast cancers at early stages (<3) suggesting they are effective screening tests with high availability and low costs that can be applied at the community level. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Using Objective Structured Clinical Examinations to Assess Intern Orthopaedic Physical Examination Skills: A Multimodal Didactic Comparison.

    Science.gov (United States)

    Phillips, Donna; Pean, Christian A; Allen, Kathleen; Zuckerman, Joseph; Egol, Kenneth

    Patient care is 1 of the 6 core competencies defined by the Accreditation Council for Graduate Medical Education (ACGME). The physical examination (PE) is a fundamental skill to evaluate patients and make an accurate diagnosis. The purpose of this study was to investigate 3 different methods to teach PE skills and to assess the ability to do a complete PE in a simulated patient encounter. Prospective, uncontrolled, observational. Northeastern academic medical center. A total of 32 orthopedic surgery residents participated and were divided into 3 didactic groups: Group 1 (n = 12) live interactive lectures, demonstration on standardized patients, and textbook reading; Group 2 (n = 11) video recordings of the lectures given to Group 1 and textbook reading alone; Group 3 (n = 9): 90-minute modules taught by residents to interns in near-peer format and textbook reading. The overall score for objective structured clinical examinations from the combined groups was 66%. There was a trend toward more complete PEs in Group 1 taught via live lectures and demonstrations compared to Group 2 that relied on video recording. Near-peer taught residents from Group 3 significantly outperformed Group 2 residents overall (p = 0.02), and trended toward significantly outperforming Group 1 residents as well, with significantly higher scores in the ankle (p = 0.02) and shoulder (p = 0.02) PE cases. This study found that orthopedic interns taught musculoskeletal PE skills by near-peers outperformed other groups overall. An overall score of 66% for the combined didactic groups suggests a baseline deficit in first-year resident musculoskeletal PE skills. The PE should continue to be taught and objectively assessed throughout residency to confirm that budding surgeons have mastered these fundamental skills before going into practice. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  15. Examining how discussing underrepresentation may mediate female engagement in physics

    Science.gov (United States)

    Lock, Robynne M.; Tompkins, Reganne; Hazari, Zahra

    2013-04-01

    Despite the large number of female students taking high school physics, only about a fifth of physics bachelor's degrees are awarded to women. In a previous study, we tested five factors commonly proposed to positively impact female students' choice of a physical science career using multivariate matching methods on national survey data. Four of these factors (having a single-sex class, having female scientist guest speakers, having a female physics teacher, and discussing the work of female scientists) were found to have no effect. The only factor found to have a positive effect was the explicit discussion of the underrepresentation of women in physics. In order to explore this further, a case study of the classes of one teacher reported to discuss the underrepresentation of women was conducted. Two classroom underrepresentation discussions were recorded, students and teacher were interviewed, and relevant student work was collected. Analyzing the case study data, we report on how discussing underrepresentation may mediate female engagement in physics.

  16. Incidence and etiology of sports-related sudden cardiac death in Denmark--implications for preparticipation screening

    DEFF Research Database (Denmark)

    Holst, Anders Gaarsdal; Winkel, Bo Gregers; Theilade, Juliane

    2010-01-01

    BACKGROUND: Studies on incidences of sports-related sudden cardiac death (SrSCD) are few and data are needed for the discussion of preparticipation screening for cardiac disease. OBJECTIVE: We sought to chart the incidence and etiology of SrSCD in the young in Denmark (population 5.4 million...

  17. Examination of physical activity in adolescents over the school year.

    Science.gov (United States)

    Bruner, Mark W; Chad, Karen E; Beattie-Flath, Jodie A; Humbert, M Louise; Verrall, Tanya C; Vu, Lan; Muhajarine, Nazeem

    2009-11-01

    This study monitored the physical activity behavior of adolescent students over a ten month school year. Physical activity was assessed at two month intervals using self-report and objective (Actical accelerometers) measures. Self-report results (n = 547) indicated a decline in physical activity throughout the school year for all grades and genders. The decline was attributed largely to a decrease in organized activity participation. Objective physical activity results (n = 40) revealed a significant decline in activity in the latter half of the school year (February to June). Declining physical activity was attributed to a decrease in vigorous activity which was consistent across grade and gender. Collectively, the results highlight the importance of promoting consistent opportunities for adolescents to be active throughout the school year.

  18. CERN and ESA examine future fundamental physics research in space

    CERN Multimedia

    CERN Press Office. Geneva

    2000-01-01

    A special workshop on Fundamental Physics in Space and related topics will be held at CERN in Geneva from 5 to 7 April 2000. Remarkable advances in technology and progress made in reliability and cost effectiveness of European space missions in recent years have opened up exciting new directions for such research. The workshop provides a forum for sharing expertise gained in high energy physics research with colleagues working in research in space.

  19. Oral Anatomy Laboratory Examinations in a Physical Therapy Program

    Science.gov (United States)

    Fabrizio, Philip A.

    2013-01-01

    The process of creating and administering traditional tagged anatomy laboratory examinations is time consuming for instructors and limits laboratory access for students. Depending on class size and the number of class, sections, creating, administering, and breaking down a tagged laboratory examination may involve one to two eight-hour days.…

  20. Between-Day Reliability of Pre-Participation Screening Components in Pre-Professional Ballet and Contemporary Dancers.

    Science.gov (United States)

    Kenny, Sarah J; Palacios-Derflingher, Luz; Owoeye, Oluwatoyosi B A; Whittaker, Jackie L; Emery, Carolyn A

    2018-03-15

    Critical appraisal of research investigating risk factors for musculoskeletal injury in dancers suggests high quality reliability studies are lacking. The purpose of this study was to determine between-day reliability of pre-participation screening (PPS) components in pre-professional ballet and contemporary dancers. Thirty-eight dancers (35 female, 3 male; median age; 18 years; range: 11 to 30 years) participated. Screening components (Athletic Coping Skills Inventory-28, body mass index, percent total body fat, total bone mineral density, Foot Posture Index-6, hip and ankle range of motion, three lumbopelvic control tasks, unipedal dynamic balance, and the Y-Balance Test) were conducted one week apart. Intra-class correlation coefficients (ICCs: 95% confidence intervals), standard error of measurement, minimal detectable change (MDC), Bland-Altman methods of agreement [95% limits of agreement (LOA)], Cohen's kappa coefficients, standard error, and percent agreements were calculated. Depending on the screening component, ICC estimates ranged from 0.51 to 0.98, kappa coefficients varied between -0.09 and 0.47, and percent agreement spanned 71% to 95%. Wide 95% LOA were demonstrated by Foot Posture Index-6 (right: -6.06, 7.31), passive hip external rotation (right: -9.89, 16.54), and passive supine turnout (left: -15.36, 17.58). The PPS components examined demonstrated moderate to excellent relative reliability with mean between-day differences less than MDC, or sufficient percent agreement, across all assessments. However, due to wide 95% limits of agreement, the Foot Posture Index-6 and passive hip range of motion are not recommended for screening injury risk in pre-professional dancers.

  1. Physical examination of sexual assault victims in Belgrade area

    Directory of Open Access Journals (Sweden)

    Alempijević Đorđe

    2006-01-01

    Full Text Available Introduction: Sexual crimes represent various forms of contact of perpetrator’s genitals, lips, tongue, and fingers with genitals, lips and/or anus of the victim, in order to achieve sexual satisfaction, without victim’s consent. Objective: The aim of this work was to analyze the type of medical institution in which victims of sexual assaults are being examined in Belgrade area, to assess the quality of these examinations and medical records, as well as to control whether standardized protocols are followed. Method: Data were obtained through analysis of 113 cases of sexual assaults prosecuted in the District Court of Belgrade. Results: All victims were females with mean age of 24.1 years. The majority of victims (85% were examined in one medical institution, most often in the Institute of Gynecology and Obstetrics, Clinical Center of Serbia, and only by one medical doctor (81.4%. Gynecologists were most frequently included in examination, while specialists of forensic medicine were engaged in only 9 cases (7.9%. In 84% of victims, the examination was performed during the first three days after the assault, and in 52% of cases on the first day. Standard techniques of clinical and gynecological examinations were applied only, without following any protocols, so the reports were made exclusively on individual basis. In no case an informed consent by victim was obtained before examination. Anamnestic data were collected in only 15.9% of cases, and they were generally incomplete. Conclusion: The results of investigation show that the quality of examination of sexual assault victims in Belgrade area is not adequate. Therefore, such negative practice should be changed in future through introduction of standardized protocols for examination of victims, as well as development of clinical forensic medicine.

  2. Risk Stratification for Athletes and Adventurers in High-Altitude Environments: Recommendations for Preparticipation Evaluation.

    Science.gov (United States)

    Campbell, Aaron D; McIntosh, Scott E; Nyberg, Andy; Powell, Amy P; Schoene, Robert B; Hackett, Peter

    2015-12-01

    High-altitude athletes and adventurers face a number of environmental and medical risks. Clinicians often advise participants or guiding agencies before or during these experiences. Preparticipation evaluation (PPE) has the potential to reduce risk of high-altitude illnesses in athletes and adventurers. Specific conditions susceptible to high-altitude exacerbation also important to evaluate include cardiovascular and lung diseases. Recommendations by which to counsel individuals before participation in altitude sports and adventures are few and of limited focus. We reviewed the literature, collected expert opinion, and augmented principles of a traditional sport PPE to accommodate the high-altitude wilderness athlete/adventurer. We present our findings with specific recommendations on risk stratification during a PPE for the high-altitude athlete/adventurer. Copyright © 2015. Published by Elsevier Inc.

  3. Abnormal hip physical examination findings in asymptomatic female soccer athletes

    Science.gov (United States)

    Hunt, Devyani; Rho, Monica; Yemm, Ted; Fong, Kathryn; Brophy, Robert H.

    2016-01-01

    Purpose Examination of the hip provides information regarding risk for pre-arthritic hip disorders, knee injuries, and low back pain. The purpose of this study was to report a hip screening examination of asymptomatic female soccer athletes and to test the hypothesis that these findings vary by competition experience. Methods Asymptomatic females from a youth soccer club, a college, and a professional team were evaluated. Passive hip range of motion, hip abduction strength, and hip provocative tests were assessed. Data were compared for the grade/middle school, high school, college, and professional athletes. Results One hundred and seventy-two athletes with a mean age of 16.7 ± 5 years (range 10–30) participated. Professional athletes had less flexion (HF) for both hips (p hips as compared to all other groups (p hip abduction strength as compared to other groups (p hip tests were found in 22 % of all players and 36 % of the professionals. In professionals, a positive provocative test was associated with ipsilateral decreased HF (p = 0.04). Conclusion Asymptomatic elite female soccer athletes with the most competition experience had less bilateral hip flexion and preferred kicking leg IR than less-experienced athletes. Positive provocative hip tests were found in 22 % of athletes. Future studies are needed to show whether these findings link to risk for intra-articular hip or lumbar spine and knee disorders. Level of evidence III. PMID:24150125

  4. Student performance of the general physical examination in internal medicine: an observational study

    Science.gov (United States)

    2014-01-01

    Background Many practicing physicians lack skills in physical examination. It is not known whether physical examination skills already show deficiencies after an early phase of clinical training. At the end of the internal medicine clerkship students are expected to be able to perform a general physical examination in every new patient encounter. In a previous study, the basic physical examination items that should standardly be performed were set by consensus. The aim of the current observational study was to assess whether medical students were able to correctly perform a general physical examination regarding completeness as well as technique at the end of the clerkship internal medicine. Methods One hundred students who had just finished their clerkship internal medicine were asked to perform a general physical examination on a standardized patient as they had learned during the clerkship. They were recorded on camera. Frequency of performance of each component of the physical examination was counted. Adequacy of performance was determined as either correct or incorrect or not assessable using a checklist of short descriptions of each physical examination component. A reliability analysis was performed by calculation of the intra class correlation coefficient for total scores of five physical examinations rated by three trained physicians and for their agreement on performance of all items. Results Approximately 40% of the agreed standard physical examination items were not performed by the students. Students put the most emphasis on examination of general parameters, heart, lungs and abdomen. Many components of the physical examination were not performed as was taught during precourses. Intra-class correlation was high for total scores of the physical examinations 0.91 (p internal medicine clerkship. Possible causes and suggestions for improvement are discussed. PMID:24712683

  5. Pre-Participation Screening: The Use of Fundamental Movements as an Assessment of Function – Part 1

    OpenAIRE

    Cook, Gray; Burton, Lee; Hoogenboom, Barb

    2006-01-01

    To prepare an athlete for the wide variety of activities needed to participate in their sport, the analysis of fundamental movements should be incorporated into pre-participation screening in order to determine who possesses, or lacks, the ability to perform certain essential movements. In a series of two articles, the background and rationale for the analysis of fundamental movement will be provided. In addition, one such evaluation tool that attempts to assess the fundamental movement patte...

  6. Critical Look at Physics Identity: An Operationalized Framework for Examining Race and Physics Identity

    Science.gov (United States)

    Hyater-Adams, Simone; Fracchiolla, Claudia; Finkelstein, Noah; Hinko, Kathleen

    2018-01-01

    Studies on physics identity are appearing more frequently and often responding to increased awareness of the underrepresentation of students of color in physics. In our broader research, we focus our efforts on understanding how racial identity and physics identity are negotiated throughout the experiences of Black physicists. In this paper, we…

  7. Sensitivity of physical examination versus arthroscopy in diagnosing subscapularis tendon injury.

    Science.gov (United States)

    Faruqui, Sami; Wijdicks, Coen; Foad, Abdullah

    2014-01-01

    The purpose of this study was to examine the accuracy of physical examination in the detection of subscapularis tendon tears and compare it with the gold standard of arthroscopy to determine whether clinical examination can reliably predict the presence of subscapularis tendon tears. This was a retrospective analysis of 52 patients (52 shoulders) who underwent arthroscopic subscapularis tendon repairs between September 2008 and April 2012. Positive findings on any combination of the belly press, lift-off, and bear hug tests constituted a positive physical examination result. There was a positive finding on physical examination in 42 of 52 patients. The sensitivity of the physical examination as a whole was 81%. The literature has shown that the belly press, bear hug, and lift-off tests are specific to the subscapularis tendon. To the authors’ knowledge, this is the first study to evaluate the sensitivity of these 3 separate clinical tests as a composite. Knowledge regarding the sensitivity of the subscapularis-specific physical examination as a composite can lead practitioners to implement all 3 components, even when 1 test has a negative finding, thus promoting a more thorough physical examination. Because unrepaired subscapularis tendon tears can result in poor outcomes in the repair of other rotator cuff tendons, a complete physical examination would be beneficial to patients with shoulder pathology. The authors conclude that physical examination, when performed consistently by an experienced practitioner, can reliably predict the presence of subscapularis tendon tears.

  8. The Clinical anatomy of the physical examination of the abdomen: A comprehensive review.

    Science.gov (United States)

    Bilal, Muhammad; Voin, Vlad; Topale, Nitsa; Iwanaga, Joe; Loukas, Marios; Tubbs, R Shane

    2017-04-01

    Physical examination of the abdomen is an essential skill. Knowledge of its clinical anatomy and application is vital for making diagnoses. Misinterpretation of anatomy during examination can have serious consequences. This review addresses understanding of the anatomy, methodology, and complications of abdominal physical examination. It includes particular reference to modern technology and investigations. Physical examination is performed for diagnostic purposes. However, the art of physical examination is declining as more and more clinicians rely on newer technology. This can have regrettable consequences: negligence, waste of time and resources, and deterioration of clinical skills. With a sound knowledge of clinical anatomy, and realization of the importance of physical examination of the abdomen, clinician, and patients alike can benefit. Clin. Anat. 30:352-356, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  9. A core physical examination in internal medicine: what should students do and how about their supervisors?

    Science.gov (United States)

    Haring, Catharina M; van der Meer, Jos W M; Postma, Cornelis T

    2013-09-01

    Performance of a focused physical examination will induce a high cognitive load for medical students in the early phase of the clinical clerkships. To come to a workable and clinically applicable standard physical examination for medical students to be used in every new patient in the daily clinical practice of internal medicine. A questionnaire held among physicians that supervise students during the clerkship of internal medicine in one Dutch training region. Of the complete list of physical examination 55 items were considered to be an integral part of the standard general physical examination for medical students. Most emphasized were elements of the physical examination aimed at general parameters, thorax and abdomen, vascular status, lymph nodes, spinal column, skin and some parts of the neurological examination. The standard physical examinations performed by supervisors themselves contain fewer items than they expected from the students. The expectations a supervisor has towards the student correlates with the frequency with which they apply the various components in their own physical examination. This study provides us with a 'core' physical examination for medical students that can be applied in the early phase of the clinical clerkships.

  10. Physical articular examination in the activity of rheumatoid arthritis: a systematic review of the literature : Systematic review of the literature regarding physical examination in rheumatoid arthritis.

    Science.gov (United States)

    Medina, Yimy F; Ruíz-Gaviria, Rafael Eduardo; Buitrago-Lopez, Adriana; Villota, Catalina

    2018-06-01

    To summarize evidence concerning the articular examination needed to determine rheumatoid arthritis (RA) activity (follow-up or control) via a systematic review. A search of Medline, Embase, Lilacs, SciELO, the Web of Science, the National Technical Reports Library, and the reference lists of relevant studies through March 2017 was conducted using a systematic methodology to identify studies of patients with RA older than 18 years in which a detailed description of the physical examination or a description of the components of the articular examination was provided. Of 8322 references, 74 studies were included according to the selection criteria, and 6 references were ultimately included at the end of the review. Most of the included studies (n = 5) were associated with a moderate risk of bias. There was great variability among the studies and the articular examination methods used. Some studies presented the examination with a complete specification of the technique (n = 2), the consensus of rheumatologists (n = 2), or training through audiovisual materials and face-to-face courses (n = 2), but none of the studies explicitly showed the technique by which the physical examination was performed. Despite the importance of the clinical evaluation and physical examination of patients with RA for diagnosis, prognosis, clinimetrics, and follow-up, evidence concerning how to perform the articular examination is scarce.

  11. The value of the physical examination in clinical practice: an international survey.

    Science.gov (United States)

    Elder, Andrew T; McManus, I Chris; Patrick, Alan; Nair, Kichu; Vaughan, Louella; Dacre, Jane

    2017-12-01

    A structured online survey was used to establish the views of 2,684 practising clinicians of all ages in multiple countries about the value of the physical examination in the contemporary practice of internal medicine. 70% felt that physical examination was 'almost always valuable' in acute general medical referrals. 66% of trainees felt that they were never observed by a consultant when undertaking physical examination and 31% that consultants never demonstrated their use of the physical examination to them. Auscultation for pulmonary wheezes and crackles were the two signs most likely to be rated as frequently used and useful, with the character of the jugular venous waveform most likely to be rated as -infrequently used and not useful. Physicians in contemporary hospital general medical practice continue to value the contribution of the physical examination to assessment of outpatients and inpatients, but, in the opinion of trainees, teaching and demonstration could be improved. © Royal College of Physicians 2017. All rights reserved.

  12. Longitudinal examination of social and environmental influences on motivation for physical activity.

    Science.gov (United States)

    Richards, Elizabeth A; McDonough, Meghan; Fu, Rong

    2017-10-01

    Physical activity behavior is influenced by numerous factors including motivation, social interactions, and the walkability of the environment. To examine how social contexts and environmental features affect physical activity motivational processes across time. Participants (N=104) completed 3 monthly online surveys assessing self-determination theory constructs, social partners in physical activity, neighborhood walkability, and weekly physical activity. Longitudinal path analysis examined the degree to which physical activity was predicted by individual goals, orientation, and autonomy support and whether these associations were meditated by motivation and moderated by the social and environmental contexts of physical activity. The effect of controlled exercise orientations on physical activity was mediated by autonomous motivation. This association was stronger among those who perceived less crime in their neighborhoods. To improve the ability to tailor physical activity counseling it is important to understand how each person views exercise situations and to understand his/her social and neighborhood environments. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. A survey of paediatricians on the use of electrocardiogram for pre-participation sports screening.

    Science.gov (United States)

    Patel, Angira; Webster, Gregory; Ward, Kendra; Lantos, John

    2017-07-01

    Aim The aim of the present study was to determine general paediatrician knowledge, practices, and attitudes towards electrocardiogram (ECG) screening in school athletes during pre-participation screening exam (PPSE). Paediatricians affiliated with a tertiary children's hospital completed a survey about ECGs for PPSE. In total, 205/498 (41%) responded; 92% of the paediatricians did not include an ECG as part of PPSE; 56% were aware of a case in which a student athlete in their own community had died of sudden unexplained death; 4% had an athlete in their practice die. Only 16% of paediatricians perform all 12 American Heart Association recommended elements of the PPSE. If any of these screening elements are abnormal, 69% obtain an ECG, 36% an echocardiogram, and 30% restrict patients from sports activity; 73% of them refer the patient to a cardiologist. Most of the general paediatricians surveyed did not currently perform ECGs for PPSE. In addition, there was a low rate of adherence to performing the 12 screening elements recommended by the American Heart Association. They have trouble obtaining timely, accurate ECG interpretations, worry about potential unnecessary exercise restrictions, and cost-effectiveness. The practical hurdles to ECG implementation emphasise the need for a fresh look at PPSE, and not just ECG screening. Improvements in ECG performance/interpretation would be necessary for ECGs to be a useful part of PPSE.

  14. Telemedicine Physical Examination Utilizing a Consumer Device Demonstrates Poor Concordance with In-Person Physical Examination in Emergency Department Patients with Sore Throat: A Prospective Blinded Study.

    Science.gov (United States)

    Akhtar, Moneeb; Van Heukelom, Paul G; Ahmed, Azeemuddin; Tranter, Rachel D; White, Erinn; Shekem, Nathaniel; Walz, David; Fairfield, Catherine; Vakkalanka, J Priyanka; Mohr, Nicholas M

    2018-02-22

    Telemedicine allows patients to connect with healthcare providers remotely. It has recently expanded to evaluate low-acuity illnesses such as pharyngitis by using patients' personal communication devices. The purpose of our study was to compare the telemedicine-facilitated physical examination with an in-person examination in emergency department (ED) patients with sore throat. This was a prospective, observational, blinded diagnostic concordance study of patients being seen for sore throat in a 60,000-visit Midwestern academic ED. A telemedicine and a face-to-face examination were performed independently by two advanced practice providers (APP), blinded to the results of the other evaluator. The primary outcome was agreement on pharyngeal redness between the evaluators, with secondary outcomes of agreement and inter-rater reliability on 14 other aspects of the pharyngeal physical examination. We also conducted a survey of patients and providers to evaluate perceptions and preferences for sore throat evaluation using telemedicine. Sixty-two patients were enrolled, with a median tonsil size of 1.0. Inter-rater agreement (kappa) for tonsil size was 0.394, which was worse than our predetermined concordance threshold. Other kappa values ranged from 0 to 0.434, and telemedicine was best for detecting abnormal coloration of the palate and tender superficial cervical lymph nodes (anterior structures), but poor for detecting abnormal submandibular lymph nodes or asymmetry of the posterior pharynx (posterior structures). In survey responses, telemedicine was judged easier to use and more comfortable for providers than patients; however, neither patients nor providers preferred in-person to telemedicine evaluation. Telemedicine exhibited poor agreement with the in-person physical examination on the primary outcome of tonsil size, but exhibited moderate agreement on coloration of the palate and cervical lymphadenopathy. Future work should better characterize the importance of

  15. Time to Add a Fifth Pillar to Bedside Physical Examination: Inspection, Palpation, Percussion, Auscultation, and Insonation.

    Science.gov (United States)

    Narula, Jagat; Chandrashekhar, Y; Braunwald, Eugene

    2018-04-01

    Inspection, palpation, percussion, and auscultation have been the 4 pillars of clinical bedside medicine. Although these basic methods of physical examination have served us well, traditional bedside examination, for a number of reasons including diminishing interest and expertise, performs well less than what is required of a modern diagnostic strategy. Improving the performance of physical examination is vital given that it is crucial to guide diagnostic possibilities and further testing. Current efforts at improving physical examination skills during medical training have not been very successful, and incorporating appropriate technology at the bedside might improve its performance. Selective use of bedside ultrasound (or insonation) can be one such strategy that could be incorporated as the fifth component of the physical examination. Seeing pathology through imaging might improve interest in physical examination among trainees, and permit appropriate downstream testing and possibly superior decision making. Current ultrasound technology makes this feasible, and further miniaturization of ultrasound devices and reduced cost will allow for routine use at the bedside. It is time to have a wider debate and a possible consensus about updates required to enhance current paradigms of physical examination.

  16. Physical Examination for the Academic Psychiatrist: Primer and Common Clinical Scenarios.

    Science.gov (United States)

    Azzam, Pierre N; Gopalan, Priya; Brown, Jennifer R; Aquino, Patrick R

    2016-04-01

    As clinical psychiatry has evolved to mirror the patient care model followed in other medical specialties, psychiatrists are called upon increasingly to utilize general medical skills in routine practice. Psychiatrists who practice in academic settings are often required to generate broad differential diagnoses that include medical and neurologic conditions and, as a result, benefit from incorporating physical examination into their psychiatric assessments. Physical examination allows psychiatrists to follow and to teach patient-informed clinical practices and comprehensive treatment approaches. In this commentary, the authors encourage routine use of a targeted physical examination and outline common scenarios in which physical examination would be useful for the academic psychiatrist: delirium, toxidromes, and unexplained medical conditions (e.g., somatic symptom disorders).

  17. Physical Examination Findings Among Children and Adolescents With Obesity: An Evidence-Based Review.

    Science.gov (United States)

    Armstrong, Sarah; Lazorick, Suzanne; Hampl, Sarah; Skelton, Joseph A; Wood, Charles; Collier, David; Perrin, Eliana M

    2016-02-01

    Overweight and obesity affects 1 in 3 US children and adolescents. Clinical recommendations have largely focused on screening guidelines and counseling strategies. However, the physical examination of the child or adolescent with obesity can provide the clinician with additional information to guide management decisions. This expert-based review focuses on physical examination findings specific to children and adolescents with obesity. For each physical examination element, the authors define the finding and its prevalence among pediatric patients with obesity, discuss the importance and relevance of the finding, describe known techniques to assess severity, and review evidence regarding the need for additional evaluation. The recommendations presented represent a comprehensive review of current evidence as well as expert opinion. The goal of this review is to highlight the importance of conducting a targeted physical examination during pediatric weight management visits. Copyright © 2016 by the American Academy of Pediatrics.

  18. Examining the Role of Physical Appearance in Latino Adolescents' Ethnic Identity

    Science.gov (United States)

    Gonzales-Backen, Melinda A.; Umana-Taylor, Adriana J.

    2011-01-01

    Guided by ecological theory, the current study examined physical appearance as a moderator of the relation between familial ethnic socialization (FES) and ethnic identity among 167 Latino adolescents. Results indicated that FES was positively associated with ethnic identity exploration and resolution. Furthermore, as expected, physical appearance…

  19. The Examination of the Attitudes of Secondary School Students towards Physical Education Course

    Science.gov (United States)

    Keskin, Özkan; Hergüner, Gülten; Dönmez, Ahmet; Berisha, Milaim; Üçan, Erkan

    2017-01-01

    The aim of this study is to examine the attitudes of primary education students towards physical education courses according to certain variables. 640 students from elementary schools in the city center and several counties of Sakarya participated in the study. In the designating of the students' attitudes towards the physical education courses,…

  20. Physical examination tests for screening and diagnosis of cervicogenic headache: A systematic review.

    Science.gov (United States)

    Rubio-Ochoa, J; Benítez-Martínez, J; Lluch, E; Santacruz-Zaragozá, S; Gómez-Contreras, P; Cook, C E

    2016-02-01

    It has been suggested that differential diagnosis of headaches should consist of a robust subjective examination and a detailed physical examination of the cervical spine. Cervicogenic headache (CGH) is a form of headache that involves referred pain from the neck. To our knowledge, no studies have summarized the reliability and diagnostic accuracy of physical examination tests for CGH. The aim of this study was to summarize the reliability and diagnostic accuracy of physical examination tests used to diagnose CGH. A systematic review following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines was performed in four electronic databases (MEDLINE, Web of Science, Embase and Scopus). Full text reports concerning physical tests for the diagnosis of CGH which reported the clinometric properties for assessment of CGH, were included and screened for methodological quality. Quality Appraisal for Reliability Studies (QAREL) and Quality Assessment of Studies of Diagnostic Accuracy (QUADAS-2) scores were completed to assess article quality. Eight articles were retrieved for quality assessment and data extraction. Studies investigating diagnostic reliability of physical examination tests for CGH scored poorer on methodological quality (higher risk of bias) than those of diagnostic accuracy. There is sufficient evidence showing high levels of reliability and diagnostic accuracy of the selected physical examination tests for the diagnosis of CGH. The cervical flexion-rotation test (CFRT) exhibited both the highest reliability and the strongest diagnostic accuracy for the diagnosis of CGH. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Exploration of the value of using a formula sheet for physics examinations

    International Nuclear Information System (INIS)

    Chang, Wheijen; Shieh, Ruey S

    2013-01-01

    The purpose of this study is to explore whether and how allowing students to prepare their own formula sheet (FS) for use in examinations helps them engage in meaningful learning and improve their academic performance. An action research is adopted to conduct the study. Three years (2009–11) of evaluation of the FS policy in introductory physics courses was undertaken. The data collection consists of the students' FS, examination results, and self-reported surveys. The results show that the students who were allowed to bring an FS to the examination outperformed those who were not. It is also found that the quality of individual students' FS was significantly correlated to their examination score (p < 0.001). The reported benefits of using an FS consists of facilitating conceptual understanding, highlighting cognitive demands in learning physics, and alleviating stress in examinations. The FS strategy appears to have the potential for strengthening students' understanding of physics concepts. (paper)

  2. Special physical examination tests for superior labrum anterior-posterior shoulder tears: an examination of clinical usefulness.

    Science.gov (United States)

    Sandrey, Michelle A

    2013-01-01

    Calvert E, Chambers GK, Regan W, Hawkins RH, Leith JM. Special physical examination tests for superior labrum anterior-posterior shoulder injuries are clinically limited and invalid: a diagnostic systematic review. J Clin Epidemiol. 2009;62(5):558-563. The systematic review focused on diagnostic accuracy studies to determine if evidence was sufficient to support the use of superior labrum anterior-posterior (SLAP) physical examination tests as valid and reliable. The primary question was whether there was sufficient evidence in the published literature to support the use of SLAP physical examination tests as valid and reliable diagnostic test procedures. Studies published in English were identified through database searches on MEDLINE, EMBASE, and the Cochrane database (1970-2004) using the search term SLAP lesions. The medical subject headings of arthroscopy, shoulder joint, and athletic injuries were combined with test or testing, physical examination, and sensitivity and specificity to locate additional sources. Other sources were identified by rereviewing the reference lists of included studies and review articles. Studies were eligible based on the following criteria: (1) published in English, (2) focused on the physical examination of SLAP lesions, and (3) presented original data. A study was excluded if the article was limited to a clinical description of 1 or more special tests without any research focus to provide clinical accuracy data or if it did not focus on the topic. The abstracts that were located through the search strategies were reviewed, and potentially relevant abstracts were selected. Strict epidemiologic methods were used to obtain and collate all relevant studies; the authors developed a study questionnaire to record study name, year of publication, study design, sample size, and statistics. Validity of the diagnostic test study was determined by applying the 5 criteria proposed by Calvert et al. If the study met the inclusion and validity

  3. Nicotine dependence matters: examining longitudinal association between smoking and physical activity among Canadian adults.

    Science.gov (United States)

    Azagba, Sunday; Asbridge, Mark

    2013-11-01

    A number of studies point to the inverse relationship between physical activity and smoking; however, none has examined the role of nicotine dependence in physical activity participation among smokers. This study examined whether levels of nicotine dependence modify the association between leisure time physical activity and smoking status. The study used longitudinal data on 6795 adults from the Canadian National Population Health Survey (2004-2010). Generalized estimating equations were used to examine the association between physical activity, smoking, and nicotine dependence. We found that nicotine dependent smokers were significantly less likely to be physically active compared to non-smokers. Specifically, using the Fagerstrom Test for Nicotine Dependence, nicotine dependent smokers (OR 0.65, 95% CI 0.55-0.76) were less likely to be physically active while no significant difference was found for non-dependent smokers (OR 0.90, 95% CI 0.80-1.02) compared to non-smokers. Nicotine dependence matters in shaping engagement in physical activity among daily smokers. Efforts directed at promoting smoking cessation through nicotine dependence treatment intervention may provide additional benefits to health and well-being through an increased participation in physical activity. © 2013.

  4. Examining the Physical Self in Adolescent Girls Over Time: Further Evidence against the Hierarchical Model.

    Science.gov (United States)

    Kowalski, Kent C.; Crocker, Peter R. E.; Kowalski, Nanette P.; Chad, Karen E.; Humbert, M. Louise

    2003-01-01

    Examined the direction of causal flow between global and specific dimensions of self-concept. Adolescent girls completed the Physical Self-Perception Profile and a global self-esteem scale in 9th and 10th grade. Results showed little support for top-down or bottom-up effects over the year. When self-concept was examined over time, there was…

  5. Medical educators' perspectives of teaching physical examinations using ultrasonography at the undergraduate level

    Directory of Open Access Journals (Sweden)

    Irene Ma

    2013-03-01

    Full Text Available Background: Ultrasonography is increasingly used for teaching physical examination in medical schools. This study seeks the opinions of educators as to which physical examinations would be most enhanced by the addition of ultrasonography. We also asked when ultrasound-aided physical examination teaching could have deleterious effects if used outside its intended scope. Methods: All of the educators from the University of Calgary Master Teacher Program were invited to complete a 22-item paper-based survey. Survey items were generated independently by two investigators, with input from an expert panel (N = 5. Results: Of the 36 educators, 27 (75% completed the survey. Examinations identified to be potentially most useful included: measuring the size of the abdominal aorta, identifying the presence/absence of ascites, identifying the presence/absence of pleural effusions, and measuring the size of the bladder. Examinations thought to be potentially most harmful included: identifying the presence/absence of intrauterine pregnancy, measuring the size of the abdominal aorta, and identifying the presence/absence of pericardial effusion. Conclusions: Examinations that are potentially the most useful may also be potentially the most harmful. When initiating an ultrasound curriculum for physical examinations, educators should weigh the risks and benefits of examinations chosen.

  6. Short communication: final year students' deficits in physical examination skills performance in Germany.

    Science.gov (United States)

    Krautter, Markus; Diefenbacher, Katja; Koehl-Hackert, Nadja; Buss, Beate; Nagelmann, Lars; Herzog, Wolfgang; Jünger, Jana; Nikendei, Christoph

    2015-01-01

    The physical examination of patients is an important diagnostic competence, but little is known about the examination skills of final-year medical students. To investigate physical examination skills of final-year medical students. In a cross-sectional study, 40 final-year students were asked to perform a detailed physical examination on standardized patients. Their performances were video-recorded and rated by independent video assessors. Video ratings showed a mean success rate of 40.1 % (SD 8.2). As regards accompanying doctor-patient communication, final-year students achieved a mean of no more than 36.7 % (SD 8.9) in the appropriate use of the corresponding communication items. Our study revealed severe deficits among final-year medical students in performing a detailed physical examination on a standardized patient. Thus, physical examination skills training should aim to improve these deficits while also paying attention to communicative aspects. Copyright © 2015. Published by Elsevier GmbH.

  7. Using web-based video to enhance physical examination skills in medical students.

    Science.gov (United States)

    Orientale, Eugene; Kosowicz, Lynn; Alerte, Anton; Pfeiffer, Carol; Harrington, Karen; Palley, Jane; Brown, Stacey; Sapieha-Yanchak, Teresa

    2008-01-01

    Physical examination (PE) skills among U.S. medical students have been shown to be deficient. This study examines the effect of a Web-based physical examination curriculum on first-year medical student PE skills. Web-based video clips, consisting of instruction in 77 elements of the physical examination, were created using Microsoft Windows Moviemaker software. Medical students' PE skills were evaluated by standardized patients before and after implementation of the Internet-based video. Following implementation of this curriculum, there was a higher level of competency (from 87% in 2002-2003 to 91% in 2004-2005), and poor performances on standardized patient PE exams substantially diminished (from a 14%-22%failure rate in 2002-2003, to 4% in 2004-2005. A significant improvement in first-year medical student performance on the adult PE occurred after implementing Web-based instructional video.

  8. Examining the relationship between psychosocial working conditions, physical work demands, and leisure time physical activity in Canada.

    Science.gov (United States)

    Morassaei, Sara; Smith, Peter M

    2011-10-01

    To examine the effects of psychosocial working conditions and physical work demands on leisure time physical activity (LTPA). Using path analysis, direct and indirect effects of self-reported working conditions on LTPA levels were assessed in a representative sample of 4167 workers from the 2000 to 2001 Canadian National Population Health Survey. Higher levels of skill discretion and decision latitude were associated with higher LTPA. Physical work demands had opposite effects among men versus women, and skill discretion had a stronger effect among women than among men. Job security had a stronger effect on older workers and those without children younger than 13 years. The results support the influence of the work environment on LTPA and suggest that certain work conditions should be targeted in future interventions seeking to impact participation in physical activity.

  9. Utility of the physical examination in detecting pulmonary hypertension. A mixed methods study.

    Directory of Open Access Journals (Sweden)

    Rebecca Colman

    Full Text Available INTRODUCTION: Patients with pulmonary hypertension (PH often present with a variety of physical findings reflecting a volume or pressure overloaded right ventricle (RV. However, there is no consensus regarding the diagnostic utility of the physical examination in PH. METHODS: We conducted a systematic review of publications that evaluated the clinical examination and diagnosis of PH using MEDLINE (1946-2013 and EMBASE (1947-2013. We also prospectively evaluated the diagnostic utility of the physical examination findings. Patients who underwent right cardiac catheterization for any reason were recruited. After informed consent, participants were examined by 6 physicians (3 "specialists" and 3 "generalists" who were unaware of the results of the patient's hemodynamics. Each examiner independently assessed patients for the presence of a RV lift, loud P2, jugular venous distension (JVD, tricuspid insufficiency murmur and right-sided 4th heart sound at rest and during a slow inspiration. A global rating (scale of 1-5 of the likelihood that the patient had pulmonary hypertension was provided by each examiner. RESULTS: 31 articles that assessed the physical examination in PH were included in the final analysis. There was heterogeneity amongst the studies and many did not include control data. The sign most associated with PH in the literature was a loud pulmonic component of the second heart sound (P2. In our prospective study physical examination was performed on 52 subjects (25 met criteria for PH; mPAP ≥ 25 mmHg. The physical sign with the highest likelihood ratio (LR was a loud P2 on inspiration with a LR +ve 1.9, 95% CrI [1.2, 3.1] when data from all examiners was analyzed together. Results from the specialist examiners had higher diagnostic utility; a loud P2 on inspiration was associated with a positive LR of 3.2, 95% CrI [1.5, 6.2] and a right sided S4 on inspiration had a LR +ve 4.7, 95% CI [1.0, 15.6]. No aspect of the physical exam, could

  10. Utility of the physical examination in detecting pulmonary hypertension. A mixed methods study.

    Science.gov (United States)

    Colman, Rebecca; Whittingham, Heather; Tomlinson, George; Granton, John

    2014-01-01

    Patients with pulmonary hypertension (PH) often present with a variety of physical findings reflecting a volume or pressure overloaded right ventricle (RV). However, there is no consensus regarding the diagnostic utility of the physical examination in PH. We conducted a systematic review of publications that evaluated the clinical examination and diagnosis of PH using MEDLINE (1946-2013) and EMBASE (1947-2013). We also prospectively evaluated the diagnostic utility of the physical examination findings. Patients who underwent right cardiac catheterization for any reason were recruited. After informed consent, participants were examined by 6 physicians (3 "specialists" and 3 "generalists") who were unaware of the results of the patient's hemodynamics. Each examiner independently assessed patients for the presence of a RV lift, loud P2, jugular venous distension (JVD), tricuspid insufficiency murmur and right-sided 4th heart sound at rest and during a slow inspiration. A global rating (scale of 1-5) of the likelihood that the patient had pulmonary hypertension was provided by each examiner. 31 articles that assessed the physical examination in PH were included in the final analysis. There was heterogeneity amongst the studies and many did not include control data. The sign most associated with PH in the literature was a loud pulmonic component of the second heart sound (P2). In our prospective study physical examination was performed on 52 subjects (25 met criteria for PH; mPAP ≥ 25 mmHg). The physical sign with the highest likelihood ratio (LR) was a loud P2 on inspiration with a LR +ve 1.9, 95% CrI [1.2, 3.1] when data from all examiners was analyzed together. Results from the specialist examiners had higher diagnostic utility; a loud P2 on inspiration was associated with a positive LR of 3.2, 95% CrI [1.5, 6.2] and a right sided S4 on inspiration had a LR +ve 4.7, 95% CI [1.0, 15.6]. No aspect of the physical exam, could consistently rule out PH (negative LRs 0

  11. Utility of the Physical Examination in Detecting Pulmonary Hypertension. A Mixed Methods Study

    Science.gov (United States)

    Colman, Rebecca; Whittingham, Heather; Tomlinson, George; Granton, John

    2014-01-01

    Introduction Patients with pulmonary hypertension (PH) often present with a variety of physical findings reflecting a volume or pressure overloaded right ventricle (RV). However, there is no consensus regarding the diagnostic utility of the physical examination in PH. Methods We conducted a systematic review of publications that evaluated the clinical examination and diagnosis of PH using MEDLINE (1946–2013) and EMBASE (1947–2013). We also prospectively evaluated the diagnostic utility of the physical examination findings. Patients who underwent right cardiac catheterization for any reason were recruited. After informed consent, participants were examined by 6 physicians (3 “specialists” and 3 “generalists”) who were unaware of the results of the patient's hemodynamics. Each examiner independently assessed patients for the presence of a RV lift, loud P2, jugular venous distension (JVD), tricuspid insufficiency murmur and right-sided 4th heart sound at rest and during a slow inspiration. A global rating (scale of 1–5) of the likelihood that the patient had pulmonary hypertension was provided by each examiner. Results 31 articles that assessed the physical examination in PH were included in the final analysis. There was heterogeneity amongst the studies and many did not include control data. The sign most associated with PH in the literature was a loud pulmonic component of the second heart sound (P2). In our prospective study physical examination was performed on 52 subjects (25 met criteria for PH; mPAP ≥25 mmHg). The physical sign with the highest likelihood ratio (LR) was a loud P2 on inspiration with a LR +ve 1.9, 95% CrI [1.2, 3.1] when data from all examiners was analyzed together. Results from the specialist examiners had higher diagnostic utility; a loud P2 on inspiration was associated with a positive LR of 3.2, 95% CrI [1.5, 6.2] and a right sided S4 on inspiration had a LR +ve 4.7, 95% CI [1.0, 15.6]. No aspect of the physical exam, could

  12. Rationale for promoting physical activity among cancer survivors: literature review and epidemiologic examination.

    Science.gov (United States)

    Loprinzi, Paul D; Lee, Hyo

    2014-03-01

    To review the extant literature on the link between physical activity and health outcomes among cancer survivors; identify evidence-based strategies to promote physical activity among this population; and conduct an epidemiologic study based on gaps from the literature review, examining the association between physical activity and various biologic markers. The authors used PubMed and Google Scholar up to July 2013, as well as data from the 2003-2006 National Health and Nutrition Examination Survey for the empirical study. Studies were examined through a systematic review process. In the epidemiologic study, 227 adult cancer survivors wore an accelerometer for four days or longer, with biologic markers (e.g., cholesterol) assessed from a blood sample. The review study demonstrated that cancer survivors are relatively inactive, but physical activity may help to reduce the risk of cancer recurrence and cancer-related mortality, increase cancer treatment rates, reduce pain and other side effects associated with cancer treatment, and improve physical and mental health. The epidemiologic study showed that physical activity was associated with several understudied biomarkers (e.g., neutrophils, white blood cells) that are linked with cancer recurrence, cancer-related mortality, and other chronic diseases. Nurses are encouraged to promote physical activity in cancer survivors.

  13. Pre-Participation Screening: The Use of Fundamental Movements as an Assessment of Function – Part 1

    Science.gov (United States)

    Burton, Lee; Hoogenboom, Barb

    2006-01-01

    To prepare an athlete for the wide variety of activities needed to participate in their sport, the analysis of fundamental movements should be incorporated into pre-participation screening in order to determine who possesses, or lacks, the ability to perform certain essential movements. In a series of two articles, the background and rationale for the analysis of fundamental movement will be provided. In addition, one such evaluation tool that attempts to assess the fundamental movement patterns performed by an individual, the Functional Movement Screen (FMS™), will be described. Three of the seven fundamental movement patterns that comprise the FMS™ are described in detail in Part I: deep squat, hurdle step, and in-line lunge. Part II of this series, which will be published in the August issue of NAJSPT, will provide a brief review of the analysis of fundamental movements, as well a detailed description of the four additional patterns that complement those presented in Part I (to complete the total of seven fundamental movement patterns which comprise the FMS™): shoulder mobility, active straight leg raise, trunk stability push-up, and rotary stability. The intent of this two part series is to introduce the concept of the evaluation of fundamental movements, whether it is the FMS™ system or a different system devised by another clinician. Such a functional assessment should be incorporated into pre-participation screening in order to determine whether the athlete has the essential movements needed to participate in sports activities with a decreased risk of injury. PMID:21522216

  14. Expected prevalence from the differential diagnosis of anterior knee pain in adolescent female athletes during preparticipation screening.

    Science.gov (United States)

    Barber Foss, Kim D; Myer, Gregory D; Chen, Stephen S; Hewett, Timothy E

    2012-01-01

    Anterior knee pain is a common disorder in female athletes with an undefined cause. The relative prevalence of specific patellofemoral disorders associated with anterior knee pain in adolescent females remains undetermined. To determine the prevalence of specific patellofemoral disorders obtained using the differential diagnosis of anterior knee pain in adolescent female athletes during preparticipation screening. Descriptive epidemiology study. Preparticipation screening evaluations at a county public school district in Kentucky. A total of 419 unique middle and high school-aged female athletes. Participants were evaluated by physicians for anterior knee pain over 3 consecutive basketball seasons. Given the longitudinal nature of this study, some participants were tested longitudinally over multiple years. Over the course of 3 basketball seasons, 688 patient evaluations were performed. Of these, 183 (26.6%) were positive for anterior knee pain. A statistically significant difference was noted in the prevalence of anterior knee pain by school level, with 34.4% (n = 67) in high school-aged athletes versus 23.5% (n = 116) in middle school-aged athletes (P patellar tendinopathy, with 38 cases (9.7%) in high school-aged and 31 (3.1%) in middle school-aged athletes (P < .05). Anterior knee pain was present in 26.6% of the adolescent female athletes screened over 3 years. Symptoms of anterior knee pain likely persist after middle school-aged onset and reach peak prevalence during the high school years.

  15. Multidrug-resistant bacteria infection and nursing quality management application in the department of physical examination.

    Science.gov (United States)

    Xu, Li; Luo, Qiang; Chen, Liangzhen; Jiao, Lingmei

    2017-09-01

    The main problem of clinical prevention and control of multi drug resistant bacteria infection is to strengthen the monitoring of pathogenic bacteria spectrum, this study research on the multi drug-resistant bacteria infection and nursing quality management application in the department of physical examination. The results of this study showed that the number of patients with multiple drug resistant infections showed an increasing trend. Therefore, once the patients with multiple drug-resistant bacteria infection are found, the prevention and control of the patients with multiple drug-resistant bacteria should be strictly followed, and the patient's medication care should be highly valued. Also, the nurses need to be classified based on the knowledge and skill characteristics of the nurses in the department of physical examination, and compare the nursing effect before and after classification and grouping. The physicians and individuals receiving physical examinations in the department of physical examination had a higher degree of satisfaction for nursing effect after classification compared with those before classification. Classification and grouping management helps improve the nursing quality and overall quality of the nurses in the department of physical examination.

  16. Ultrasound Findings on Hands and Wrists of Patients with Systemic Lupus Erythematosus: Relationship with Physical Examination.

    Science.gov (United States)

    Lins, Carolina Freitas; Lima de Sá Ribeiro, Daniel; Dourado Santos, Willer Gonçalves; Rosa, Genevievi; Machicado, Viviane; Pedreira, Ana Luisa; Pimenta da Fonseca, Emanuela; Mota Duque Sousa, Anna Paula; Rodrigues Silva, Carla Baleeiro; Matos, Marcos Antonio Almeida; Santiago, Mittermayer Barreto

    2017-09-01

    Diagnosis of synovitis/tenosynovitis by physical examination can be difficult. Ultrasound (US) can be an effective tool for the evaluation of joint involvement in systemic lupus erythematosus (SLE). This study will describe musculoskeletal findings by US in SLE patients and the evaluation of their correlation with physical examination. SLE patients underwent clinical/sonographic evaluation of hand/wrists. In total, 896 joints were evaluated: at least 1 change on physical examination was found in 136 joints and at least 1 US abnormality was found in 65 of 896 joints. Out of the 65 joints with US changes, only 13 had findings on physical examination. Conversely, 111 joints had tenderness on physical examination with no sonographic abnormalities. Tenosynovitis was statistically significant more frequently with joint edema (41%) (p = 0.0003). US can detect musculoskeletal changes in only a minority of symptomatic SLE patients. Clinical findings may be related to some reasons that cannot be explained using US. Copyright © 2017 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  17. Physical examination tests for the diagnosis of posterior cruciate ligament rupture: a systematic review.

    Science.gov (United States)

    Kopkow, Christian; Freiberg, Alice; Kirschner, Stephan; Seidler, Andreas; Schmitt, Jochen

    2013-11-01

    Systematic literature review. To summarize and evaluate research on the accuracy of physical examination tests for diagnosis of posterior cruciate ligament (PCL) tear. Rupture of the PCL is a severe knee injury that can lead to delayed rehabilitation, instability, or chronic knee pathologies. To our knowledge, there is currently no systematic review of studies on the diagnostic accuracy of clinical examination tests to evaluate the integrity of the PCL. A comprehensive systematic literature search was conducted in MEDLINE from 1946, Embase from 1974, and the Allied and Complementary Medicine Database from 1985 until April 30, 2012. Studies were considered eligible if they compared the results of physical examination tests performed in the context of a PCL physical examination to those of a reference standard (arthroscopy, arthrotomy, magnetic resonance imaging). Methodological quality assessment was performed by 2 independent reviewers using the revised version of the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. The search strategy revealed 1307 articles, of which 11 met the inclusion criteria for this review. In these studies, 11 different physical examination tests were identified. Due to differences in study types, different patient populations, and methodological quality, meta-analysis was not indicated. Presently, most physical examination tests have not been evaluated sufficiently enough to be confident in their ability to either confirm or rule out a PCL tear. The diagnostic accuracy of physical examination tests to assess the integrity of the PCL is largely unknown. There is a strong need for further research in this area. Level of Evidence Diagnosis, level 3a.

  18. Physical examination of the hemodialysis arteriovenous fistula to detect early dysfunction.

    Science.gov (United States)

    Abreo, Kenneth; Amin, Bakhtiar M; Abreo, Adrian P

    2018-04-01

    The maintenance of vascular access patency for end-stage renal disease patients on hemodialysis is necessary for survival. Many nephrologists, nurse practitioners, and nurses have limited experience with the physical examination of the arteriovenous fistula. In this review, we define key terms used in the assessment of an arteriovenous fistula. We discuss the arteriovenous fistula physical exam, including details of inspection, palpation, and auscultation. Using these concepts, we review the abnormal findings that can assist practitioners in determining the location of a stenosis. We review the existing literature that validates physical exam findings with gold standard tests such as ultrasound and angiography. Finally, we review data supporting the value of training physicians and nurses in arteriovenous fistula physical examination.

  19. Examining the Pathways between Gratitude and Self-Rated Physical Health across Adulthood

    Science.gov (United States)

    Hill, Patrick L.; Allemand, Mathias; Roberts, Brent W.

    2012-01-01

    The current study examined whether dispositional gratitude predicts physical health among adults, and if so, whether this relationship occurs because grateful individuals lead healthier lives, either psychologically or physically. Specifically, we examined whether psychological health, healthy activities, and willingness to seek help for health concerns mediated the link between gratitude and self-reported physical health, as well as if these mediational pathways are moderated by age, in a broad sample of Swiss adults (N = 962, Mage = 52 years, age range: 19 to 84). Dispositional gratitude correlated positively with self-reported physical health, and this link was mediated by psychological health, healthy activities, and willingness to seek help for health concerns. However, the indirect effects for psychological health and healthy activities were stronger for older than younger adults. In other words, the mechanisms explaining why gratitude predicts health appear to differ across adulthood. PMID:23139438

  20. [Importance of history and physical examination for the care of nurses].

    Science.gov (United States)

    Santos, Neuma; Veiga, Patrícia; Andrade, Renata

    2011-01-01

    The history and physical examination are part of data collection of the Nursing Process. Its implementation is aimed at individualized care, holistic, humane and scientific foundation. The literature review was carried out in indexed databases as LILACS and SciELO, books and journals available in local libraries as published between the years 2000 to 2009. The aim is to describe the importance of clinical history and physical examination in the care provided by nurses. The results of this research will enable nursing students and health professionals can better understand the importance of history taking and physical examination to their professional practice, implement properly all stages of NAS and arouse interest in research on this topic.

  1. Diagnostic accuracy of scapular physical examination tests for shoulder disorders: a systematic review.

    Science.gov (United States)

    Wright, Alexis A; Wassinger, Craig A; Frank, Mason; Michener, Lori A; Hegedus, Eric J

    2013-09-01

    To systematically review and critique the evidence regarding the diagnostic accuracy of physical examination tests for the scapula in patients with shoulder disorders. A systematic, computerised literature search of PubMED, EMBASE, CINAHL and the Cochrane Library databases (from database inception through January 2012) using keywords related to diagnostic accuracy of physical examination tests of the scapula. The Quality Assessment of Diagnostic Accuracy Studies tool was used to critique the quality of each paper. Eight articles met the inclusion criteria; three were considered to be of high quality. Of the three high-quality studies, two were in reference to a 'diagnosis' of shoulder pain. Only one high-quality article referenced specific shoulder pathology of acromioclavicular dislocation with reported sensitivity of 71% and 41% for the scapular dyskinesis and SICK scapula test, respectively. Overall, no physical examination test of the scapula was found to be useful in differentially diagnosing pathologies of the shoulder.

  2. The physical examination content of the Japanese National Health and Nutrition Survey: temporal changes.

    Science.gov (United States)

    Tanaka, Hisako; Imai, Shino; Nakade, Makiko; Imai, Eri; Takimoto, Hidemi

    2016-12-01

    Survey items of the Japan National Nutrition Survey (J-NNS) have changed over time. Several papers on dietary surveys have been published; however, to date, there are no in-depth papers regarding physical examinations. Therefore, we investigated changes in the survey items in the physical examinations performed in the J-NNS and the National Health and Nutrition Survey (NHNS), with the aim of incorporating useful data for future policy decisions. We summarized the description of physical examinations and marshalled the changes of survey items from the J-NNS and NHNS from 1946 to 2012. The physical examination is roughly classified into the following six components: some are relevant to anthropometric measurements, clinical measurements, physical symptoms, blood tests, lifestyle and medication by interview, and others. Items related to nutritional deficiency, such as anaemia and tendon reflex disappearance, and body weight measurements were collected during the early period, according to the instructions of the General Headquarters. From 1989, blood tests and measurement of physical activity were added, and serum total protein, total cholesterol, triglycerides, HDL-cholesterol, blood glucose, red blood corpuscles and haemoglobin measurements have been performed continuously for more than 20 years. This is the first report on the items of physical examination in the J-NNS and NHNS. Our research results provide basic information for the utilization of the J-NNS and NHNS, to researchers, clinicians or policy makers. Monitoring the current state correctly is essential for national health promotion, and also for improvement of the investigation methods to apply country-by-country comparisons.

  3. Association between physical activity and kidney function: National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Hawkins, Marquis S; Sevick, Mary Ann; Richardson, Caroline R; Fried, Linda F; Arena, Vincent C; Kriska, Andrea M

    2011-08-01

    Chronic kidney disease is a condition characterized by the deterioration of the kidney's ability to remove waste products from the body. Although treatments to slow the progression of the disease are available, chronic kidney disease may eventually lead to a complete loss of kidney function. Previous studies have shown that physical activities of moderate intensity may have renal benefits. Few studies have examined the effects of total movement on kidney function. The purpose of this study was to determine the association between time spent at all levels of physical activity intensity and sedentary behavior and kidney function. Data were obtained from the 2003-2004 and 2005-2006 National Health and Nutrition Examination Survey, a cross-sectional study of a complex, multistage probability sample of the US population. Physical activity was assessed using an accelerometer and questionnaire. Glomerular filtration rate (eGFR) was estimated using the Modification of Diet in Renal Disease study formula. To assess linear associations between levels of physical activity and sedentary behavior with log-transformed estimated GFR (eGFR), linear regression was used. In general, physical activity (light and total) was related to log eGFR in females and males. For females, the association between light and total physical activity with log eGFR was consistent regardless of diabetes status. For males, the association between light and total physical activity and log eGFR was only significant in males without diabetes. When examining the association between physical activity, measured objectively with an accelerometer, and kidney function, total and light physical activities were found to be positively associated with kidney function.

  4. Examining the Knowledge and Capacity of Elementary Teachers to Implement Classroom Physical Activity Breaks

    Directory of Open Access Journals (Sweden)

    Danae M. DINKEL

    2016-09-01

    Full Text Available This study examined teachers’ zone of proximal development for classroom physical activity breaks by assessing teachers’ knowledge and capacity for implementing classroom physical activity breaks. Five school districts of various sizes (n=346 teachers took part in a short online survey. Descriptive statistics were calculated and chi-square analyses were used to identify differences between districts. Almost all teachers utilized classroom physical activity to some extent. A third of teachers who stated they implemented classroom physical activity, experienced barriers to implementation. A majority of teachers were interested in learning more about classroom physical activity. There were significant differences between districts on the number of days per week classroom physical activity was integrated, the frequency of collaboration that occurred between teachers, the percentage of teachers who experienced barriers, and preferred delivery method of professional development. These findings support the importance of identifying teachers’ zone of proximal development to increase the use of classroom physical activity breaks. Understanding teachers’ knowledge and capacity for implementing classroom physical activity breaks can allow educational professionals to shift the implementation of classroom physical activity beyond sporadic use by isolated teachers and schools to a more systematic and consistent delivery across classrooms and throughout districts.

  5. Validity of Combining History Elements and Physical Examination Tests to Diagnose Patellofemoral Pain.

    Science.gov (United States)

    Décary, Simon; Frémont, Pierre; Pelletier, Bruno; Fallaha, Michel; Belzile, Sylvain; Martel-Pelletier, Johanne; Pelletier, Jean-Pierre; Feldman, Debbie; Sylvestre, Marie-Pierre; Vendittoli, Pascal-André; Desmeules, François

    2018-04-01

    To assess the validity of diagnostic clusters combining history elements and physical examination tests to diagnose or exclude patellofemoral pain (PFP). Prospective diagnostic study. Orthopedic outpatient clinics, family medicine clinics, and community-dwelling. Consecutive patients (N=279) consulting one of the participating orthopedic surgeons (n=3) or sport medicine physicians (n=2) for any knee complaint. Not applicable. History elements and physical examination tests were obtained by a trained physiotherapist blinded to the reference standard: a composite diagnosis including both physical examination tests and imaging results interpretation performed by an expert physician. Penalized logistic regression (least absolute shrinkage and selection operator) was used to identify history elements and physical examination tests associated with the diagnosis of PFP, and recursive partitioning was used to develop diagnostic clusters. Diagnostic accuracy measures including sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios with associated 95% confidence intervals (CIs) were calculated. Two hundred seventy-nine participants were evaluated, and 75 had a diagnosis of PFP (26.9%). Different combinations of history elements and physical examination tests including the age of participants, knee pain location, difficulty descending stairs, patellar facet palpation, and passive knee extension range of motion were associated with a diagnosis of PFP and used in clusters to accurately discriminate between individuals with PFP and individuals without PFP. Two diagnostic clusters developed to confirm the presence of PFP yielded a positive likelihood ratio of 8.7 (95% CI, 5.2-14.6) and 3 clusters to exclude PFP yielded a negative likelihood ratio of .12 (95% CI, .06-.27). Diagnostic clusters combining common history elements and physical examination tests that can accurately diagnose or exclude PFP compared to various knee

  6. Physical design correlates of efficiency and safety in emergency departments: a qualitative examination.

    Science.gov (United States)

    Pati, Debajyoti; Harvey, Thomas E; Pati, Sipra

    2014-01-01

    The objective of this study was to explore and identify physical design correlates of safety and efficiency in emergency department (ED) operations. This study adopted an exploratory, multimeasure approach to (1) examine the interactions between ED operations and physical design at 4 sites and (2) identify domains of physical design decision-making that potentially influence efficiency and safety. Multidisciplinary gaming and semistructured interviews were conducted with stakeholders at each site. Study data suggest that 16 domains of physical design decisions influence safety, efficiency, or both. These include (1) entrance and patient waiting, (2) traffic management, (3) subwaiting or internal waiting areas, (4) triage, (5) examination/treatment area configuration, (6) examination/treatment area centralization versus decentralization, (7) examination/treatment room standardization, (8) adequate space, (9) nurse work space, (10) physician work space, (11) adjacencies and access, (12) equipment room, (13) psych room, (14) staff de-stressing room, (15) hallway width, and (16) results waiting area. Safety and efficiency from a physical environment perspective in ED design are mutually reinforcing concepts--enhancing efficiency bears positive implications for safety. Furthermore, safety and security emerged as correlated concepts, with security issues bearing implications for safety, thereby suggesting important associations between safety, security, and efficiency.

  7. Understanding the medical markers of elder abuse and neglect: physical examination findings.

    Science.gov (United States)

    Gibbs, Lisa M

    2014-11-01

    A specific foundation of knowledge is important for evaluating potential abuse from physical findings in the older adult. The standard physical examination is a foundation for detecting many types of abuse. An understanding of traumatic injuries, including patterns of injury, is important for health care providers, and inclusion of elder abuse in the differential diagnosis of patient care is essential. One must possess the skills needed to piece the history, including functional capabilities, and physical findings together. Armed with this skill set, health care providers will develop the confidence needed to identify and intervene in cases of elder abuse. Copyright © 2014 Elsevier Inc. All rights reserved.

  8. The FAMULATUR PLUS as an innovative approach for teaching physical examination skills

    Directory of Open Access Journals (Sweden)

    Jerg, Achim

    2016-02-01

    Full Text Available The FAMULATUR PLUS is an innovative approach to teaching physical examination skills. The concept is aimed at medical students during the clinical part of their studies and includes a clinical traineeship (English for “Famulatur” extended to include various courses (“PLUS”. The courses are divided into clinical examination courses and problembased-learning (PBL seminars. The concept’s special feature is the full integration of these courses into a 30-day hospital traineeship. The aim is to facilitate the transfer of knowledge from the courses into daily practice. Each week of the FAMULATUR PLUS is structured in line with the courses and focuses on a particular part of the body (e.g., abdomen. A physical examination course under the supervision of a physician is offered at the beginning of the week. Here, medical students learn the relevant examination techniques by practicing on each other (partner exercises. Subsequently, the techniques taught are applied independently during everyday work on the ward, corrected by the supervisor, if necessary, and thereby reinforced. The final POL seminar takes place towards the end of the week. Possible differential diagnoses are developed based on a clinical case study. The goal is to check these by taking a fictitious medical history and performing a physical examination, as well as to make a preliminary diagnosis. Finally, during the PBL seminar, medical students will be shown how physical examination techniques can be efficiently applied in the diagnosis of common cardinal symptoms (e.g., abdominal pain. The initial implementation of the FAMULATUR PLUS proved the practical feasibility of the concept. In addition, the accompanying evaluation showed that the participants of the pilot project improved with regard to their practical physical examination skills.

  9. Chaperones and intimate physical examinations: what do male and female patients want?

    Science.gov (United States)

    Fan, V C; Choy, H T; Kwok, G Yj; Lam, H G; Lim, Q Y; Man, Y Y; Tang, C K; Wong, C C; Yu, Y F; Leung, G Kk

    2017-02-01

    Many studies of patients' perception of a medical chaperone have focused on female patients; that of male patients are less well studied. Moreover, previous studies were largely based on patient populations in English-speaking countries. Therefore, this study was conducted to investigate the perception and attitude of male and female Chinese patients to the presence of a chaperone during an intimate physical examination. A cross-sectional guided questionnaire survey was conducted on a convenient sample of 150 patients at a public teaching hospital in Hong Kong. Over 90% of the participants considered the presence of a chaperone appropriate during intimate physical examination, and 84% felt that doctors, irrespective of gender, should always request the presence of a chaperone. The most commonly cited reasons included the availability of an objective account should any legal issue arise, protection against sexual harassment, and to provide psychological support. This contrasted with the experience of those who had previously undergone an intimate physical examination of whom only 72.6% of women and 35.7% of men had reportedly been chaperoned. Among female participants, 75.0% preferred to be chaperoned during an intimate physical examination by a male doctor, and 28.6% would still prefer to be chaperoned when being examined by a female doctor. Among male participants, over 50% indicated no specific preference but a substantial minority reported a preference for chaperoned examination (21.2% for male doctor and 25.8% for female doctor). Patients in Hong Kong have a high degree of acceptance and expectations about the role of a medical chaperone. Both female and male patients prefer such practice regardless of physician gender. Doctors are strongly encouraged to discuss the issue openly with their patients before they conduct any intimate physical examination.

  10. The FAMULATUR PLUS as an innovative approach for teaching physical examination skills.

    Science.gov (United States)

    Jerg, Achim; Öchsner, Wolfgang; Wander, Henriette; Traue, Harald C; Jerg-Bretzke, Lucia

    2016-01-01

    The FAMULATUR PLUS is an innovative approach to teaching physical examination skills. The concept is aimed at medical students during the clinical part of their studies and includes a clinical traineeship (English for "Famulatur") extended to include various courses ("PLUS"). The courses are divided into clinical examination courses and problembased-learning (PBL) seminars. The concept's special feature is the full integration of these courses into a 30-day hospital traineeship. The aim is to facilitate the transfer of knowledge from the courses into daily practice. Each week of the FAMULATUR PLUS is structured in line with the courses and focuses on a particular part of the body (e.g., abdomen). A physical examination course under the supervision of a physician is offered at the beginning of the week. Here, medical students learn the relevant examination techniques by practicing on each other (partner exercises). Subsequently, the techniques taught are applied independently during everyday work on the ward, corrected by the supervisor, if necessary, and thereby reinforced. The final POL seminar takes place towards the end of the week. Possible differential diagnoses are developed based on a clinical case study. The goal is to check these by taking a fictitious medical history and performing a physical examination, as well as to make a preliminary diagnosis. Finally, during the PBL seminar, medical students will be shown how physical examination techniques can be efficiently applied in the diagnosis of common cardinal symptoms (e.g., abdominal pain). The initial implementation of the FAMULATUR PLUS proved the practical feasibility of the concept. In addition, the accompanying evaluation showed that the participants of the pilot project improved with regard to their practical physical examination skills.

  11. Point-of-care cardiac ultrasound techniques in the physical examination: better at the bedside.

    Science.gov (United States)

    Kimura, Bruce J

    2017-07-01

    The development of hand-carried, battery-powered ultrasound devices has created a new practice in ultrasound diagnostic imaging, called 'point-of-care' ultrasound (POCUS). Capitalising on device portability, POCUS is marked by brief and limited ultrasound imaging performed by the physician at the bedside to increase diagnostic accuracy and expediency. The natural evolution of POCUS techniques in general medicine, particularly with pocket-sized devices, may be in the development of a basic ultrasound examination similar to the use of the binaural stethoscope. This paper will specifically review how POCUS improves the limited sensitivity of the current practice of traditional cardiac physical examination by both cardiologists and non-cardiologists. Signs of left ventricular systolic dysfunction, left atrial enlargement, lung congestion and elevated central venous pressures are often missed by physical techniques but can be easily detected by POCUS and have prognostic and treatment implications. Creating a general set of repetitive imaging skills for these entities for application on all patients during routine examination will standardise and reduce heterogeneity in cardiac bedside ultrasound applications, simplify teaching curricula, enhance learning and recollection, and unify competency thresholds and practice. The addition of POCUS to standard physical examination techniques in cardiovascular medicine will result in an ultrasound-augmented cardiac physical examination that reaffirms the value of bedside diagnosis. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  12. Tests and measures used by specialist physical therapists when examining patients with stroke.

    Science.gov (United States)

    Andrews, A Williams; Folger, Stephen E; Norbet, Shannon E; Swift, Lindsay C

    2008-09-01

    Examination procedures preferred by physical therapists have not been documented either specifically or comprehensively. The purpose of this study was to determine which tests and measures are used most frequently by specialists in the examination of adults with stroke. Physical therapy specialists were identified as having geriatric or neurologic certification through the American Board of Physical Therapy Specialties. A request to participate in a Web-based survey was sent to 471 individuals in the American Physical Therapy Association's Directory of Certified Specialists. A comprehensive list of tests and measures was first derived from the Interactive Guide to Physical Therapist Practice. The list was finalized based on several exclusion criteria and the results of a pilot study. Subjects rated the frequency of use of 294 tests and measures with patients post-stroke on a Likert scale. The survey response rate was 31.7% (n = 128). The 50 most frequently used tests and measures were identified. The results of this study do not identify the tests and measures that clinicians should use, only those that the specialists use. Nevertheless, clinicians may want to consider tests and measurements frequently used by specialists when examining adults with stroke.

  13. [Physical activity: results of the German Health Interview and Examination Survey for Adults (DEGS1)].

    Science.gov (United States)

    Krug, S; Jordan, S; Mensink, G B M; Müters, S; Finger, J; Lampert, T

    2013-05-01

    Regular physical activity can have a positive effect on health at any age. Today's lifestyles, however, can often be characterised as sedentary. Therefore, the promotion of physical activity and sports has become an integral part of public health measures. The representative data of adults aged 18 to 79 years in Germany obtained from the "German Health Interview and Examination Survey for Adults" (DEGS1) provide an overview of self-estimated current physical activity behaviour. The results show that one third of the adult population claims to pay close attention to reaching a sufficient level of physical activity and one fourth participates in sports for at least 2 h/week on a regular basis. Thus, the percentage of adults regularly engaged in sports has increased compared to the previous "German National Health Interview and Examination Survey 1998". Still, four out of five adults do not achieve at least 2.5 h/week of moderate-intensity physical activity as recommended by the World Health Organisation. Consequently, future individual-level and population-level interventions should focus on target group-specific measures while continuing to promote regular physical activity in all segments of the population. An English full-text version of this article is available at SpringerLink as supplemental.

  14. Is physical examination required before prescribing hormones to patients with gender dysphoria?

    NARCIS (Netherlands)

    Vardi, Y.; Wylie, K.R.; Moser, C; Assalian, P.; Dean, J.; Asscheman, H.

    2008-01-01

    Introduction. A genital examination can have psychologic effects on a patient, particularly when the source of their sexual medicine complaint is a body part. How necessary is a physical exam before prescribing hormones in cases of gender dsyphoria? Methods. Five people with expertise and/or

  15. Comparative Analyses of Physics Candidates Scores in West African and National Examinations Councils

    Science.gov (United States)

    Utibe, Uduak James; Agah, John Joseph

    2015-01-01

    The study is a comparative analysis of physics candidates' scores in West African and National Examinations Councils. It also investigates influence of gender. Results of 480 candidates were randomly selected form three randomly selected Senior Science Colleges using the WASSCE and NECOSSCE computer printout sent to the schools, transformed using…

  16. Examining the Values of Students in the Physical Education and Sport Departments

    Science.gov (United States)

    Gullu, Mehmet

    2016-01-01

    In this study, the values of students in the physical education and sport departments were examined according to their gender, age, grade, and departments. The questionnaire method was used in the study. As the data collection tool, the Portrait Values Questionnaire was applied. The study group consisted of a total of 389 students 126 of whom were…

  17. Captured on Film: A Critical Examination of Representations of Physical Education at the Movies

    Science.gov (United States)

    Walton-Fisette, Jennifer L.; Walton-Fisette, Theresa A.; Chase, Laura Frances

    2017-01-01

    Background: Throughout this mediated society, young people, in particular, are mass consumers of corporatized media. The mediation of sport has long been critically examined within sociology and physical cultural studies [(e.g. Mcdonald, M. G., and S. Birrell. 1999. "Reading Sport Critically: A Methodology for Interrogating Power."…

  18. Multiple physical healthcare needs among outpatients with schizophrenia: findings from a health examination study.

    Science.gov (United States)

    Eskelinen, Saana; Sailas, Eila; Joutsenniemi, Kaisla; Holi, Matti; Koskela, Tuomas H; Suvisaari, Jaana

    2017-08-01

    Despite the abundant literature on physical comorbidity, the full range of the concurrent somatic healthcare needs among individuals with schizophrenia has rarely been studied. This observational study aimed to assess the distressing somatic symptoms and needs for physical health interventions in outpatients with schizophrenia, and factors predicting those needs. A structured, comprehensive health examination was carried out, including a visit to a nurse and a general practitioner on 275 outpatients with schizophrenia. The required interventions were classified by type of disease. Logistic regression was used to assess the influence of sociodemographic factors, lifestyle, functional limitations, factors related to psychiatric disorder, and healthcare use on the need for interventions. In total, 44.9% of the patients (mean age 44.9 years) reported somatic symptoms affecting daily life; 87.6% needed specific interventions for a disease or condition, most commonly for cardiovascular, dermatological, dental, ophthalmological, and gastrointestinal conditions, and for altered glucose homeostasis. Smoking and obesity predicted significantly a need of any intervention, but the predictors varied in each disease category. Strikingly, use of general practitioner services during the previous year did not reduce the need for interventions. Health examinations for outpatients with schizophrenia revealed numerous physical healthcare needs. The health examinations for patients with schizophrenia should contain a medical history taking and a physical examination, in addition to basic measurements and laboratory tests. Prevention and treatment of obesity and smoking should be given priority in order to diminish somatic comorbidities in schizophrenia.

  19. Examining End-of-Chapter Problems across Editions of an Introductory Calculus-Based Physics Textbook

    Science.gov (United States)

    Xiao, Bin

    2016-01-01

    End-Of-Chapter (EOC) problems have been part of many physics education studies. Typically, only problems "localized" as relevant to a single chapter were used. This work examines how well this type of problem represents all EOC problems and whether EOC problems found in leading textbooks have changed over the past several decades. To…

  20. An Examination of Sixth Graders' Self-Determined Motivation and Learning in Physical Education

    Science.gov (United States)

    Sun, Haichun; Chen, Ang

    2010-01-01

    Self-determination theory (SDT), when applied in education, emphasizes helping learners internalize extrinsic motivation so as to regulate their learning behavior from an amotivation state to intrinsic motivation. The purpose of this study was to examine the relationship between SDT components and learning in middle school physical education.…

  1. Medial tibial stress syndrome can be diagnosed reliably using history and physical examination

    NARCIS (Netherlands)

    Winters, M.; Bakker, E. W. P.; Moen, M. H.; Barten, C. C.; Teeuwen, R.; Weir, A.

    2017-01-01

    The majority of sporting injuries are clinically diagnosed using history and physical examination as the cornerstone. There are no studies supporting the reliability of making a clinical diagnosis of medial tibial stress syndrome (MTSS). Our aim was to assess if MTSS can be diagnosed reliably, using

  2. Examine of Mobbing via Humour Styles of Lecturers at Schools of Physical Education and Sport

    Science.gov (United States)

    Cengiz, Recep; Sunay, Hakan; Yasar, Onur Mutlu

    2018-01-01

    The aim of the study was to examine the mobbing via humour of the lecturers at Schools of Physical Education and Sport. The sample of the study consisted of 470 lecturers dutied at those schools. In order to analyze the lecturers' perception levels about mobbing via humour behaviours, the "Scale of Humour Behaviours" was used. T-test and…

  3. Learning Physical Examination Skills outside Timetabled Training Sessions: What Happens and Why?

    Science.gov (United States)

    Duvivier, Robbert J.; van Geel, Koos; van Dalen, Jan; Scherpbier, Albert J. J. A.; van der Vleuten, Cees P. M.

    2012-01-01

    Lack of published studies on students' practice behaviour of physical examination skills outside timetabled training sessions inspired this study into what activities medical students undertake to improve their skills and factors influencing this. Six focus groups of a total of 52 students from Years 1-3 using a pre-established interview guide.…

  4. To observe or not to observe peers when learning physical examination skills; That is the question

    NARCIS (Netherlands)

    B. Martineau (Bernard); S. Mamede (Silvia); C. St-Onge (Christina); R.M.J.P. Rikers (Remy); H.G. Schmidt (Henk)

    2013-01-01

    textabstractBackground: Learning physical examination skills is an essential element of medical education. Teaching strategies include practicing the skills either alone or in-group. It is unclear whether students benefit more from training these skills individually or in a group, as the latter

  5. The role of physical examinations in studies of musculoskeletal disorders of the elbow

    DEFF Research Database (Denmark)

    Kryger, Ann Isabel; Lassen, C. F.; Andersen, JH

    2007-01-01

    OBJECTIVES: To present data on pain and physical findings from the elbow region, and to discuss the role of diagnostic criteria in epidemiological studies of epicondylitis. METHODS: From a cohort of computer workers a subgroup of 1369 participants, who reported at least moderate pain in the neck...... completed on the day of examination. RESULTS: 349 participants met the authors' criteria for being an arm case and 249 were elbow cases. Among the 1369 participants the prevalence of at least mild palpation tenderness and indirect tenderness at the lateral epicondyle was 5.8%. The occurrence of physical...... findings increased markedly by level of pain score. Only about one half with physical findings fulfilled the authors' pain criteria for having lateral epicondylitis. A large part with physical findings reported no pain at all in the elbow in any of the two questionnaires, 28% and 22%, respectively. Inter...

  6. Development and validation of a musculoskeletal physical examination decision-making test for medical students.

    Science.gov (United States)

    Bishop, Julie Y; Awan, Hisham M; Rowley, David M; Nagel, Rollin W

    2013-01-01

    Despite a renewed emphasis among educators, musculoskeletal education is still lacking in medical school and residency training programs. We created a musculoskeletal multiple-choice physical examination decision-making test to assess competency and physical examination knowledge of our trainees. We developed a 20-question test in musculoskeletal physical examination decision-making test with content that most medical students and orthopedic residents should know. All questions were reviewed by ratings of US orthopedic chairmen. It was administered to postgraduate year 2 to 5 orthopedic residents and 2 groups of medical students: 1 group immediately after their 3-week musculoskeletal course and the other 1 year after the musculoskeletal course completion. We hypothesized that residents would score highest, medical students 1 year post-musculoskeletal training lowest, and students immediately post-musculoskeletal training midrange. We administered an established cognitive knowledge test to compare student knowledge base as we expected the scores to correlate. Academic medical center in the Midwestern United States. Orthopedic residents, chairmen, and medical students. Fifty-four orthopedic chairmen (54 of 110 or 49%) responded to our survey, rating a mean overall question importance of 7.12 (0 = Not Important; 5 = Important; 10 = Very Important). Mean physical examination decision-making scores were 89% for residents, 77% for immediate post-musculoskeletal trained medical students, and 59% 1 year post-musculoskeletal trained medical students (F = 42.07, pphysical examination decision-making test was found to be internally consistent (Kuder-Richardson Formula 20 = 0.69). The musculoskeletal cognitive knowledge test was 78% for immediate post-musculoskeletal trained students and 71% for the 1 year post-musculoskeletal trained students. The student physical examination and cognitive knowledge scores were correlated (r = 0.54, pphysical examination decision-making test

  7. Continuous physical examination during subcortical resection in awake craniotomy patients: Its usefulness and surgical outcome.

    Science.gov (United States)

    Bunyaratavej, Krishnapundha; Sangtongjaraskul, Sunisa; Lerdsirisopon, Surunchana; Tuchinda, Lawan

    2016-08-01

    To evaluate the value of physical examination as a monitoring tool during subcortical resection in awake craniotomy patients and surgical outcomes. Authors reviewed medical records of patients underwent awake craniotomy with continuous physical examination for pathology adjacent to the eloquent area. Between January 2006 and August 2015, there were 37 patients underwent awake craniotomy with continuous physical examination. Pathology was located in the left cerebral hemisphere in 28 patients (75.7%). Thirty patients (81.1%) had neuroepithelial tumors. Degree of resections were defined as total, subtotal, and partial in 16 (43.2%), 11 (29.7%) and 10 (27.0%) patients, respectively. Median follow up duration was 14 months. The reasons for termination of subcortical resection were divided into 3 groups as follows: 1) by anatomical landmark with the aid of neuronavigation in 20 patients (54%), 2) by reaching subcortical stimulation threshold in 8 patients (21.6%), and 3) by abnormal physical examination in 9 patients (24.3%). Among these 3 groups, there were statistically significant differences in the intraoperative (p=0.002) and early postoperative neurological deficit (p=0.005) with the lowest deficit in neuronavigation group. However, there were no differences in neurological outcome at later follow up (3-months p=0.103; 6-months p=0.285). There were no differences in the degree of resection among the groups. Continuous physical examination has shown to be of value as an additional layer of monitoring of subcortical white matter during resection and combining several methods may help increase the efficacy of mapping and monitoring of subcortical functions. Copyright © 2016 Elsevier B.V. All rights reserved.

  8. Novel Use of Ultrasound to Teach Reproductive System Physical Examination Skills and Pelvic Anatomy.

    Science.gov (United States)

    Parikh, Tejal; Czuzak, Maria; Bui, Naomi; Wildner, Corinna; Koch, Bryna; Leko, Elizabeth; Rappaport, William; Adhikari, Srikar; Gordon, Paul; Gura, Mike; Ellis, Susan

    2018-03-01

    To determine whether integration of ultrasound (US) into a reproductive system examination clinical skills lab can increase confidence in palpating key reproductive structures during testicular and bimanual pelvic examinations, reduce anxiety about conducting testicular and bimanual pelvic examinations, and improve performance on multiple-choice questions based on structure identification using US images. Second-year medical students enrolled in the Life Cycle preclinical course participated in this cross-sectional study. A single learning activity was developed to pair the teaching of the reproductive system physical examination with the use of US in the clinical skills lab. The evaluation of the teaching session consisted of a pre-post analysis of student self-reported knowledge, confidence, and anxiety. The response rate for the pre survey was 82% (n = 96), and the rate for the post survey was 79% (n = 93). Students' confidence in their ability to identify reproductive system structures on US images increased from pre to post survey. Their confidence in their ability to palpate the epididymis, uterus, and ovary during a physical examination improved, and their anxiety about conducting testicular and bimanual pelvic examinations decreased. Student satisfaction with the session was high. Students' performance on multiple-choice questions based on structure identification using US images was at 96% or higher. Our study findings support the integration of US into a reproductive system examination clinical skills lab. Medical students acquire competency and confidence in reproductive system physical examination skills with US integration. © 2017 by the American Institute of Ultrasound in Medicine.

  9. Relationship of physical examination test of shoulder instability to arthroscopic findings in dogs.

    Science.gov (United States)

    Devitt, Chad M; Neely, Marlon R; Vanvechten, Brian J

    2007-10-01

    To determine the diagnostic validity of commonly used physical examination maneuvers for shoulder instability. Retrospective study. Dogs (n=24) referred for shoulder arthroscopy. Results of physical maneuvers and arthroscopic findings were recorded and sensitivity, specificity, positive likelihood ratios (LR+), and negative likelihood ratios (LR-) were calculated for each of 4 physical examination test findings for arthroscopic changes in the medial, lateral, cranial, or caudal compartments of the shoulder joint viewed in dorsal recumbency by lateral and craniomedial portals. Distribution of compartment changes was: medial (17 dogs), caudal (15), cranial (12), and lateral (5). The biceps test had a moderate effect (LR+=9) on post-test probability of cranial compartment changes and a small effect on post-test probability of lateral and caudal compartment changes (LR+=3 and 2.4, respectively). Hyperabduction had a minimal effect and mediolateral instability test had a small effect (LR+=1.64 and 2.68, respectively) on post-test probability of medial compartment changes. Craniocaudal instability test had little to no effect on post-test probability of changes in any compartment. Physical examination tests evaluated were limited in their ability to predict the type of arthroscopic pathology in this study population. Clinicians should understand that a diagnostic test performs inconsistently based on prevalence of a condition in a given patient population. The use of likelihood ratios can assist clinicians in determining the probability of intraarticular changes from a group with a differing prevalence than the patient population presented.

  10. Femoral anteversion assessment: Comparison of physical examination, gait analysis, and EOS biplanar radiography.

    Science.gov (United States)

    Westberry, David E; Wack, Linda I; Davis, Roy B; Hardin, James W

    2018-05-01

    Multiple measurement methods are available to assess transverse plane alignment of the lower extremity. This study was performed to determine the extent of correlation between femoral anteversion assessment using simultaneous biplanar radiographs and three-dimensional modeling (EOS imaging), clinical hip rotation by physical examination, and dynamic hip rotation assessed by gait analysis. Seventy-seven patients with cerebral palsy (GMFCS Level I and II) and 33 neurologically typical children with torsional abnormalities completed a comprehensive gait analysis with same day biplanar anterior-posterior and lateral radiographs and three-dimensional transverse plane assessment of femoral anteversion. Correlations were determined between physical exam of hip rotation, EOS imaging of femoral anteversion, and transverse plane hip kinematics for this retrospective review study. Linear regression analysis revealed a weak relationship between physical examination measures of hip rotation and biplanar radiographic assessment of femoral anteversion. Similarly, poor correlation was found between clinical evaluation of femoral anteversion and motion assessment of dynamic hip rotation. Correlations were better in neurologically typical children with torsional abnormalities compared to children with gait dysfunction secondary to cerebral palsy. Dynamic hip rotation cannot be predicted by physical examination measures of hip range of motion or from three-dimensional assessment of femoral anteversion derived from biplanar radiographs. Copyright © 2018 Elsevier B.V. All rights reserved.

  11. 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...

  12. The influence of students' gender on equity in Peer Physical Examination: a qualitative study.

    Science.gov (United States)

    Vnuk, Anna K; Wearn, Andy; Rees, Charlotte E

    2017-08-01

    Peer Physical Examination (PPE) is an educational tool used globally for learning early clinical skills and anatomy. In quantitative research, there are differences in students' preferences and actual participation in PPE by gender. This novel study qualitatively explores the effect that gender has on medical students' experiences of learning physical examination through PPE. We employ an interpretative approach to uncover the PPE experiences of students from a European, graduate-entry medical school. Volunteers participated in either individual or group interviews. The data were transcribed, de-identified and analysed using thematic analysis. There was evidence of gender inequity in PPE, with students describing significant imbalances in participation. Male students adopted roles that generated significant personal discomfort and led to fewer experiences as examiners. Assumptions were made by tutors and students about gender roles: male students' ready acceptance of exposure to be examined and female students' need to be protected from particular examinations. In contrast with the first assumption, male students did feel coerced or obliged to be examined. Students described their experiences of taking action to break down the gender barrier. Importantly, students reported that tutors played a role in perpetuating inequities. These findings, whilst relating to one university, have implications for all settings where PPE is used. Educators should be vigilant about gender issues and the effect that they may have on students' participation in PPE to ensure that students are not disadvantaged in their learning.

  13. Total physical activity volume, physical activity intensity, and metabolic syndrome: 1999-2004 National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Churilla, James R; Fitzhugh, Eugene C

    2012-02-01

    This study examined the association of total physical activity volume (TPAV) and physical activity (PA) from three domains [leisure-time physical activity (LTPA), domestic, transportation] with metabolic syndrome. We also investigated the relationship between LTPA intensity and metabolic syndrome risk. Sample included adults who participated in the 1999-2004 National Health and Nutrition Examination Survey. Physical activity measures were created for TPAV, LTPA, domestic PA, and transportational PA. For each, a six-level measure based upon no PA (level 1) and quintiles (levels 2-6) of metabolic equivalents (MET)·min·wk(-1) was created. A three-level variable associated with the current Department of Health and Human Services (DHHS) PA recommendation was also created. SAS and SUDAAN were used for the statistical analysis. Adults reporting the greatest volume of TPAV and LTPA were found to be 36% [odds ratio (OR) 0.64; 95% confidence interval (CI) 0.49-0.83] and 42% (OR 0.58; 95% CI 0.43-0.77), respectively, less likely to have metabolic syndrome. Domestic and transportational PA provided no specific level of protection from metabolic syndrome. Those reporting a TPAV that met the DHHS PA recommendation were found to be 33% (OR 0.67; 95%; CI 0.55-0.83) less likely to have metabolic syndrome compared to their sedentary counterparts. Adults reporting engaging in only vigorous-intensity LTPA were found to be 37% (OR 0.63; 95 CI 0.42-0.96) to 56% (OR 0.44; 95% CI 0.29-0.67) less likely to have metabolic syndrome. Volume, intensity, and domain of PA may all play important roles in reducing the prevalence and risk of metabolic syndrome.

  14. Chronic low back pain in older adults: prevalence, reliability, and validity of physical examination findings.

    Science.gov (United States)

    Weiner, Debra K; Sakamoto, Sara; Perera, Subashan; Breuer, Paula

    2006-01-01

    To develop a structured physical examination protocol that identifies common biomechanical and soft-tissue abnormalities for older adults with chronic low back pain (CLBP) that can be used as a triage tool for healthcare providers and to test the interobserver reliability and discriminant validity of this protocol. Cross-sectional survey and examination. Older adult pain clinic. One hundred eleven community-dwelling adults aged 60 and older with CLBP and 20 who were pain-free. Clinical history for demographics, pain duration, previous lumbar surgery or advanced imaging, neurogenic claudication, and imaging clinically serious symptoms. Physical examination for scoliosis, functional leg length discrepancy, pain with lumbar movement, myofascial pain (paralumbar, piriformis, tensor fasciae latae (TFL)), regional bone pain (sacroiliac joint (SIJ), hip, vertebral body), and fibromyalgia. Scoliosis was prevalent in those with (77.5%) and without pain (60.0%), but prevalence of SIJ pain (84% vs 5%), fibromyalgia tender points (19% vs 0%), myofascial pain (96% vs 10%), and hip pain (48% vs 0%) was significantly different between groups (P physical examination. Their recognition may save unnecessary healthcare expenditure and patient suffering.

  15. Diagnosis of Pediatric Foreign Body Ingestion: Clinical Presentation, Physical Examination, and Radiologic Findings.

    Science.gov (United States)

    Sink, Jacquelyn R; Kitsko, Dennis J; Mehta, Deepak K; Georg, Matthew W; Simons, Jeffrey P

    2016-04-01

    (1) To describe clinical and radiologic findings in patients with esophageal foreign bodies. (2) To examine the sensitivity and specificity of history, physical examination, and radiologic studies in children with suspected foreign body ingestion. A retrospective cohort study was performed evaluating all children who underwent esophagoscopy for suspected foreign body ingestion at our institution from 2006 to 2013. Five hundred forty-three patients were included (54% male). Average age was 4.7 years (SD = 4.1 years). Foreign bodies were identified on esophagoscopy in 497 cases (92%). Ingestion was witnessed in 23% of cases. Most common presenting symptoms were choking/gagging (49%), vomiting (47%), and dysphagia/odynophagia (42%). Most patients with foreign bodies had a normal exam (76%). Most foreign bodies were radiopaque (83%). In 59% of patients with normal chest radiographs, a foreign body was present. Sensitivity and specificity of 1 or more findings on history, physical examination, and imaging were 99% and 0%, 21% and 76%, and 83% and 100%, respectively. Most patients with esophageal foreign bodies are symptomatic. Although many patients will have a normal physical examination, an abnormal exam should increase suspicion for a foreign body. Most esophageal foreign bodies are radiopaque, but a normal chest radiograph cannot rule out a foreign body. © The Author(s) 2015.

  16. Content analysis of physical examination templates in electronic health records using SNOMED CT.

    Science.gov (United States)

    Gøeg, Kirstine Rosenbeck; Chen, Rong; Højen, Anne Randorff; Elberg, Pia

    2014-10-01

    Most electronic health record (EHR) systems are built on proprietary information models and terminology, which makes achieving semantic interoperability a challenge. Solving interoperability problems requires well-defined standards. In contrast, the need to support clinical work practice requires a local customization of EHR systems. Consequently, contrasting goals may be evident in EHR template design because customization means that local EHR organizations can define their own templates, whereas standardization implies consensus at some level. To explore the complexity of balancing these two goals, this study analyzes the differences and similarities between templates in use today. A similarity analysis was developed on the basis of SNOMED CT. The analysis was performed on four physical examination templates from Denmark and Sweden. The semantic relationships in SNOMED CT were used to quantify similarities and differences. Moreover, the analysis used these identified similarities to investigate the common content of a physical examination template. The analysis showed that there were both similarities and differences in physical examination templates, and the size of the templates varied from 18 to 49 fields. In the SNOMED CT analysis, exact matches and terminology similarities were represented in all template pairs. The number of exact matches ranged from 7 to 24. Moreover, the number of unrelated fields differed a lot from 1/18 to 22/35. Cross-country comparisons tended to have more unrelated content than within-country comparisons. On the basis of identified similarities, it was possible to define the common content of a physical examination. Nevertheless, a complete view on the physical examination required the inclusion of both exact matches and terminology similarities. This study revealed that a core set of items representing the physical examination templates can be generated when the analysis takes into account not only exact matches but also terminology

  17. Full Coverage Sports Physicals: School Nurses' Untapped Role in Health Promotion among Student Athletes

    Science.gov (United States)

    Johnson, Karen E.; Morris, Marian; McRee, Annie-Laurie

    2018-01-01

    Pre-participation physical exams (PPEs) hold great potential for addressing adolescents' health-risk behaviors. School nurses may be well positioned to assist with PPEs, yet little is known about their involvement. In this mixed methods study conducted in 2015, we collected data from school nurses in Texas (surveys, n = 208; key informant…

  18. Reliability of physical examination tests for the diagnosis of knee disorders: Evidence from a systematic review.

    Science.gov (United States)

    Décary, Simon; Ouellet, Philippe; Vendittoli, Pascal-André; Desmeules, François

    2016-12-01

    Clinicians often rely on physical examination tests to guide them in the diagnostic process of knee disorders. However, reliability of these tests is often overlooked and may influence the consistency of results and overall diagnostic validity. Therefore, the objective of this study was to systematically review evidence on the reliability of physical examination tests for the diagnosis of knee disorders. A structured literature search was conducted in databases up to January 2016. Included studies needed to report reliability measures of at least one physical test for any knee disorder. Methodological quality was evaluated using the QAREL checklist. A qualitative synthesis of the evidence was performed. Thirty-three studies were included with a mean QAREL score of 5.5 ± 0.5. Based on low to moderate quality evidence, the Thessaly test for meniscal injuries reached moderate inter-rater reliability (k = 0.54). Based on moderate to excellent quality evidence, the Lachman for anterior cruciate ligament injuries reached moderate to excellent inter-rater reliability (k = 0.42 to 0.81). Based on low to moderate quality evidence, the Tibiofemoral Crepitus, Joint Line and Patellofemoral Pain/Tenderness, Bony Enlargement and Joint Pain on Movement tests for knee osteoarthritis reached fair to excellent inter-rater reliability (k = 0.29 to 0.93). Based on low to moderate quality evidence, the Lateral Glide, Lateral Tilt, Lateral Pull and Quality of Movement tests for patellofemoral pain reached moderate to good inter-rater reliability (k = 0.49 to 0.73). Many physical tests appear to reach good inter-rater reliability, but this is based on low-quality and conflicting evidence. High-quality research is required to evaluate the reliability of knee physical examination tests. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. Who Becomes a Physics Major? A Long-term Longitudinal Study Examining the Roles of Pre-college Beliefs about Physics and Learning Physics, Interest, and Academic Achievement

    Science.gov (United States)

    Perkins, Katherine K.; Gratny, Mindy

    2010-10-01

    In this paper, we examine the correlation between students' beliefs upon entering college and their likelihood of continuing on to become a physics major. Since 2004, we have collected CLASS survey and self-reported level-of-interest responses from students in the first-term, introductory calculus-based physics course (N>2500). Here, we conduct a retrospective analysis of students' incoming CLASS scores and level of interest, comparing those students who go on to become physics majors with those who do not. We find the incoming CLASS scores and reported interest of these future physics majors to be substantially higher than the class average, indicating that these students enter their first college course already having quite expert-like beliefs. The comparative differences are much smaller for grades, SAT score, and university predicted-GPA.

  20. An examination of multilevel factors that may explain gender differences in children's physical activity.

    Science.gov (United States)

    Crespo, Noe C; Corder, Kirsten; Marshall, Simon; Norman, Gregory J; Patrick, Kevin; Sallis, Jim F; Elder, John P

    2013-09-01

    Girls are less physically active than boys, yet no single study has examined the factors that may explain gender differences in children's physical activity (PA). This study was a cross-sectional analysis of data from 116 caregivers and their children aged 5-8 years who participated in the MOVE study. Caregivers reported various factors that may relate to children's PA (eg, encouragement for child PA and PA equipment at home). Child PA was measured by 7-day accelerometry. Linear regression tested for the variance in moderate-to-vigorous physical activity (MVPA) explained by gender and several variables. Gender and ethnicity interactions were examined. Caregivers were mostly female (97%), mean age 38 ± 6 years, mean BMI 28 ± 6 (kg/m2). Child's mean age was 8.1 ± 0.7, 54% were female and 40% were overweight/obese. Girls were less physically active than boys (54.1 ± 19.7 vs. 65.2 ± 28.0 daily minutes of MVPA, respectively). Among girls, more days of PE/week was associated with greater MVPA. Among boys, greater parent support for PA, greater parent modeling for PA, and greater number of PA equipment in the home were associated with greater MVPA. This study supports that boys and girls have different correlates for MVPA, which may partly explain gender differences in PA.

  1. Reliability of physical examination for diagnosis of myofascial trigger points: a systematic review of the literature.

    Science.gov (United States)

    Lucas, Nicholas; Macaskill, Petra; Irwig, Les; Moran, Robert; Bogduk, Nikolai

    2009-01-01

    Trigger points are promoted as an important cause of musculoskeletal pain. There is no accepted reference standard for the diagnosis of trigger points, and data on the reliability of physical examination for trigger points are conflicting. To systematically review the literature on the reliability of physical examination for the diagnosis of trigger points. MEDLINE, EMBASE, and other sources were searched for articles reporting the reliability of physical examination for trigger points. Included studies were evaluated for their quality and applicability, and reliability estimates were extracted and reported. Nine studies were eligible for inclusion. None satisfied all quality and applicability criteria. No study specifically reported reliability for the identification of the location of active trigger points in the muscles of symptomatic participants. Reliability estimates varied widely for each diagnostic sign, for each muscle, and across each study. Reliability estimates were generally higher for subjective signs such as tenderness (kappa range, 0.22-1.0) and pain reproduction (kappa range, 0.57-1.00), and lower for objective signs such as the taut band (kappa range, -0.08-0.75) and local twitch response (kappa range, -0.05-0.57). No study to date has reported the reliability of trigger point diagnosis according to the currently proposed criteria. On the basis of the limited number of studies available, and significant problems with their design, reporting, statistical integrity, and clinical applicability, physical examination cannot currently be recommended as a reliable test for the diagnosis of trigger points. The reliability of trigger point diagnosis needs to be further investigated with studies of high quality that use current diagnostic criteria in clinically relevant patients.

  2. Medial tibial stress syndrome can be diagnosed reliably using history and physical examination.

    Science.gov (United States)

    Winters, M; Bakker, E W P; Moen, M H; Barten, C C; Teeuwen, R; Weir, A

    2017-02-08

    The majority of sporting injuries are clinically diagnosed using history and physical examination as the cornerstone. There are no studies supporting the reliability of making a clinical diagnosis of medial tibial stress syndrome (MTSS). Our aim was to assess if MTSS can be diagnosed reliably, using history and physical examination. We also investigated if clinicians were able to reliably identify concurrent lower leg injuries. A clinical reliability study was performed at multiple sports medicine sites in The Netherlands. Athletes with non-traumatic lower leg pain were assessed for having MTSS by two clinicians, who were blinded to each others' diagnoses. We calculated the prevalence, percentage of agreement, observed percentage of positive agreement (Ppos), observed percentage of negative agreement (Pneg) and Kappa-statistic with 95%CI. Forty-nine athletes participated in this study, of whom 46 completed both assessments. The prevalence of MTSS was 74%. The percentage of agreement was 96%, with Ppos and Pneg of 97% and 92%, respectively. The inter-rater reliability was almost perfect; k=0.89 (95% CI 0.74 to 1.00), phistory and physical examination, in clinical practice and research settings. We also found that concurrent lower leg injuries are common in athletes with MTSS. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  3. Physical examination-indicated cerclage in singleton and twin pregnancies: maternal-fetal outcomes.

    Science.gov (United States)

    Bernabeu, Andrea; Goya, Maria; Martra, Miquel; Suy, Anna; Pratcorona, Laia; Merced, Carme; Llurba, Elisa; Casellas, Manel; Carreras, Elena; Cabero, Luis

    2016-01-01

    To study maternal and perinatal outcomes after physical examination-indicated cerclage in both singleton and twin pregnancies and evaluate the possible risk factors associated. Retrospective review of all women undergoing physical examination-indicated cerclage at the Hospital Vall d'Hebro, Barcelona from January 2009 to December 2012 after being diagnosed with cervical incompetence and risk of premature birth. During the study period, 60 cases of women diagnosed with cervical incompetence who were carrying live and morphologically-normal fetuses (53 singleton and 7 twin pregnancies), and who had an imminent risk of premature birth were evaluated. Mean gestational age until birth was 35 weeks in singleton and 32 weeks in twin pregnancies. Four cases (7.5%) of immature births and one case (2.0%) of neonatal death were recorded in singleton pregnancies. No cases of immature births or neonatal deaths were recorded in twin pregnancies. Diagnostic amniocentesis was performed IN all cases to rule out possible chorioamnionitis. Physical examination-indicated cerclage for cervical incompetence in women at risk for immature or preterm birth demonstrates good perinatal prognosis without increasing maternal morbidity in either singleton or twin pregnancies. The increase in gestation time in our study may also have been due to the fact that patients with subclinical chorioamnionitis were excluded by diagnostic amniocentesis.

  4. Physical examination tests for the diagnosis of femoroacetabular impingement. A systematic review.

    Science.gov (United States)

    Pacheco-Carrillo, Aitana; Medina-Porqueres, Ivan

    2016-09-01

    Numerous clinical tests have been proposed to diagnose FAI, but little is known about their diagnostic accuracy. To summarize and evaluate research on the accuracy of physical examination tests for diagnosis of FAI. A search of the PubMed, SPORTDiscus and CINAHL databases was performed. Studies were considered eligible if they compared the results of physical examination tests to those of a reference standard. Methodological quality and internal validity assessment was performed by two independent reviewers using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool. The systematic search strategy revealed 298 potential articles, five of which articles met the inclusion criteria. After assessment using the QUADAS score, four of the five articles were of high quality. Clinical tests included were Impingement sign, IROP test (Internal Rotation Over Pressure), FABER test (Flexion-Abduction-External Rotation), Stinchfield/RSRL (Resisted Straight Leg Raise) test, Scour test, Maximal squat test, and the Anterior Impingement test. IROP test, impingement sign, and FABER test showed the most sensitive values to identify FAI. The diagnostic accuracy of physical examination tests to assess FAI is limited due to its heterogenecity. There is a strong need for sound research of high methodological quality in this area. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Utility of AD8 for Cognitive Impairment in a Chinese Physical Examination Population: A Preliminary Study

    Science.gov (United States)

    Xie, Yue; Gao, Ya; Jia, Jianjun; Wang, Xiaohong; Wang, Zhenfu; Xie, Hengge

    2014-01-01

    Objective. To investigate the utility of AD8 for cognitive impairment in a Chinese physical examination population. Methods. Military cadres who took routine physical examination in Chinese PLA General Hospital from Jan 1, 2013, to Dec 31, 2013, were subjected to AD8 scale. Individual information such as age, gender, and education was also collected. All data were analyzed by SPSS 19.0. Results. 1544 subjects were enrolled in this study with mean age 75.4 ± 10.6 years. The subjects who scored 0 to 8 of AD8 scale were 1015, 269, 120, 60, 30, 14, 19, 8, and 9, respectively. Corresponding proportions were 65.7%, 17.4%, 7.8%, 3.9%, 2.0%, 0.9%, 1.2%, 0.5%, and 0.6%, respectively. The endorsement prevalence of 8 questions was 5.6%, 9.2%, 6.6%, 9.2%, 4.8%, 4.5%, 8.9%, and 24.1%, respectively. The endorsement prevalence of question 8 was significantly higher than others (P physical examination population. PMID:25436227

  6. Utility of AD8 for Cognitive Impairment in a Chinese Physical Examination Population: A Preliminary Study

    Directory of Open Access Journals (Sweden)

    Yue Xie

    2014-01-01

    Full Text Available Objective. To investigate the utility of AD8 for cognitive impairment in a Chinese physical examination population. Methods. Military cadres who took routine physical examination in Chinese PLA General Hospital from Jan 1, 2013, to Dec 31, 2013, were subjected to AD8 scale. Individual information such as age, gender, and education was also collected. All data were analyzed by SPSS 19.0. Results. 1544 subjects were enrolled in this study with mean age 75.4 ± 10.6 years. The subjects who scored 0 to 8 of AD8 scale were 1015, 269, 120, 60, 30, 14, 19, 8, and 9, respectively. Corresponding proportions were 65.7%, 17.4%, 7.8%, 3.9%, 2.0%, 0.9%, 1.2%, 0.5%, and 0.6%, respectively. The endorsement prevalence of 8 questions was 5.6%, 9.2%, 6.6%, 9.2%, 4.8%, 4.5%, 8.9%, and 24.1%, respectively. The endorsement prevalence of question 8 was significantly higher than others (P<0.05. 260 subjects were scored equal to or greater than 2. The abnormal rate was 16.9%. All the participants were stratified into 9 groups by age; the prevalence of dementia was highly correlated with age (P<0.01. Conclusion. AD8 scale is a convenient and effective tool for cognitive screening in routine physical examination population.

  7. Using cluster analysis to examine the combinations of motivation regulations of physical education students.

    Science.gov (United States)

    Ullrich-French, Sarah; Cox, Anne

    2009-06-01

    According to self-determination theory, motivation is multidimensional, with motivation regulations lying along a continuum of self-determination (Ryan & Deci, 2007). Accounting for the different types of motivation in physical activity research presents a challenge. This study used cluster analysis to identify motivation regulation profiles and examined their utility by testing profile differences in relative levels of self-determination (i.e., self-determination index), and theoretical antecedents (i.e., competence, autonomy, relatedness) and consequences (i.e., enjoyment, worry, effort, value, physical activity) of physical education motivation. Students (N= 386) in 6th- through 8th-grade physical education classes completed questionnaires of the variables listed above. Five profiles emerged, including average (n = 81), motivated (n = 82), self-determined (n = 91), low motivation (n = 73), and external (n = 59). Group difference analyses showed that students with greater levels of self-determined forms of motivation, regardless of non-self-determined motivation levels, reported the most adaptive physical education experiences.

  8. MOTIVATIONAL CLUSTER PROFILES OF ADOLESCENT ATHLETES: AN EXAMINATION OF DIFFERENCES IN PHYSICAL-SELF PERCEPTION

    Directory of Open Access Journals (Sweden)

    Emine Çağlar

    2010-06-01

    Full Text Available The primary purpose of the present study was to identify motivational profiles of adolescent athletes using cluster analysis in non-Western culture. A second purpose was to examine relationships between physical self-perception differences of adolescent athletes and motivational profiles. One hundred and thirty six male (Mage = 17.46, SD = 1.25 years and 80 female adolescent athletes (Mage = 17.61, SD = 1.19 years from a variety of team sports including basketball, soccer, volleyball, and handball volunteered to participate in this study. The Sport Motivation Scale (SMS and Physical Self-Perception Profile (PSPP were administered to all participants. Hierarchical cluster analysis revealed a four-cluster solution for this sample: amotivated, low motivated, moderate motivated, and highly motivated. A 4 x 5 (Cluster x PSPP Subscales MANOVA revealed no significant main effect of motivational clusters on physical self-perception levels (p > 0.05. As a result, findings of the present study showed that motivational types of the adolescent athletes constituted four different motivational clusters. Highly and moderate motivated athletes consistently scored higher than amotivated athletes on the perceived sport competence, physical condition, and physical self-worth subscales of PSPP. This study identified motivational profiles of competitive youth-sport participants

  9. Subjective neighborhood assessment and physical inactivity: An examination of neighborhood-level variance.

    Science.gov (United States)

    Prochaska, John D; Buschmann, Robert N; Jupiter, Daniel; Mutambudzi, Miriam; Peek, M Kristen

    2018-06-01

    Research suggests a linkage between perceptions of neighborhood quality and the likelihood of engaging in leisure-time physical activity. Often in these studies, intra-neighborhood variance is viewed as something to be controlled for statistically. However, we hypothesized that intra-neighborhood variance in perceptions of neighborhood quality may be contextually relevant. We examined the relationship between intra-neighborhood variance of subjective neighborhood quality and neighborhood-level reported physical inactivity across 48 neighborhoods within a medium-sized city, Texas City, Texas using survey data from 2706 residents collected between 2004 and 2006. Neighborhoods where the aggregated perception of neighborhood quality was poor also had a larger proportion of residents reporting being physically inactive. However, higher degrees of disagreement among residents within neighborhoods about their neighborhood quality was significantly associated with a lower proportion of residents reporting being physically inactive (p=0.001). Our results suggest that intra-neighborhood variability may be contextually relevant in studies seeking to better understand the relationship between neighborhood quality and behaviors sensitive to neighborhood environments, like physical activity. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Examining Physical and Sexual Abuse Histories as Correlates of Suicide Risk Among Firefighters.

    Science.gov (United States)

    Hom, Melanie A; Matheny, Natalie L; Stanley, Ian H; Rogers, Megan L; Cougle, Jesse R; Joiner, Thomas E

    2017-12-01

    Research indicates that physical and sexual abuse are associated with increased suicide risk; however, these associations have not been investigated among firefighters-an occupational group that has been shown to be at elevated suicide risk. This study examined whether physical and sexual abuse histories are associated with (a) career suicide ideation, plans, and attempts; and (b) current suicide risk (controlling for theoretically relevant symptoms) in this occupational group. A sample of 929 U.S. firefighters completed self-report surveys that assessed lifetime history of physical and sexual abuse; career suicide ideation, plans, and attempts; current suicide risk; and theoretically relevant symptoms. Logistic regression analyses revealed that individuals who reported a history of physical abuse were significantly more likely to report career suicide ideation, adjusted odds ratio [AOR] = 6.12, plans, AOR = 13.05, and attempts, AOR = 23.81, than those who did not. A similar pattern of findings emerged for individuals who reported a sexual abuse history, AORs = 7.83, 18.35, and 29.58 respectively. Linear regression analyses revealed that physical and sexual abuse histories each significantly predicted current suicide risk, even after controlling for theoretically relevant symptoms and demographics, pr 2 = .07 and .06, respectively. Firefighters with a history of physical and/or sexual abuse may be at increased risk for suicidal thoughts and behaviors. A history of physical and sexual abuse were each significantly correlated with current suicide risk in this population, even after accounting for the effects of theoretically relevant symptoms. Thus, when conceptualizing suicide risk among firefighters, factors not necessarily related to one's firefighter career should be considered. Copyright © 2017 International Society for Traumatic Stress Studies.

  11. The association between leisure time physical activity and smoking in adolescence: an examination of potential mediating and moderating factors

    NARCIS (Netherlands)

    Verkooijen, K.T.; Nielsen, G.A.; Kremers, S.P.J.

    2008-01-01

    Although physical activity has been associated negatively with smoking in adolescence, the association is not well understood. Purpose: This study examines the relationship between adolescents' leisure time physical activity and smoking behavior, while considering BMI, weight concern, sense of

  12. The Association between leisure time physical activity and smoking in adolescence: an examination of potential mediating and moderating factors

    DEFF Research Database (Denmark)

    Verkooijen, Kirsten; Nielsen, Gert A; Kremers, Stef P J

    2008-01-01

    BACKGROUND: Although physical activity has been associated negatively with smoking in adolescence, the association is not well understood. PURPOSE: This study examines the relationship between adolescents' leisure time physical activity and smoking behavior, while considering BMI, weight concern,...

  13. Clinical Assessment of Physical Examination Maneuvers for Superior Labral Anterior to Posterior Lesions.

    Science.gov (United States)

    Somerville, Lyndsay E; Willits, Kevin; Johnson, Andrew M; Litchfield, Robert; LeBel, Marie-Eve; Moro, Jaydeep; Bryant, Dianne

    2017-10-01

    Purpose  Shoulder pain and disability pose a diagnostic challenge owing to the numerous etiologies and the potential for multiple disorders to exist simultaneously. The evidence to support the use of clinical tests for superior labral anterior to posterior complex (SLAP) is weak or absent. The purpose of this study is to determine the diagnostic validity of physical examination maneuvers for SLAP lesions by performing a methodologically rigorous, clinically applicable study. Methods  We recruited consecutive new shoulder patients reporting pain and/or disability. The physician took a history and indicated their certainty about each possible diagnosis ("certain the diagnosis is absent/present," or "uncertain requires further testing"). The clinician performed the physical tests for diagnoses where uncertainty remained. Magnetic resonance imaging arthrogram and arthroscopic examination were the gold standards. We calculated sensitivity, specificity, and likelihood ratios (LRs) and investigated whether combinations of the top tests provided stronger predictions. Results  Ninety-three patients underwent physical examination for SLAP lesions. When using the presence of a SLAP lesion (Types I-V) as disease positive, none of the tests was sensitive (10.3-33.3) although they were moderately specific (61.3-92.6). When disease positive was defined as repaired SLAP lesion (including biceps tenodesis or tenotomy), the sensitivity (10.5-38.7) and specificity (70.6-93.8) of tests improved although not by a substantial amount. None of the tests was found to be clinically useful for predicting repairable SLAP lesions with all LRs close to one. The compression rotation test had the best LR for both definitions of disease (SLAP tear present = 1.8 and SLAP repaired = 1.67). There was no optimal combination of tests for diagnosing repairable SLAP lesions, with at least two tests positive providing the best combination of measurement properties (sensitivity 46.1% and

  14. Adolescents' reports of physical violence by peers in residential care settings: an ecological examination.

    Science.gov (United States)

    Khoury-Kassabri, Mona; Attar-Schwartz, Shalhevet

    2014-03-01

    Physical victimization by peers was examined among 1,324 Jewish and Arab adolescents, aged 11 to 19, residing in 32 residential care settings (RCS) for children at-risk in Israel. Hierarchical Linear Modeling (HLM) was used to examine the relationships between physical victimization and adolescents' characteristics (age, gender, self-efficacy, adjustment difficulties, maltreatment by staff, and perceived social climate) as well as institution-level characteristics (care setting type, size, structure, and ethnic affiliation). For this study, we define physical violence as being grabbed, shoved, kicked, punched, hit with a hand, or hit with an object. Over 50% (56%) of the adolescents surveyed reported having experienced at least one form of physical violence by peers. Boys and younger adolescents were more likely to be victimized than girls and older adolescents. The results show that adolescents with adjustment difficulties or low social self-efficacy, and adolescents who perceive an institution's staff as strict and/or had experienced maltreatment by staff, are vulnerable groups for peer victimization. Lower levels of victimization were found in RCS with a familial element than in traditional group settings. Institutions with high concentrations of young people with adjustment difficulties and violent staff behaviors had higher levels of violence among residents. Applying an ecological perspective to an investigation of peer victimization in RCS enables the identification of risk factors at adolescent and institution levels. This type of examination has implications for child welfare practice and policy that can help in the development of prevention and intervention methods designed to tackle the involvement in violence of youth in care.

  15. Using the Physical Examination to Diagnose Patients with Acute Dizziness and Vertigo.

    Science.gov (United States)

    Edlow, Jonathan A; Newman-Toker, David

    2016-04-01

    Emergency department (ED) patients who present with acute dizziness or vertigo can be challenging to diagnose. Roughly half have general medical disorders that are usually apparent from the context, associated symptoms, or initial laboratory tests. The rest include a mix of common inner ear disorders and uncommon neurologic ones, particularly vertebrobasilar strokes or posterior fossa mass lesions. In these latter cases, misdiagnosis can lead to serious adverse consequences for patients. Our aim was to assist emergency physicians to use the physical examination effectively to make a specific diagnosis in patients with acute dizziness or vertigo. Recent evidence indicates that the physical examination can help physicians accurately discriminate between benign inner ear conditions and dangerous central ones, enabling correct management of peripheral vestibular disease and avoiding dangerous misdiagnoses of central ones. Patients with the acute vestibular syndrome mostly have vestibular neuritis, but some have stroke. Data suggest that focused eye movement examinations, at least when performed by specialists, are more sensitive for detecting early stroke than brain imaging, including diffusion-weighted magnetic resonance imaging. Patients with the triggered episodic vestibular syndrome mostly have benign paroxysmal positional vertigo (BPPV), but some have posterior fossa mass lesions. Specific positional tests to provoke nystagmus can confirm a BPPV diagnosis at the bedside, enabling immediate curative therapy, or indicate the need for imaging. Emergency physicians can effectively use the physical examination to make a specific diagnosis in patients with acute dizziness or vertigo. They must understand the limitations of brain imaging. This may reduce misdiagnosis of serious central causes of dizziness, including posterior circulation stroke and posterior fossa mass lesions, and improve resource utilization. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. The Effects of Music during a Physical Examination Skills Practice: A Pilot Study.

    Science.gov (United States)

    Artemiou, Elpida; Gilbert, Gregory E; Sithole, Fortune; Koster, Liza S

    2017-09-27

    Some veterinary students experience elevated stress, anxiety, and depression resulting in disease and psychological changes. Elevated arousal, negative moods, and lack of interest can negatively affect performance and learning. Psychoacoustic music promotes calming effects using simple and slow piano sounds and can positively impact well-being and functioning. This pilot study assessed the effects of music on blood pressure, pulse, arousal, and mood during a canine physical examination laboratory. In an AB/BA crossover study, 17 students were randomly allocated to practice physical examination skills while listening to Through a Dog's Ear, Volume 1 . Psychological and physiologic data were collected. Nonparametric methods were used to test for significant differences in psychological and physiologic data and a linear mixed models approach was used to test for physiological differences. There were no significant baseline differences between the music and no music groups for DASS-21 depression, anxiety, or stress scores; however, there were significant time differences between pretest and posttest on arousal and mood as measured by the Profile of Mood Sates (POMS) Depression, Fatigue-Inertia, and Tension Anxiety subscales. Linear mixed models revealed no significant treatment effect on the pulse and diastolic blood pressure; however, there was a significant systolic blood pressure treatment effect. Future indications include repeating the study with a larger sample to examine longitudinal psychological and physiological benefits.

  17. The Effects of Music during a Physical Examination Skills Practice: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Elpida Artemiou

    2017-09-01

    Full Text Available Some veterinary students experience elevated stress, anxiety, and depression resulting in disease and psychological changes. Elevated arousal, negative moods, and lack of interest can negatively affect performance and learning. Psychoacoustic music promotes calming effects using simple and slow piano sounds and can positively impact well-being and functioning. This pilot study assessed the effects of music on blood pressure, pulse, arousal, and mood during a canine physical examination laboratory. In an AB/BA crossover study, 17 students were randomly allocated to practice physical examination skills while listening to Through a Dog’s Ear, Volume 1. Psychological and physiologic data were collected. Nonparametric methods were used to test for significant differences in psychological and physiologic data and a linear mixed models approach was used to test for physiological differences. There were no significant baseline differences between the music and no music groups for DASS-21 depression, anxiety, or stress scores; however, there were significant time differences between pretest and posttest on arousal and mood as measured by the Profile of Mood Sates (POMS Depression, Fatigue–Inertia, and Tension Anxiety subscales. Linear mixed models revealed no significant treatment effect on the pulse and diastolic blood pressure; however, there was a significant systolic blood pressure treatment effect. Future indications include repeating the study with a larger sample to examine longitudinal psychological and physiological benefits.

  18. Enhancing elderly health examination effectiveness by adding physical function evaluations and interventions.

    Science.gov (United States)

    Li, Chia-Ming; Chang, Ching-I; Yu, Wen-Ruey; Yang, Winnie; Hsu, Chih-Cheng; Chen, Ching-Yu

    This study aimed to assess the benefit of adding physical function evaluations and interventions to routine elderly health examination. This is a Quasi-experimental controlled trial. 404 elderly adults (aged 70 and over) scoring 3-6 on the Canadian Study of Health and Aging Clinical Frailty Scale Chinese In-Person Interview Version (CSHA-CFS) in a 2012 annual elderly health examination were enrolled. Both the control and experimental groups received the routine annual health examination with the latter further provided with functional evaluations, exercise instruction, and nutrition education. 112 (84.8%) persons in the experiment group and 267 (98.2%) in the control group completed the study. CSHA-CFS performance of the experimental group was more likely to improve (odds ratio=9.50, 95% confidence interval (CI)=4.62-19.56) and less likely to deteriorate (OR=0.04, 95% CI=0.01-0.31) one year after intervention. Within the experimental group, Fried Frailty Index improvement percentage surpassed the deterioration percentage (29.5% vs. 0.9%, pPhysical Performance Battery increased from 10.0±1.6 to 11.6±0.9 (pexamination appeared to benefit the health of adults aged 70 years and older. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  19. Preoperative physical examination and imaging of femoroacetabular impingement prior to hip arthroscopy-a systematic review.

    Science.gov (United States)

    Haldane, Chloe E; Ekhtiari, Seper; de Sa, Darren; Simunovic, Nicole; Ayeni, Olufemi R

    2017-08-01

    The purpose of this systematic review is to report current preoperative assessment for femoroacetabular impingement (FAI) including physical examination and imaging modalities prior to hip arthroscopy, and report current imaging measures used in the diagnosis of FAI. The electronic databases MEDLINE, EMBASE and PubMed were searched and screened in duplicate for relevant studies. Data regarding patient demographics, non-operative treatment, preoperative assessment including physical examination and imaging prior to hip arthroscopy were abstracted. Study quality was assessed in duplicate using the Methodological Index for Non-Randomized Studies criteria. Sixty-eight studies of fair quality evidence that involved a total of 5125 patients (5400 hips) were included. In total, 56% of all patients were male and mean age was 36 years (SD ± 10.0). Within physical examination, FADIR impingement testing was reported in 57% of patients. All included studies reported plain radiographic imaging as a component of preoperative assessment with anterior-posterior pelvis view being the most commonly reported view, followed by the cross-table lateral and Dunn views. Magnetic resonance imaging was obtained for 52% of included patients and computed tomography for 26% of patients. The most commonly reported measure within imaging for the diagnosis of cam type impingement was alpha angle (66%), whereas for pincer type impingement, the cross-over sign (48%) was most reported. Preoperative assessment is underreported in the FAI literature. Improved reporting is warranted to develop a more consistent and validated diagnostic algorithm for FAI to enhance patient selection. Level of evidence : Level IV, Systematic Review of Level I-IV Studies.

  20. Physical Examination-Indicated Cerclage: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Ehsanipoor, Robert M; Seligman, Neil S; Saccone, Gabriele; Szymanski, Linda M; Wissinger, Christina; Werner, Erika F; Berghella, Vincenzo

    2015-07-01

    To estimate the effectiveness of physical examination-indicated cerclage in the setting of second-trimester cervical dilatation by systematic review and meta-analysis of published studies. We searched MEDLINE, EMBASE, Scopus, ClinicalTrials.gov, Web of Science, and the Cochrane Library for studies published between 1966 and 2014 that evaluated cervical cerclage for the treatment of cervical insufficiency. The search yielded 6,314 citations. We included cohort studies and randomized controlled trials comparing cerclage placement with expectant management of women with cervical dilatation between 14 and 27 weeks of gestation. Two investigators independently reviewed each citation for inclusion or exclusion and discordant decisions were arbitrated by a third reviewer. Summary estimates were reported as the mean difference and 95% confidence interval (CI) for continuous variables or relative risk and with 95% CI for dichotomous outcomes. Fixed- and random-effects meta-analysis was used, depending on heterogeneity. Ten studies met inclusion criteria and were included in the final analysis. One was a randomized controlled trial, two were prospective cohort studies, and the remaining seven were retrospective cohort studies. Of the 757 women, 485 (64%) underwent physical examination-indicated cerclage placement and 272 (36%) were expectantly managed. Cerclage was associated with increased neonatal survival (71% compared with 43%; relative risk 1.65, 95% CI 1.19-2.28) and prolongation of pregnancy (mean difference 33.98 days, 95% CI 17.88-50.08). Physical examination-indicated cerclage is associated with a significant increase in neonatal survival and prolongation of pregnancy of approximately 1 month when compared with no such cerclage. The strength of this conclusion is limited by the potential for bias in the included studies.

  1. Preoperative physical examination and imaging of femoroacetabular impingement prior to hip arthroscopy—a systematic review

    Science.gov (United States)

    Haldane, Chloe E.; Ekhtiari, Seper; de SA, Darren; Simunovic, Nicole

    2017-01-01

    Abstract The purpose of this systematic review is to report current preoperative assessment for femoroacetabular impingement (FAI) including physical examination and imaging modalities prior to hip arthroscopy, and report current imaging measures used in the diagnosis of FAI. The electronic databases MEDLINE, EMBASE and PubMed were searched and screened in duplicate for relevant studies. Data regarding patient demographics, non-operative treatment, preoperative assessment including physical examination and imaging prior to hip arthroscopy were abstracted. Study quality was assessed in duplicate using the Methodological Index for Non-Randomized Studies criteria. Sixty-eight studies of fair quality evidence that involved a total of 5125 patients (5400 hips) were included. In total, 56% of all patients were male and mean age was 36 years (SD ± 10.0). Within physical examination, FADIR impingement testing was reported in 57% of patients. All included studies reported plain radiographic imaging as a component of preoperative assessment with anterior–posterior pelvis view being the most commonly reported view, followed by the cross-table lateral and Dunn views. Magnetic resonance imaging was obtained for 52% of included patients and computed tomography for 26% of patients. The most commonly reported measure within imaging for the diagnosis of cam type impingement was alpha angle (66%), whereas for pincer type impingement, the cross-over sign (48%) was most reported. Preoperative assessment is underreported in the FAI literature. Improved reporting is warranted to develop a more consistent and validated diagnostic algorithm for FAI to enhance patient selection. Level of evidence: Level IV, Systematic Review of Level I–IV Studies. PMID:28948032

  2. Annual physical examination reports vary by gender once teenagers become sexually active

    Science.gov (United States)

    Marcell, Arik V.; Matson, Pam; Ellen, Jonathan M.; Ford, Carol A.

    2010-01-01

    Introduction Few sexually active male adolescents receive sexual/reproductive health (SRH) services. We examine whether the association between adolescents’ sexual behavior status and physical examination over time can help us understand why. Methods We conducted longitudinal cohort analysis of the National Longitudinal Study of Adolescent Health with 9239 adolescents who completed the baseline school (1994/95) and Wave 2 (1996) follow-up surveys approximately 1.5 years later (retention rate=71%). We fit logistic regression models with random effects to estimate individual odds of reporting a physical examination in the past 12 months at follow-up, as compared to baseline, stratified by sexual behavior status and gender, and adjusting for sociodemographic and healthcare access factors. Results 34.5% males and 38.2% females reported experiencing vaginal intercourse by follow-up, and 22.4% males and 24.7% females reported first experiencing intercourse during the study. Among sexually active adolescents, about half reported annual exams and one-fifth no exams. Among females, baseline to follow-up exam reports significantly increased in: sex initiators (adjusted Odds Ratio [95% confidence interval]=2.09 [1.66–2.64]); those reporting sex at both times (2.16 [1.51–3.09]); and those reporting no sex either time (2.47 [2.00–3.04]). Among males, baseline to follow-up exam reports significantly increased in those reporting no sex either time (1.57 [1.26–1.96]) and showed increasing trends in sex initiators (1.27 [0.92–1.76]). Discussion A majority of sexually active adolescents report annual physical exams over time. Providers should not miss opportunities to deliver evidence-based SRH to sexually active adolescents. Future efforts are needed to increase all adolescents’ access to SRH services. PMID:21700156

  3. Clinical examination and physical assessment of hip joint-related pain in athletes

    DEFF Research Database (Denmark)

    Reiman, Michael P; Thorborg, Kristian

    2014-01-01

    UNLABELLED: Evidence-based clinical examination and assessment of the athlete with hip joint related pain is complex. It requires a systematic approach to properly differentially diagnose competing potential causes of athletic pain generation. An approach with an initial broad focus (and hence use...... of highly sensitive tests/measures) that then is followed by utilizing more specific tests/measures to pare down this imprecise differential diagnosis list is suggested. Physical assessment measures are then suggested to discern impairments, activity and participation restrictions for athletes with hip...

  4. Examining relationship among self-esteem with obesity, physical fitness level and participation to sport

    OpenAIRE

    ERASLAN, Meric; ATAY, Emrah; YUKSEL, Yılmaz

    2014-01-01

    This study' purpose was to examine relationship among self-esteem with obesity, physical fitness level and participation situation to sport. 115 male and 124 female participated to study. Participants' mean age is 12.98±1.04 year, mean height 157.38±9.21 cm, mean BMI value 19.37±3.63 kg/m2. Only %28 of participants participates to sport. Besides, their %73.6 participates to sporting activities out of lesson. Coopersmith Self-Esteem Inventory was used as data collection material at s...

  5. The "Near-Peer" Approach to Teaching Musculoskeletal Physical Examination Skills Benefits Residents and Medical Students.

    Science.gov (United States)

    Rosenberg, Casandra J; Nanos, Katherine N; Newcomer, Karen L

    2017-03-01

    The musculoskeletal physical examination (MSK PE) is an essential part of medical student training, and it is best taught in a hands-on, longitudinal fashion. A barrier to this approach is faculty instructor availability. "Near-peer" teaching refers to physicians-in-training teaching their junior colleagues. It is unknown whether near-peer teaching is effective in teaching this important physical examination skill. To investigate attitudes of medical students and physical medicine and rehabilitation (PM&R) residents regarding near-peer teaching in an MSK PE curriculum. Qualitative, anonymous paper and online surveys. Tertiary academic center with a medical school and PM&R training program. Ninety-nine second- and third-year medical students and 13 PM&R residents in their third or fourth postgraduate year. Attitudes of second- and third-year medical students were measured immediately after their MSK PE course. Resident attitudes were measured in a single cross-sectional sample. Student attitudes were assessed via a questionnaire with 5-point Likert scales and a free-text comment section. The resident questionnaire included a combination of multiple-choice questions, rankings, free-text responses, and Likert scales. All 99 students completed the questionnaire. The majority of students (n = 79 [80%]) reported that resident involvement as hands-on instructors of examination skills was "very useful," and 87 (88%) indicated that resident-led small discussion groups were "very helpful" or "somewhat helpful." Fifty-seven of 99 students (58%) reported that the resident-facilitated course was "much better" than courses without resident involvement. Twelve of 13 eligible residents completed the survey, and of those, 8 found teaching "very helpful" to their MSK knowledge, and 11 became "somewhat" or "much more confident" in clinical examination skills. Our study supports educational benefits to medical students and resident instructors in our MSK PE program. We recommend

  6. Examining problem solving in physics-intensive Ph.D. research

    Science.gov (United States)

    Leak, Anne E.; Rothwell, Susan L.; Olivera, Javier; Zwickl, Benjamin; Vosburg, Jarrett; Martin, Kelly Norris

    2017-12-01

    Problem-solving strategies learned by physics undergraduates should prepare them for real-world contexts as they transition from students to professionals. Yet, graduate students in physics-intensive research face problems that go beyond problem sets they experienced as undergraduates and are solved by different strategies than are typically learned in undergraduate coursework. This paper expands the notion of problem solving by characterizing the breadth of problems and problem-solving processes carried out by graduate students in physics-intensive research. We conducted semi-structured interviews with ten graduate students to determine the routine, difficult, and important problems they engage in and problem-solving strategies they found useful in their research. A qualitative typological analysis resulted in the creation of a three-dimensional framework: context, activity, and feature (that made the problem challenging). Problem contexts extended beyond theory and mathematics to include interactions with lab equipment, data, software, and people. Important and difficult contexts blended social and technical skills. Routine problem activities were typically well defined (e.g., troubleshooting), while difficult and important ones were more open ended and had multiple solution paths (e.g., evaluating options). In addition to broadening our understanding of problems faced by graduate students, our findings explore problem-solving strategies (e.g., breaking down problems, evaluating options, using test cases or approximations) and characteristics of successful problem solvers (e.g., initiative, persistence, and motivation). Our research provides evidence of the influence that problems students are exposed to have on the strategies they use and learn. Using this evidence, we have developed a preliminary framework for exploring problems from the solver's perspective. This framework will be examined and refined in future work. Understanding problems graduate students

  7. Examining problem solving in physics-intensive Ph.D. research

    Directory of Open Access Journals (Sweden)

    Anne E. Leak

    2017-07-01

    Full Text Available Problem-solving strategies learned by physics undergraduates should prepare them for real-world contexts as they transition from students to professionals. Yet, graduate students in physics-intensive research face problems that go beyond problem sets they experienced as undergraduates and are solved by different strategies than are typically learned in undergraduate coursework. This paper expands the notion of problem solving by characterizing the breadth of problems and problem-solving processes carried out by graduate students in physics-intensive research. We conducted semi-structured interviews with ten graduate students to determine the routine, difficult, and important problems they engage in and problem-solving strategies they found useful in their research. A qualitative typological analysis resulted in the creation of a three-dimensional framework: context, activity, and feature (that made the problem challenging. Problem contexts extended beyond theory and mathematics to include interactions with lab equipment, data, software, and people. Important and difficult contexts blended social and technical skills. Routine problem activities were typically well defined (e.g., troubleshooting, while difficult and important ones were more open ended and had multiple solution paths (e.g., evaluating options. In addition to broadening our understanding of problems faced by graduate students, our findings explore problem-solving strategies (e.g., breaking down problems, evaluating options, using test cases or approximations and characteristics of successful problem solvers (e.g., initiative, persistence, and motivation. Our research provides evidence of the influence that problems students are exposed to have on the strategies they use and learn. Using this evidence, we have developed a preliminary framework for exploring problems from the solver’s perspective. This framework will be examined and refined in future work. Understanding problems

  8. Youth physical activity and the neighbourhood environment: examining correlates and the role of neighbourhood definition.

    Science.gov (United States)

    van Loon, Josh; Frank, Lawrence D; Nettlefold, Lindsay; Naylor, Patti-Jean

    2014-03-01

    The primary objective of this study was to examine relationships between neighbourhood built and social environment characteristics and moderate to vigorous physical activity (MVPA) in a sample of children aged 8-11 in Vancouver, British Columbia and the surrounding lower mainland region (n = 366). A secondary objective was to assess how neighbourhood definition influences these relationships, by using measures calculated at multiple buffer sizes: 200, 400, 800 and 1600 m (1 mile). Geographic information systems -software was used to create a broad set of measures of neighbourhood environments. Physical activity was measured objectively using accelerometers. Relationships between MVPA and neighborhood characteristics were assessed using generalized estimating equations to account for the clustering of children within schools. Sex specific relationships were assessed through sex stratified models. When controlling for child age, sex and ethnicity, MVPA was positively associated with commercial density, residential density, number of parks and intersection density; and negatively associated with distance to school and recreation sites. When entered as a composite index, these measures accounted for 4.4% in the variation in MVPA for the full sample (boys and girls). Sex stratified models better explained the relationships between neighbourhood environment and physical activity. For boys, built and social environment characteristics of neighbourhoods accounted for 8.7% of the variation in MVPA, and for girls, neighborhood factors explained 7.2% of the variation. Sex stratified models also point towards distinct differences in factors associated with physical activity, with MVPA of boys associated with wider ranging neighborhood characteristics than MVPA of girls. For girls, two safety-related neighbourhood features were found to be significantly associated with MVPA: cul-de-sac density and proportion of low speed limit streets. In all models, larger buffer sizes

  9. Preparticipation evaluation of novice, middle-age, long-distance runners.

    Science.gov (United States)

    Aagaard, Philip; Sahlén, Anders; Bergfeldt, Lennart; Braunschweig, Frieder

    2013-01-01

    The purpose of this study was to assess the cardiovascular health and risk profile in middle-age men making an entry to participate for their first time in a long-distance race. Male first-time participants, 45 yr and older, in the world's largest cross-country running race, the Lidingöloppet, were evaluated with a medical history and physical examination, European systematic coronary risk evaluation (SCORE), 12-lead ECG, echocardiography, and blood tests. Further diagnostic workup was performed when clinically indicated. Of 265 eligible runners, 153 (58%, age 51 ± 5 yr) completed the study. Although the 10-yr fatal cardiovascular event risk was low (SCORE, 1%; interquartile range, 0%-1%), mild abnormalities were common, for example, elevated blood pressure (19%), left ventricular hypertrophy (6%), and elevated LDL cholesterol (5%). ECG changes compatible with the "athlete's heart" were present in 82%, for example, sinus bradycardia (61%) and/or early repolarization (32%). ECG changes considered training unrelated were found in 24%, for example, prolonged QTc-interval (13%), left axis deviation (5.3%), and left atrial enlargement (4%). In 14 runners (9%), additional diagnostic workup was clinically motivated, and 4 runners (2%) were ultimately discouraged from vigorous exercise because of QTc intervals >500 ms (n = 2), symptomatic atrioventricular block (n = 1), and cardiac tumor (n = 1). The physician examination and the ECG identified 12 of the 14 participants requiring further evaluation. Cardiovascular evaluation of middle-age men, including a physician examination and a 12-lead ECG, appears useful to identify individuals requiring further testing before vigorous exercise. The additional yield of routine echocardiography was small.

  10. Built Environment Influences of Children’s Physical Activity: Examining Differences by Neighbourhood Size and Sex

    Directory of Open Access Journals (Sweden)

    Christine A. Mitchell

    2016-01-01

    Full Text Available Neighbourhoods can facilitate or constrain moderate-to-vigorous physical activity (MVPA among children by providing or restricting opportunities for MVPA. However, there is no consensus on how to define a child’s neighbourhood. This study examines the influence of the neighbourhood built environment on objectively measured MVPA among 435 children (aged 9–14 years in London (ON, Canada. As there is no consensus on how to delineate a child’s neighbourhood, a geographic information system was used to generate measures of the neighbourhood built environment at two buffer sizes (500 m and 800 m around each child’s home. Linear regression models with robust standard errors (cluster were used to analyze the relationship between built environment characteristics and average daily MVPA during non-school hours on weekdays. Sex-stratified models assessed sex-specific relationships. When accounting for individual and neighbourhood socio-demographic variables, park space and multi-use path space were found to influence children’s MVPA. Sex-stratified models found significant associations between MVPA and park space, with the 800 m buffer best explaining boys’ MVPA and the 500 m buffer best explaining girls’ MVPA. Findings emphasize that, when designing built environments, programs, and policies to facilitate physical activity, it is important to consider that the size of the neighbourhood influencing a child’s physical activity may differ according to sex.

  11. Yield of yearly routine physical examination in HIV-1 infected patients is limited : A retrospective cohort study in the Netherlands

    NARCIS (Netherlands)

    van Amsterdam, Marleen A.; van Assen, Sander; Sprenger, Herman G.; Wilting, Kasper R.; Stienstra, Ymkje; Bierman, Wouter F. W.

    2017-01-01

    Background Routine physical examinations might be of value in HIV-infected patients, but the yield is unknown. We determined the diagnoses that would have been missed without performing annual routine physical examinations in HIV-infected patients with stable disease. Methods Data were collected

  12. Measuring Professional Behaviour in Canadian Physical Therapy Students' Objective Structured Clinical Examinations: An Environmental Scan

    Science.gov (United States)

    Ellerton, Cindy; Evans, Cathy

    2015-01-01

    ABSTRACT Purpose: To identify professional behaviours measured in objective structured clinical examinations (OSCEs) by Canadian university physical therapy (PT) programs. Method: A cross-sectional telephone survey was conducted to review current practice and determine which OSCE items Canadian PT programs are using to measure PT students' professional behaviours. Telephone interviews using semi-structured questions were conducted with individual instructors responsible for courses that included an OSCE as part of the assessment component. Results: Nine PT programmes agreed to take part in the study, and all reported conducting at least one OSCE. The number and characteristics of OSCEs varied both within and across programs. Participants identified 31 professional behaviour items for use in an OSCE; these items clustered into four categories: communication (n=14), respect (n=10), patient safety (n=4), and physical therapists' characteristics (n=3). Conclusions: All Canadian entry-level PT programmes surveyed assess professional behaviours in OSCE-type examinations; however, the content and style of assessment is variable. The local environment should be considered when determining what professional behaviours are appropriate to assess in the OSCE context in individual programmes. PMID:25931656

  13. Anatomy and physical examination of the knee menisci: a narrative review of the orthopedic literature.

    Science.gov (United States)

    Chivers, Michael D; Howitt, Scott D

    2009-12-01

    The objective of this study was to review the physical examination tests available to a practitioner in order to arrive at a clinical diagnosis or suspicion of a meniscal lesion. The menisci transmit weight bearing forces and increase stability of the knee. The menisci also facilitate nutrition, provide lubrication and shock absorption for the articular cartilage and promote knee proprioception. The combinations of torsional and axial loading appear to be the cause of most meniscal injuries. Diagnosis of acute knee injuries has long been a topic for discussion throughout the orthopedic literature. Many clinical tests and diagnostic studies have been developed to increase the clinician's ability to accurately diagnose these types of disorders of the knee. The accuracy of all diagnostic tests is thought to be dependant upon the skill of the examiner, and the severity and location of the injury. The multitude of tests described to assess meniscal lesions suggests that none are consistently reliable. However, recent research has focused on a composite score to accurately predict meniscus lesions. The combination of a comprehensive history, multiple physical tests and diagnostic imaging for confirmation is typical for a clinical meniscal lesion diagnosis while the gold standard remains the arthroscopic procedure itself.

  14. Association between Patient History and Physical Examination and Osteoarthritis after Ankle Sprain.

    Science.gov (United States)

    van Ochten, John M; de Vries, Anja D; van Putte, Nienke; Oei, Edwin H G; Bindels, Patrick J E; Bierma-Zeinstra, Sita M A; van Middelkoop, Marienke

    2017-09-01

    Structural abnormalities on MRI are frequent after an ankle sprain. To determine the association between patient history, physical examination and early osteoarthritis (OA) in patients after a previous ankle sprain, 98 patients with persistent complaints were selected from a cross-sectional study. Patient history taking and physical examination were applied and MRI was taken. Univariate and multivariable analyses were used to test possible associations. Signs of OA (cartilage loss, osteophytes and bone marrow edema) were seen in the talocrural joint (TCJ) in 40% and the talonavicular joint (TNJ) in 49%. Multivariable analysis showed a significant positive association between swelling (OR 3.58, 95%CI 1.13;11.4), a difference in ROM of passive plantar flexion (OR 1.09, 95%CI 1.01;1.18) and bone edema in the TCJ. A difference in ROM of passive plantar flexion (OR 1.07, 95%CI 1.00;1.15) and pain at the end range of dorsiflexion/plantar flexion (OR 5.23, 95%CI 1.88;14.58) were associated with osteophytes in the TNJ. Pain at the end of dorsiflexion/plantar flexion, a difference in ROM of passive plantar flexion and swelling seem to be associated with features of OA (bone marrow edema, osteophytes) in the TCJ and TNJ. Our findings may guide physicians to predict structural joint abnormalities as signs of osteoarthritis. 1b. © Georg Thieme Verlag KG Stuttgart · New York.

  15. Evaluation of the first seizure patient: Key points in the history and physical examination.

    Science.gov (United States)

    Nowacki, Tomasz A; Jirsch, Jeffrey D

    2017-07-01

    This review will present the history and physical examination as the launching point of the first seizure evaluation, from the initial characterization of the event, to the exclusion of alternative diagnoses, and then to the determination of specific acute or remote causes. Clinical features that may distinguish seizures from alternative diagnoses are discussed in detail, followed by a discussion of acute and remote first seizure etiologies. This review article is based on a discretionary selection of English language articles retrieved by a literature search in the PubMed database, and the authors' clinical experience. The first seizure is a dramatic event with often profound implications for patients and family members. The initial clinical evaluation focuses on an accurate description of the spell to confirm the diagnosis, along with careful scrutiny for previously unrecognized seizures that would change the diagnosis more definitively to one of epilepsy. The first seizure evaluation rests primarily on the clinical history, and to a lesser extent, the physical examination. Even in the era of digital EEG recording and neuroimaging, the initial clinical evaluation remains essential for the diagnosis, treatment, and prognostication of the first seizure. Copyright © 2016. Published by Elsevier Ltd.

  16. The viper fangs: clinical anatomy, principles of physical examination and therapy (a review

    Directory of Open Access Journals (Sweden)

    Matteo Oliveri

    2016-01-01

    Full Text Available The assessment of fangs is a fundamental part of clinical examination of viperid snakes. The long curved venom fang is carried by short, highly mobile maxilla. Short anaesthesia is advised for safe physical examination and radiography of the mouth cavity. The fangs are gently forced outside the fang pocket by passing the bar or forceps on the palato-maxillary arch, and rotating them rostrally shifting the mucosal fold. Functional fangs are periodically shed and several generations of replacement teeth lie behind and beneath each fang. In case of fang fracture, therapy should be limited to flushing with a solution of chlorhexidine or povidone iodine, and topical application of pro-coagulant and antibacterial cream. Therapy of chronic fang inflammation is based on removal of necrotized fang and repeated abundant irrigation of the fang pocket. Treatment of chronic stomatitis consists of flushing with chlorhexidine or povidone iodine, physical removal of the plaques, administration of analgesics and antibiotics (marbofloxacin, enrofloxacin or ceftazidime. Extra-oral surgical approach is the best method for odontogenic abscess removal. A vigorous flushing with sterile saline solution, chlorhexidine and povidone iodine and topical application of antibiotics (antibiotic embedded surgical sponge is advised. Force feeding of the anorectic patient suffering from fang inflammation is a mandatory part of the standard treatment protocol.

  17. Returning to the bedside: using the history and physical examination to identify rotator cuff tears.

    Science.gov (United States)

    Litaker, D; Pioro, M; El Bilbeisi, H; Brems, J

    2000-12-01

    To determine the value of elements of the bedside history and physical examination in predicting arthrography results in older patients with suspected rotator cuff tear (RCT). Retrospective chart review Orthopedic practice limited to disorders of the shoulder 448 consecutive patients with suspected RCT referred for arthrography over a 4-year period Presence of partial or complete RCT on arthrogram 301 patients (67.2%) had evidence of complete or partial RCT. Clinical findings in the univariate analysis most closely associated with rotator cuff tear included infra- and supraspinatus atrophy (P or = 65 (AOR 4.05(2.47, 16.07)), and night pain (AOR 2.61 (1.004, 7.39)) best predicted the presence of RCT. A five-point scoring system developed from this model was applied in the remaining patient sample (n = 216) to test validity. No significant differences in performance were noted using ROC curve comparison. Using likelihood ratios, a clinical score = 4 was superior in predicting RCT to the diagnostic prediction of an expert clinician. This score had specificity equivalent to magnetic resonance imaging or ultrasonography in diagnosis of RCT. The presence of three simple features in the history and physical examination of the shoulder can identify RCT efficiently. This approach offers a valuable strategy to diagnosis at the bedside without compromising sensitivity or specificity.

  18. Is there an agreement among the items of the Korean physical therapist licensing examination, learning objectives of class subjects, and physical therapists' job descriptions?

    Science.gov (United States)

    Kang, Min-Hyeok; Kwon, Oh-Yun; Kim, Yong-Wook; Kim, Ji-Won; Kim, Tae-Ho; Oh, Tae-Young; Weon, Jong-Hyuk; Lee, Tae-Sik; Oh, Jae-Seop

    2016-01-01

    To determine the agreement among the items of the Korean physical therapist licensing examination, learning objectives of class subjects, and physical therapists' job descriptions. The main tasks of physical therapists were classified, and university courses related to the main tasks were also classified. Frequency analysis was used to determine the proportions of credits for the classified courses out of the total credits of major subjects, exam items related to the classified courses out of the total number of exam items, and universities that offer courses related to the Korean physical therapist licensing examination among the surveyed universities. The proportions of credits for clinical decision making and physical therapy diagnosis-related courses out of the total number credits for major subjects at universities were relatively low (2.06% and 2.58%, respectively). Although the main tasks of physical therapists are related to diagnosis and evaluation, the proportion of physiotherapy intervention-related items (35%) was higher than that of examination and evaluation-related items (25%) on the Korean physical therapist licensing examination. The percentages of universities that offer physical therapy diagnosis and clinical decision making-related courses were 58.62% and 68.97%, respectively. Both the proportion of physiotherapy diagnosis and evaluation-related items on the Korean physical therapist licensing examination, and the number of subjects related to clinical decision making and physical therapy diagnosis in the physical therapy curriculum, should be increased to ensure that the examination items and physical therapy curriculum reflect the practical tasks of physical therapists.

  19. Assessment of structured physical examination skills training using a retro-pre-questionnaire.

    Science.gov (United States)

    Piryani, Rano Mal; Shankar, P Ravi; Piryani, Suneel; Thapa, Trilok Pati; Karki, Balmansingh; Khakurel, Mahesh Prasad; Bhandary, Shital

    2013-01-01

    The effectiveness of physical examination skills (PES) training is very rarely assessed using the "post-then-pre" approach. In this study, a retro-pre-questionnaire was used to study the effect of structured physical examination skills training (SPEST) imparted to second-year undergraduate medical students. KIST Medical College (KISTMC) affiliated to Tribhuvan University Nepal admitted its first batch of MBBS students in November 2008. The university curriculum recommends the involvement of Medicine and Surgery Departments in PES training, but the methods for teaching and assessment are not well defined. KISTMC has made training more structured and involved the Medicine, Surgery, Gynaecology and Obstetrics, Orthopaedics, ENT, Ophthalmology, Paediatrics, and Family Medicine Departments. SPEST includes the teaching/learning of basic PES for 210 minutes once a week for 28 weeks. Self-assessment is done by using a retro-pre-questionnaire at the end of the last session of training, and these data are analysed using SPSS. Out of 100 students, 98 participated in the objective structured clinical examination (OSCE); 82 completed the retro-pre-questionnaire. Forty-six skills representing various systems were selected for inclusion in the retro-pre-questionnaire from among the many skills taught in different departments. The average perceived skills score (maximum score, 46×4=184) before training was 15.9 and increased to 116.5 after training. The increase was statistically significant upon the application of a paired t-test. The students perceived that their level of skills improved after the training. The retro-pre- instrument seems to be useful for assessing the learners' self-reported changes in PES after training if a large number of skills need to be assessed. However, it should be noted that although a retro-pre-questionnaire may reveal valuable information, it is not a substitute for an objective measure or gold standard.

  20. Health maintenance in school-aged children: Part I. History, physical examination, screening, and immunizations.

    Science.gov (United States)

    Riley, Margaret; Locke, Amy B; Skye, Eric P

    2011-03-15

    The goals of the well-child examination in school-aged children (kindergarten through early adolescence) are promoting health, detecting disease, and counseling to prevent injury and future health problems. A complete history should address any concerns from the patient and family and screen for lifestyle habits, including diet, physical activity, daily screen time (e.g., television, computer, video games), hours of sleep per night, dental care, and safety habits. School performance can be used for developmental surveillance. A full physical examination should be performed; however, the U.S. Preventive Services Task Force recommends against routine scoliosis screening and testicular examination. Children should be screened for obesity, which is defined as a body mass index at or above the 95th percentile for age and sex, and resources for comprehensive, intensive behavioral interventions should be provided to children with obesity. Although the evidence is mixed regarding screening for hypertension before 18 years of age, many experts recommend checking blood pressure annually beginning at three years of age. The American Academy of Pediatrics recommends vision and hearing screening annually or every two years in school-aged children. There is insufficient evidence to recommend screening for dyslipidemia in children of any age, or screening for depression before 12 years of age. All children should receive at least 400 IU of vitamin D daily, with higher doses indicated in children with vitamin D deficiency. Children who live in areas with inadequate fluoride in the water (less than 0.6 ppm) should receive a daily fluoride supplement. Age-appropriate immunizations should be given, as well as any missed immunizations.

  1. Physical examination in undergraduate medical education in the field of general practice - a scoping review.

    Science.gov (United States)

    Moßhammer, Dirk; Graf, Joachim; Joos, Stefanie; Hertkorn, Rebekka

    2017-11-25

    Physical examination (PE) is an essential clinical skill and a central part of a physician's daily activity. Teaching of PE has been integrated into medical school by many clinical disciplines with respective specific examination procedures. For instance, PE teaching in general practice may include a full-body examination approach. Studies show that PE-skills of medical students often need enhancement. The aim of this article was to scope the literature regarding the teaching and research of PE within general practice during undergraduate medical education. We evaluated a wide breadth of literature relating to the content, study design, country of research institution and year of publication. Literature search in Medline along the PRISMA-P protocol was performed by search syntax ("physical examination" AND "medical education" AND "undergraduate" AND general practice) considering Medline MeSH (Medical Subject Heading)-Terms and Medline search term tree structure. Independent title, abstract and full-text screening with defined inclusion and exclusion criteria was performed. Full texts were analyzed by publication year, country of origin, study design and content (by categorizing articles along their main topic according to qualitative content analysis of Mayring). One-hundred seven articles were included. The annual number of publications ranged from 4 to 14 and had a slightly rising trend since 2000. Nearly half of the publications originated from the United States (n = 54), 33 from Canada and the United Kingdom. Overall, intervention studies represented the largest group (n = 60, including uncontrolled and controlled studies, randomized and non-randomized), followed by cross-sectional studies (n = 29). The 117 studies could be assigned to five categories "teaching methods (n = 53)", "teaching quality (n = 33)", "performance evaluation and examination formats (n=19)", "students' views (n = 8)" and "patients' and standardized patients' views

  2. The usefulness of physical examination and laboratory data in pediatric patients with blunt abdominal trauma

    International Nuclear Information System (INIS)

    Muramori, Katsumi; Kondo, Tsuyoshi; Zaizen, Yoshio; Tsuno, Shinsuke

    2007-01-01

    To evaluate the usefulness of clinical and laboratory data in pediatric patients with abdominal blunt trauma, the case records of 43 pediatric cases with blunt trauma who were admitted to our hospital were reviewed retrospectively. Among these patients, 23 were determined to have intraabdominal injury. Abdominal physical examination was not statistically identified to be a predictor of intraabdominal injury, however, the hematocrit and serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) values were significantly aberrant in these cases. Furthermore, the mean AST and ALT values in the non-hepatic injury cases were also apt to be higher than those in the no-injury group. These findings suggested that the serum AST and ALT may be possible predictors of intraabdominal injury, not only that restricted to the liver. Additionally, in our cases, abdominal CT examination was more diagnostic than ultrasound examination. Accordingly, in cases of pediatric abdominal blunt trauma with aberrant serum values of the liver transaminases, CT san should be performed electively. (author)

  3. Pre-participation and follow-up screening of athletes for endurance sport.

    Science.gov (United States)

    Leischik, Roman; Dworrak, Birgit; Foshag, Peter; Strauss, Markus; Spelsberg, Norman; Littwitz, Henning; Horlitz, Marc

    2015-06-01

    Physical activity increases life expectancy and sport is a priori not harmful. Exhausted sporting activity (e.g. endurance running, triathlon, cycling or competitive sport) can lead under individual conditions to negative cardiac remodelling (pathological enlargement/function of cardiac cavities/structures) or in worst case to cardiac arrhythmias and sudden cardiac death (SCD). This individually disposition can be genetically determined or behaviourally/environmentally acquired. Overall competitive young male athletes suffer five-fold higher than non-competitive athletes from sudden death and athletes aged over 30 bear a potential for arrhythmias, atrial fibrillation or a 20-fold higher possibility for SCD as female athletes. Patients with diabetes, coronary disease, obesity or hypertension require different special managements. Screening of cardiorespiratory health for sport activities has a lot of faces. Basically there is a need for indicated examinations or possible preventive measures inside or outside of pre-competition screening. The costs of screening compared to expenditure of whole effort for sporting activities are acceptable or even negligible, but of course dependent on national/regional settings. The various causes and possibilities of screening will be discussed in this article as basic suggestion for an open discussion beyond national borders and settings.

  4. Diagnostic Accuracy of 3 Physical Examination Tests in the Assessment of Hip Microinstability.

    Science.gov (United States)

    Hoppe, Daniel J; Truntzer, Jeremy N; Shapiro, Lauren M; Abrams, Geoffrey D; Safran, Marc R

    2017-11-01

    Hip microinstability is a diagnosis gaining increasing interest. Physical examination tests to identify microinstability have not been objectively investigated using intraoperative confirmation of instability as a reference standard. To determine the test characteristics and diagnostic accuracy of 3 physical examination maneuvers in the detection of hip microinstability. Cohort study (diagnosis); Level of evidence, 2. A review was conducted of 194 consecutive hip arthroscopic procedures performed by a sports medicine surgeon at a tertiary-care academic center. Physical examination findings of interest, including the abduction-hyperextension-external rotation (AB-HEER) test, the prone instability test, and the hyperextension-external rotation (HEER) test, were obtained from prospectively collected data. The reference standard was intraoperative identification of instability based on previously published objective criteria. Test characteristics, including sensitivity, specificity, positive and negative predictive values, and accuracy, were calculated for each test as well as for combinations of tests. A total of 109 patients were included in the analysis. The AB-HEER test was most accurate, with a sensitivity of 80.6% (95% CI, 70.8%-90.5%) and a specificity of 89.4% (95% CI, 80.5%-98.2%). The prone instability test had a low sensitivity (33.9%) but a very high specificity (97.9%). The HEER test performed second in both sensitivity (71.0%) and specificity (85.1%). The combination of multiple tests with positive findings did not yield significantly greater accuracy. All tests had high positive predictive values (range, 86.3%-95.5%) and moderate negative predictive values (range, 52.9%-77.8%). When all 3 tests had positive findings, there was a 95.0% (95% CI, 90.1%-99.9%) chance that the patient had microinstability. The AB-HEER test most accurately predicted hip instability, followed by the HEER test and the prone instability test. However, the high specificity of the

  5. Counseling for the Wilderness Athlete and Adventurer During a Preparticipation Evaluation for Preparation, Safety, and Injury Prevention.

    Science.gov (United States)

    Young, Justin Mark J; Campbell, Aaron D; Raastad, Kate K

    2015-12-01

    Wilderness sports and adventures continue to increase in popularity. Counseling is an essential element of the preparticipation evaluation (PPE) for athletes in traditional sports. This approach can be applied to and augmented for the wilderness athlete and adventurer. The authors reviewed the literature on counseling during PPEs and gathered expert opinion from medical professionals who perform such PPEs for wilderness sports enthusiasts. The objective was to present findings of this review and make recommendations on the counseling component of a wilderness sports/adventure PPE. The counseling component of a PPE for wilderness sports/adventures should take place after a basic medical evaluation, and include a discussion on sport or activity-specific injury prevention, personal health, travel recommendations, and emergency event planning. Counseling should be individualized and thorough, and involve shared decision making. This should take place early enough to allow ample time for the athlete or adventurer to further prepare as needed based on the recommendations. Resources may be recommended for individuals desiring more information on selected topics. Copyright © 2015. Published by Elsevier Inc.

  6. Joint-position sense is altered by football pre-participation warm-up exercise and match induced fatigue.

    Science.gov (United States)

    Salgado, Eduardo; Ribeiro, Fernando; Oliveira, José

    2015-06-01

    The demands to which football players are exposed during the match may augment the risk of injury by decreasing the sense of joint position. This study aimed to assess the effect of pre-participation warm-up and fatigue induced by an official football match on the knee-joint-position sense of football players. Fourteen semi-professional male football players (mean age: 25.9±4.6 years old) volunteered in this study. The main outcome measures were rate of perceived exertion and knee-joint-position sense assessed at rest, immediately after a standard warm-up (duration 25 min), and immediately after a competitive football match (90 minutes duration). Perceived exertion increased significantly from rest to the other assessments (rest: 8.6±2.0; after warm-up: 12.1±2.1; after football match: 18.5±1.3; pfootball match compared to both rest (pfootball match-induced fatigue. Warm-up exercises could contribute to knee injury prevention, whereas the deleterious effect of match-induced fatigue on the sensorimotor system could ultimately contribute to knee instability and injury. Copyright © 2014 Elsevier B.V. All rights reserved.

  7. Extending in-competition Athletics injury and illness surveillance with pre-participation risk factor screening: A pilot study.

    Science.gov (United States)

    Edouard, Pascal; Jacobsson, Jenny; Timpka, Toomas; Alonso, Juan-Manuel; Kowalski, Jan; Nilsson, Sverker; Karlsson, David; Depiesse, Frédéric; Branco, Pedro

    2015-05-01

    To explore the performance of retrospective health data collected from athletes before Athletics championships for the analysis of risk factors for in-competition injury and illness (I&I). For the 2013 European Athletics Indoor Championships, a self-report questionnaire (PHQ) was developed to record the health status of 127 athletes during the 4 weeks prior to the championship. Physician-based surveillance of in-competition I&I among all 577 athletes registered to compete was pursued during the championships. 74 athletes (58.3%) from the sample submitted a complete PHQ. 21 (28%) of these athletes sustained at least one injury and/or illness during the championships. Training more than 12 h/week predisposed for sustaining an in-competition injury, and a recent health problem for in-competition illness. Among the 577 registered athletes, 60 injuries (104/1000 registered athletes) were reported. 31% of injuries were caused by the track, and 29% by overuse. 29 illnesses were reported (50/1000 registered athletes); upper respiratory tract infection and gastro-enteritis/diarrhoea were the most reported diagnoses. Pre-participation screening using athletes' self-report PHQ showed promising results with regard to identification of individuals at risk. Indoor injury types could be attributed to extrinsic factors, such as small track size, track inclination, and race tactics. Copyright © 2014 Elsevier Ltd. All rights reserved.

  8. The accuracy of combined physical examination and ultrasonography for the detection of abdominal aorta aneurysm.

    Science.gov (United States)

    Cârstea, Doina; Streba, Letiţia Adela Maria; Glodeanu, Adina; Cârstea, A P; Vancu, Mihaela; Ninulescu, Ana-Maria

    2008-01-01

    Atherosclerosis is the most frequent cause in the appearance of an abdominal aorta aneurysm (AAA) and plays an important role in his development. Most AAA does not cause any symptoms, especially when talking about elderly patients, however, many of those aneurysms can be detected during physical examination. Their detection is very important because the natural evolution and the major reason in treating AAA is their tendency to rupture. We present the case of an adult man with a complex clinical pathology, but not related to the AAA. The diagnosis of the AAA has been suspicion through palpation, and the abdominal ultrasound exam confirmed it. This case is particular interesting, as the AAA requires surgical intervention, while patient's health status was poor. An essential issue is establishing the importance of the AAA screening, when there are no symptoms present. For now, there are not satisfactory studies to be used as a guide.

  9. EXAMINING OCCUPATIONAL ANXIETY LEVELS OF PHYSICAL EDUCATION AND SPORTS TEACHER DEPARTMENT STUDENTS

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    Ayşe Feray Özbal

    2017-12-01

    Full Text Available The aim of this study was to examine the occupational anxiety levels of physical education and sports teacher department students in terms of age, gender, university, grade level, mother’s and father’s educational levels and family income. A total of 511 students (208 female, 303 male from 6 different universities participated in the study. Independent samples t-test for gender and age variables; One-way Analysis of Variance (ANOVA was used for grade level, university, mother’s and father’s education levels and family income. Significant differences were found in Interaction With Students, Occupational Exam subscales in terms of gender; Interaction With Students and Individual Self-Development subscales in terms of age (p.05. As a result, It can be concluded that the significant difference between gender groups is derived from social values, and the difference in age groups is due to lack of occupational qualification.

  10. Accuracy of Medical Students in Detecting Pleural Effusion Using Lung Ultrasound as an Adjunct to the Physical Examination.

    Science.gov (United States)

    Steinmetz, Peter; Oleskevich, Sharon; Dyachenko, Alina; McCusker, Jane; Lewis, John

    2018-03-25

    This study compared the accuracy of medical students in identifying pleural effusion in hospitalized patients using the physical examination versus lung ultrasound (US). Fourth-year medical students (n = 14) received 20 hours of general practical US training (including 2 hours of specialized lung US training) plus theoretical and video documentation. The students used the physical examination alone versus the physical examination plus lung US to document the presence or absence of pleural effusion in the right and left hemithoraces of hospitalized patients (n = 11 patients; 22 hemithoraces examined 544 times in total). The reference standard for identification of pleural effusion was a lung US examination by 2 expert point-of-care sonographers. The odds of correctly identifying the presence versus absence of pleural effusion was 5 times greater with lung US as an adjunct to the physical examination compared to the physical examination alone (odds ratio [OR], 5.1 from multivariate logistic regression; 95% confidence interval, 3.3-8.0). The addition of lung US to the physical examination resulted in an increase in sensitivity from 48% to 90%, in specificity from 73% to 86%, and in accuracy from 60% to 88%. The benefits of using US were greater when pleural effusion was present versus absent (OR, 10.8 versus 2.4) and when examining older versus younger patients (OR, 10.2 versus 2.8). These results demonstrate that medical students' ability to detect the presence or absence of pleural effusion is superior when using lung US as an adjunct to the physical examination than when using the physical examination alone. © 2018 by the American Institute of Ultrasound in Medicine.

  11. Assessment of Robotic Patient Simulators for Training in Manual Physical Therapy Examination Techniques

    Science.gov (United States)

    Ishikawa, Shun; Okamoto, Shogo; Isogai, Kaoru; Akiyama, Yasuhiro; Yanagihara, Naomi; Yamada, Yoji

    2015-01-01

    Robots that simulate patients suffering from joint resistance caused by biomechanical and neural impairments are used to aid the training of physical therapists in manual examination techniques. However, there are few methods for assessing such robots. This article proposes two types of assessment measures based on typical judgments of clinicians. One of the measures involves the evaluation of how well the simulator presents different severities of a specified disease. Experienced clinicians were requested to rate the simulated symptoms in terms of severity, and the consistency of their ratings was used as a performance measure. The other measure involves the evaluation of how well the simulator presents different types of symptoms. In this case, the clinicians were requested to classify the simulated resistances in terms of symptom type, and the average ratios of their answers were used as performance measures. For both types of assessment measures, a higher index implied higher agreement among the experienced clinicians that subjectively assessed the symptoms based on typical symptom features. We applied these two assessment methods to a patient knee robot and achieved positive appraisals. The assessment measures have potential for use in comparing several patient simulators for training physical therapists, rather than as absolute indices for developing a standard. PMID:25923719

  12. Assessment of robotic patient simulators for training in manual physical therapy examination techniques.

    Directory of Open Access Journals (Sweden)

    Shun Ishikawa

    Full Text Available Robots that simulate patients suffering from joint resistance caused by biomechanical and neural impairments are used to aid the training of physical therapists in manual examination techniques. However, there are few methods for assessing such robots. This article proposes two types of assessment measures based on typical judgments of clinicians. One of the measures involves the evaluation of how well the simulator presents different severities of a specified disease. Experienced clinicians were requested to rate the simulated symptoms in terms of severity, and the consistency of their ratings was used as a performance measure. The other measure involves the evaluation of how well the simulator presents different types of symptoms. In this case, the clinicians were requested to classify the simulated resistances in terms of symptom type, and the average ratios of their answers were used as performance measures. For both types of assessment measures, a higher index implied higher agreement among the experienced clinicians that subjectively assessed the symptoms based on typical symptom features. We applied these two assessment methods to a patient knee robot and achieved positive appraisals. The assessment measures have potential for use in comparing several patient simulators for training physical therapists, rather than as absolute indices for developing a standard.

  13. Assessment of robotic patient simulators for training in manual physical therapy examination techniques.

    Science.gov (United States)

    Ishikawa, Shun; Okamoto, Shogo; Isogai, Kaoru; Akiyama, Yasuhiro; Yanagihara, Naomi; Yamada, Yoji

    2015-01-01

    Robots that simulate patients suffering from joint resistance caused by biomechanical and neural impairments are used to aid the training of physical therapists in manual examination techniques. However, there are few methods for assessing such robots. This article proposes two types of assessment measures based on typical judgments of clinicians. One of the measures involves the evaluation of how well the simulator presents different severities of a specified disease. Experienced clinicians were requested to rate the simulated symptoms in terms of severity, and the consistency of their ratings was used as a performance measure. The other measure involves the evaluation of how well the simulator presents different types of symptoms. In this case, the clinicians were requested to classify the simulated resistances in terms of symptom type, and the average ratios of their answers were used as performance measures. For both types of assessment measures, a higher index implied higher agreement among the experienced clinicians that subjectively assessed the symptoms based on typical symptom features. We applied these two assessment methods to a patient knee robot and achieved positive appraisals. The assessment measures have potential for use in comparing several patient simulators for training physical therapists, rather than as absolute indices for developing a standard.

  14. The Influence of Peer Feedback on the Acquisition of Physical-Examination Skills

    Directory of Open Access Journals (Sweden)

    Bernard Martineau

    2016-12-01

    Full Text Available Studies have suggested that having students observe peers while acquiring physical-examination (PE skills fosters the acquisition of the psychomotor skills required to conduct a PE. One difficulty, however, has been to disentangle the effect of peer observation from peer feedback, both of which occur when students learn in groups. This study investigated the influence of peer feedback on learning the neurolocomotor physical exam for low-back pain. 120 second-year medical students were randomly assigned to a peer-feedback group (n=61 or a no-peer-feedback group (n=53, during a regular learning activity with a standardized-patient instructor. Students first practised the NLE in groups of three, with or without peer feedback, depending on the group to which they were assigned. Subsequently, the members of both groups performed the NLE individually. The final NLE was videotaped and assessed later. Peer feedback had a positive effect on the acquisition of PE skills (87.9% vs. 90.8%, p=0.023, despite the fact that students had an initial preference for instructor feedback compared with peer feedback. These results support the use of group activities that give students the opportunity to provide feedback to their peers while learning PE skills.

  15. Diagnostic accuracy of physical examination tests of the ankle/foot complex: a systematic review.

    Science.gov (United States)

    Schwieterman, Braun; Haas, Deniele; Columber, Kirby; Knupp, Darren; Cook, Chad

    2013-08-01

    Orthopedic special tests of the ankle/foot complex are routinely used during the physical examination process in order to help diagnose ankle/lower leg pathologies. The purpose of this systematic review was to investigate the diagnostic accuracy of ankle/lower leg special tests. A search of the current literature was conducted using PubMed, CINAHL, SPORTDiscus, ProQuest Nursing and Allied Health Sources, Scopus, and Cochrane Library. Studies were eligible if they included the following: 1) a diagnostic clinical test of musculoskeletal pathology in the ankle/foot complex, 2) description of the clinical test or tests, 3) a report of the diagnostic accuracy of the clinical test (e.g. sensitivity and specificity), and 4) an acceptable reference standard for comparison. The quality of included studies was determined by two independent reviewers using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool. Nine diagnostic accuracy studies met the inclusion criteria for this systematic review; analyzing a total of 16 special tests of the ankle/foot complex. After assessment using the QUADAS-2, only one study had low risk of bias and low concerns regarding applicability. Most ankle/lower leg orthopedic special tests are confirmatory in nature and are best utilized at the end of the physical examination. Most of the studies included in this systematic review demonstrate notable biases, which suggest that results and recommendations in this review should be taken as a guide rather than an outright standard. There is need for future research with more stringent study design criteria so that more accurate diagnostic power of ankle/lower leg special tests can be determined. 3a.

  16. Andrological aspects of physical exercise and sport medicine.

    Science.gov (United States)

    Di Luigi, Luigi; Romanelli, Francesco; Sgrò, Paolo; Lenzi, Andrea

    2012-10-01

    Appropriate physical activity is one of the bases of healthy lifestyle. In fact, physical exercise and playing sport may be associated with both improvements and injury to both general and reproductive health. A biologically normal testosterone secretion appears fundamental in males to guarantee both a physiological exercise adaptation and safe sport participation. The reproductive system is highly sensitive to the effects of exercise-related stress and the reproductive hormones may both increase and decrease after different acute or chronic exercises. Exercise and sport participation may positively or negatively influence andrological health status depending on the type, intensity and duration of performed physical activity and on individual health status. In addition, prohibited substances administration (e.g. androgenic-anabolic steroids, and so forth) in competitive and non-competitive athletes represents the main cause of iatrogenic andrological diseases. Preventing and treating andrological problems in active healthy and unhealthy individuals is as important as promoting a correct lifestyle. Physicians need to be educated on the relationships between the male reproductive system and sport participation and on the great role of the pre-participation physical examination in the prevention of andrological diseases.

  17. The psychiatric inpatient physical health assessment sheet (PIPHAS): a useful tool to improve the speed, efficiency, and documentation of physical examination in new psychiatric inpatients.

    Science.gov (United States)

    Pettipher, Alexander; Ovens, Richard

    2015-01-01

    There is increased morbidity and mortality among patients suffering from mental illness. This is believed to be multi-factorial. Poor access to healthcare, the stigma of mental illness, reduced clinic attendance, lifestyle factors, and side effects of medications are cited as possible contributing factors. It is therefore vital to perform a physical examination to identify previously undiagnosed conditions during the admission of a psychiatric inpatient. The Royal College of Psychiatrists recommends that all patients admitted to a psychiatric hospital should receive a full physical examination on admission, or within twenty-four hours of admission. A snapshot audit was carried out at Prospect Park Hospital in Reading, which highlighted that The Royal College of Psychiatrist's recommendation, along with Trust guidelines regarding physical examination were not being met, with only 78 out of 111 patients (70.3%) undergoing an examination during their admission. In addition to this, examinations were often poorly documented and not covering all examination domains. A psychiatric inpatient physical health assessment sheet (PIPHAS) was designed and introduced, providing a quick and standardised approach to the documentation of a physical examination. After the intervention was put into practice, its impact was assessed by performing a retrospective review of the admission clerking notes of the next 100 admissions to Prospect Park Hospital. Following the introduction of the PIPHAS form there was an increase in the number of patients undergoing physical examination on admission to hospital (75 out of 100 patients, 75%). There was also an increase in the thorough documentation of all examination domains (e.g. respiratory examination) for patients that had a completed PIPHAS form scanned within their medical records. This quality improvement project demonstrates that the PIPHAS form is a useful tool to improve the speed, efficiency, and documentation of a thorough physical

  18. What contributes to action plan enactment? Examining characteristics of physical activity plans.

    Science.gov (United States)

    Fleig, Lena; Gardner, Benjamin; Keller, Jan; Lippke, Sonia; Pomp, Sarah; Wiedemann, Amelie U

    2017-11-01

    Individuals with chronic conditions can benefit from formulating action plans to engage in regular physical activity. However, the content and the successful translation of plans into action, so-called plan enactment, are rarely adequately evaluated. The aim of this study was to describe the content of user-specified plans and to examine whether participants were more likely to enact their plans if these plans were highly specific, viable, and instrumental. The study presents secondary analyses from a larger behavioural intervention in cardiac and orthopaedic rehabilitation. The content of 619 action plans from 229 participants was evaluated by two independent raters (i.e., qualitative analyses and ratings of specificity) and by participants themselves (i.e., instrumentality and viability). Plan enactment was also measured via self-reports. Multilevel analyses examined the relationship between these plan characteristics and subsequent plan enactment, and between plan enactment and aggregated physical activity. Participants preferred to plan leisure-time physical activities anchored around time-based cues. Specificity of occasion cues (i.e., when to act) and highly instrumental plans were positively associated with plan enactment. Interestingly, individuals who planned less specific behavioural responses (i.e., what to do) were more likely to enact their plans. Plan enactment was positively associated with aggregated behaviour. Interventions should not only emphasize the importance of planning, but also the benefits of formulating specific contextual cues. Planning of the behavioural response seems to require less precision. Allowing for some flexibility in executing the anticipated target behaviour seems to aid successful plan enactment. Statement of Contribution What is already known on this subject? Action planning interventions are efficacious in promoting health behaviour. Characteristics of plan content (i.e., specificity) matter for unconditional behaviour

  19. Examining the development of knowledge for teaching a novel introductory physics curriculum

    Science.gov (United States)

    Seung, Eulsun

    The purpose of this study was to investigate how graduate physics teaching assistants (TAs) develop professional knowledge for teaching a new undergraduate introductory physics curriculum, Matter and Interactions (M&I ). M&I has recently been adopted as a novel introductory physics course that focuses on the application of a small number of fundamental physical principles on the atomic and molecular nature of matter. In this study, I examined the process of five TAs' development of knowledge for implementing the M&I course---from the time they engaged in an M&I content and methods workshop through their first semester as TAs for the course. Through a qualitative, multiple case study research design, data was collected from multiple sources: non-participant observations, digitally recorded video, semi-structured interviews, TAs' written reflections, and field notes. The data were analyzed using the constant comparative method. The TAs' knowledge for teaching M&I was identified in three domains: pedagogical content knowledge, pedagogical knowledge, and subject matter knowledge. First, the three components of TAs' pedagogical content knowledge were identified: knowledge of the goals of M&I, knowledge of instructional strategies, and knowledge of students' learning. Second, pedagogical knowledge that the TAs demonstrated during the study fell predominantly into the category of classroom management and organization. The knowledge of classroom management and organization was categorized into two components: time management skills and group composition. Last, the TAs' subject matter knowledge that they developed through their M&I teaching experience was described in terms of the conceptual structure of the M&I curriculum, the new approach of the M&I curriculum, and specific topic knowledge. The TAs' knowledge for teaching developed from propositional knowledge to personal practical knowledge, and the process of knowledge development consisted of three phases: accepting

  20. Examining Relationships Between Some Physical Fitness Parameters of Elite Handball Playe rs

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    Ercan ZORBA

    2014-07-01

    Full Text Available The aim of this study was to examine the relationships between sprint speeds, reaction times, strength and vertical jump properties of handball players. 23 handball players having 23.96±2.79 ages mean, 178.57±3.68 heights mean, 77.21±3.98 weights mean 8.30±1.74 sporting age participated in the study. Age, height, weight, sprint speed, reaction time, strength and vertical jump values were measured by instruments. Collected data was recorded in SPSS. Pearson Product Correlation test was used to examine relationships between properties and significant level was accepted as p<0.05. Significant relationships were found between sprint speed and right and left hand light reaction times; values of back strength and vertical jump; BMI and right and l eft handgrip (p<0.05. Consequently, it was found that many physical fitness properties of handball players had correlations and when compared with studies in literature, in terms of strength, sprint speed, reaction times and vertical jump properties, hand ball players showed good condition.

  1. Prevalence and features of fatty liver detected by physical examination in Guangzhou

    Science.gov (United States)

    Liao, Xian-Hua; Cao, Xu; Liu, Jie; Xie, Xiao-Hua; Sun, Yan-Hong; Zhong, Bi-Hui

    2013-01-01

    AIM: To investigate the prevalence of fatty liver discovered upon physical examination of Chinese patients and determine the associated clinical characteristics. METHODS: A total of 3433 consecutive patients who received physical examinations at the Huangpu Division of the First Affiliated Hospital at Sun Yat-sen University in Guangzhou, China from June 2010 to December 2010 were retrospectively enrolled in the study. Results of biochemical tests, abdominal ultrasound, electrocardiography, and chest X-ray were collected. The diagnosis of fatty liver was made if a patient met any two of the three following ultrasonic criteria: (1) liver and kidney echo discrepancy and presence of an increased liver echogenicity (bright); (2) unclear intrahepatic duct structure; and (3) liver far field echo decay. RESULTS: The study population consisted of 2201 males and 1232 females, with a mean age of 37.4 ± 12.8 years. When all 3433 patients were considered, the overall prevalence of hyperlipidemia was 38.1%, of fatty liver was 26.0%, of increased alanine aminotransferase (ALT) and/or aspartate aminotransferase (AST) levels was 11.9%, of gallstone was 11.4%, of hyperglycemia was 7.3%, of hypertension was 7.1%, and of hyperuricemia was 6.2%. Of the 2605 patients who completed the abdominal ultrasonography exam, 677 (26.0%) were diagnosed with fatty liver and the prevalence was higher in males (32.5% vs females: 15.3%, P 50-year-old did not reach statistical significance. Only 430 of the patients diagnosed with fatty liver had complete information; among those, increased ALT and/or AST levels were detected in only 30%, with all disturbances being mild or moderate. In these 430 patients, the overall prevalence of hypertriglyceridemia was 31.4%, of mixed type hyperlipidemia was 20.9%, of hypercholesterolemia was 12.3%, of hyperglycemia was 17.6%, of hypertension was 16.0%, of hyperuricemia was 15.3%, and of gallstone was 14.4%. Again, the prevalences of hypertriglyceridemia and

  2. Examining Effects of Physical Exertion on the Dynamic Visual Acuity Test in Collegiate Athletes.

    Science.gov (United States)

    Patterson, Jessie N; Murphy, Anna M; Honaker, Julie A

    2017-01-01

    Acute symptoms of dizziness and/or imbalance commonly experienced in athletes postconcussion are speculated to arise from dysfunction at multiple levels (i.e., inner ear or central vestibular system) to appropriately integrate afferent sensory information. Disruption along any pathway of the balance system can result in symptoms of dizziness, decreased postural control function (vestibulospinal reflex), and reduced vestibulo-ocular reflex function. This may also lead to decreased gaze stability with movements of the head and may account for symptoms of blurred vision or diplopia reported in almost half of athletes sustaining a concussion. Current concussion position statements include measures of postural control to examine changes to the balance system postconcussion. The Balance Error Scoring System (BESS) is a commonly used low-cost postural control measure for concussion assessment. Although this is a widely used measure for documenting balance function on both immediate (sideline) and recovery monitoring, the BESS has been shown to be affected by physical exertion. Therefore, the BESS may not be the most efficient means of examining functional changes to the balance system immediately after head injury. Dynamic Visual Acuity Test (DVAT) has been found to effectively evaluate and monitor changes to the gaze stability system postinjury. Thus, DVAT may be an additional measure in the concussion assessment battery, as well as an alternative for more immediate sideline assessment to help make objective return-to-play decisions. The aim of the study was to determine the effects of physical exertion on a clinical vestibular assessment, the DVAT, in collegiate athletes, as a first step in defining the role of this measure in the concussion assessment battery. Cross-sectional, repeated-measures design. Twenty-eight healthy collegiate athletes (20 males, 8 females; age = 20.25 ± 1.46 yr, range = 18-25 yr) volunteered to participate in the study. Participants were

  3. An Ecological Examination of an Urban Sixth Grade Physical Education Class

    Science.gov (United States)

    James, Alisa R.; Collier, Douglas

    2011-01-01

    Background: There are several factors that influence teaching urban physical education. Violence, poverty and irrelevant curricula influence the teaching-learning environment in urban physical education. One approach to urban physical education is to look carefully at the ecology that exists within an urban physical education class. This ecology…

  4. "Heidelberg standard examination" and "Heidelberg standard procedures" - Development of faculty-wide standards for physical examination techniques and clinical procedures in undergraduate medical education.

    Science.gov (United States)

    Nikendei, C; Ganschow, P; Groener, J B; Huwendiek, S; Köchel, A; Köhl-Hackert, N; Pjontek, R; Rodrian, J; Scheibe, F; Stadler, A-K; Steiner, T; Stiepak, J; Tabatabai, J; Utz, A; Kadmon, M

    2016-01-01

    The competent physical examination of patients and the safe and professional implementation of clinical procedures constitute essential components of medical practice in nearly all areas of medicine. The central objective of the projects "Heidelberg standard examination" and "Heidelberg standard procedures", which were initiated by students, was to establish uniform interdisciplinary standards for physical examination and clinical procedures, and to distribute them in coordination with all clinical disciplines at the Heidelberg University Hospital. The presented project report illuminates the background of the initiative and its methodological implementation. Moreover, it describes the multimedia documentation in the form of pocketbooks and a multimedia internet-based platform, as well as the integration into the curriculum. The project presentation aims to provide orientation and action guidelines to facilitate similar processes in other faculties.

  5. Reliability and prevalence of physical performance examination assessing mobility and balance in older persons in the US: data from the Third National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Ostchega, Y; Harris, T B; Hirsch, R; Parsons, V L; Kington, R; Katzoff, M

    2000-09-01

    This report provides reliability and prevalence estimates by sex, age, and race/ethnicity of an observed physical performance examination (PPE) assessing mobility and balance. The Third National Health and Nutrition Examination Survey (NHANES III) 1988-1994. A cross-sectional nationally representative survey. All persons aged 60 and older (n = 5,403) who performed the PPE either in the mobile examination center (MEC) or in the home during NHANES III (conducted 1988-1994). The PPE included timed chair stand, full tandem stand, and timed 8-foot walk. Timed chair stand and 8-foot timed walk were reliable measurements (Intraclass Correlations > 0.5). Women were significantly slower (P physically limited than men.

  6. Examining the impact of a province-wide physical education policy on secondary students' physical activity as a natural experiment.

    Science.gov (United States)

    Hobin, Erin; Erickson, Tannis; Comte, Melisa; Zuo, Fei; Pasha, Saamir; Murnaghan, Donna; Manske, Steve; Casey, Catherine; Griffith, Jane; McGavock, Jonathan

    2017-07-19

    The purpose of this paper is to examine the impact of a province-wide physical education (PE) policy on secondary school students' moderate to vigorous physical activity (MVPA). Policy: In fall 2008, Manitoba expanded a policy requiring a PE credit for students in grades 11 and 12 for the first time in Canada. The PE curriculum requires grades 11 and 12 students to complete a minimum of 55 h (50% of course hours) of MVPA (e.g., ≥30 min/day of MVPA on ≥5 days a week) during a 5-month semester to achieve the course credit. A natural experimental study was designed using two sub-studies: 1) quasi-experimental controlled pre-post analysis of self-reported MVPA data obtained from census data in intervention and comparison [Prince Edward Island (PEI)] provinces in 2008 (n = 33,619 in Manitoba and n = 2258 in PEI) and 2012 (n = 41,169 in Manitoba and n = 4942 in PEI); and, 2) annual objectively measured MVPA in cohorts of secondary students in intervention (n = 447) and comparison (Alberta; n = 224) provinces over 4 years (2008 to 2012). In Study 1, two logistic regressions were conducted to model the odds that students accumulated: i) ≥30 min/day of MVPA, and ii) met Canada's national recommendation of ≥60 min/day of MVPA, in Manitoba versus PEI after adjusting for grade, sex, and BMI. In Study 2, a mixed effects model was used to assess students' minutes of MVPA per day per semester in Manitoba and Alberta, adjusting for age, sex, BMI, school location and school SES. In Study 1, no significant differences were observed in students achieving ≥30 (OR:1.13, 95% CI:0.92, 1.39) or ≥60 min/day of MVPA (OR:0.92, 95% CI: 0.78, 1.07) from baseline to follow-up between Manitoba and PEI. In Study 2, no significant policy effect on students' MVPA trajectories from baseline to last follow-up were observed between Manitoba and Alberta overall (-1.52, 95% CI:-3.47, 0.42), or by covariates. The Manitoba policy mandating PE in grades 11 and 12 had no

  7. Examination of motor skill competency in students: evidence-based physical education curriculum

    Directory of Open Access Journals (Sweden)

    Weiyun Chen

    2017-02-01

    Full Text Available Abstract Background Researchers found that children with a competent level of motor skill performance are more likely to be physically active. This study examined how well K-1 students demonstrated motor skill competency in relation to Physical Education Content Standard 1. Methods Participants were K-1 grade students (N = 1,223-1,588; boys = 568–857; girls = 526–695; Mean age = 5.5 yrs old who were enrolled in nine elementary schools. The K-1 students’ motor skill competency in running, weight transferring, hand dribbling, and underhand catching skills was assessed using four PE Metrics skill assessment rubrics in the intervention year 1 and year 2, respectively. Data were analyzed by means of descriptive statistics and independent sample t-tests. Results The students in the intervention year 1 and year 2 cohorts performed at the Competent Level or higher in the four skill assessments. The prevalence of the students’ demonstration of skill competency across the four skills was high in the two intervention years. The intervention year 2 cohort scored significantly higher than the intervention year 1 cohort in the four skill assessments. The boys significantly outperformed than the girls in the two manipulative skills in the intervention year 1 and in the two manipulative skills and the weight transferring skill in the intervention year 2. No gender differences in the running skill in either year were found. Conclusions The evidence-based CATCH PE play a critical role in developing and building K-1 students’ ability to demonstrate motor skill competency in four fundamental skills. Trial registration ClinicalTrials.gov ID: NCT03015337 , registered date: 1/09/2017, as "retrospectively registered".

  8. Evaluation of the Educational Value of YouTube Videos About Physical Examination of the Cardiovascular and Respiratory Systems

    OpenAIRE

    Azer, Samy A; AlGrain, Hala A; AlKhelaif, Rana A; AlEshaiwi, Sarah M

    2013-01-01

    Background A number of studies have evaluated the educational contents of videos on YouTube. However, little analysis has been done on videos about physical examination. Objective This study aimed to analyze YouTube videos about physical examination of the cardiovascular and respiratory systems. It was hypothesized that the educational standards of videos on YouTube would vary significantly. Methods During the period from November 2, 2011 to December 2, 2011, YouTube was searched by three ass...

  9. Examining the Intersection of Bullying and Physical Relationship Violence Among New York City High School Students.

    Science.gov (United States)

    Peters, Zachary J; Hatzenbuehler, Mark L; Davidson, Leslie L

    2017-01-01

    Research is just beginning to explore the intersection of bullying and relationship violence. The relationship between these forms of youth aggression has yet to be examined in diverse urban centers, including New York City (NYC). This study seeks to identify intersections of joint victimization from bullying and electronic bullying (e-bullying) with physical relationship violence (pRV). This study examines data from the NYC Youth Risk Behavior Survey (YRBS), a representative sample of NYC public high school students, to assess the concurrent victimization from bullying at school and e-bullying with pRV, operationalized as physical violence by a dating partner in the past 12 months. Students who reported being bullied at school and e-bullied had increased odds (bullied: OR = 2.5, 95% CI [2.1, 2.9]; e-bullied: OR = 3.0, 95% CI [2.6, 3.5]) of also being victimized by pRV compared with those who did not report being bullied or e-bullied. In logistic regression models, being bullied at school and being e-bullied remained significant predictors of students' odds of reporting pRV (bullied: AOR = 2.6, 95% CI [2.2, 3.1]; e-bullied: AOR = 3.0, 95% CI [2.5, 3.6]) while controlling for race, gender, sexual orientation, and age. This research is the first to assess the intersection of victimization from bullying and e-bullying with pRV in a large, diverse, random sample of urban high school students. In this sample, students who report being bullied or e-bullied are more likely also to report pRV than students who have not been bullied or e-bullied. This research has potential implications for educators, adolescent health and social service providers, and policy makers to tailor programs and enact policies that jointly address bullying and pRV. Future studies are needed to longitudinally assess both victimization from and perpetration of bullying and pRV. © The Author(s) 2015.

  10. Insufficient evidence for the use of a physical examination to detect maltreatment in children without prior suspicion: a systematic review.

    Science.gov (United States)

    Hoytema van Konijnenburg, Eva Mm; Teeuw, Arianne H; Sieswerda-Hoogendoorn, Tessa; Leenders, Arnold G E; van der Lee, Johanna H

    2013-12-06

    Although it is often performed in clinical practice, the diagnostic value of a screening physical examination to detect maltreatment in children without prior suspicion has not been reviewed. This article aims to evaluate the diagnostic value of a complete physical examination as a screening instrument to detect maltreatment in children without prior suspicion. We systematically searched the databases of MEDLINE, EMBASE, PsychINFO, CINAHL, and ERIC, using a sensitive search strategy. Studies that i) presented medical findings of a complete physical examination for screening purposes in children 0-18 years, ii) specifically recorded the presence or absence of signs of child maltreatment, and iii) recorded child maltreatment confirmed by a reference standard, were included. Two reviewers independently performed study selection, data extraction, and quality appraisal using the QUADAS-2 tool. The search yielded 4,499 titles, of which three studies met the eligibility criteria. The prevalence of confirmed signs of maltreatment during screening physical examination varied between 0.8% and 13.5%. The designs of the studies were inadequate to assess the diagnostic accuracy of a screening physical examination for child maltreatment. Because of the lack of informative studies, we could not draw conclusions about the diagnostic value of a screening physical examination in children without prior suspicion of child maltreatment.

  11. The diagnostic value of history and physical examination for COPD in suspected or known cases: a systematic review.

    Science.gov (United States)

    Broekhuizen, Berna D L; Sachs, Alfred P E; Oostvogels, Rimke; Hoes, Arno W; Verheij, Theo J M; Moons, Karel G M

    2009-08-01

    According to current guidelines, spirometry should be performed in patients suspected of chronic obstructive pulmonary disease (COPD) by the results of history taking and physical examination. However, little is known about the diagnostic value of patient history and physical examination for COPD. To review the existing evidence on the diagnostic value of history taking and physical examination in recognizing COPD in patients suspected of COPD. A systematic literature search was performed in electronic medical databases. Studies were included after using defined inclusion and exclusion criteria and judged on their methodological quality by using the Quality Assessment of Diagnostic Accuracy Studies criteria. A formal meta-analysis was not performed because all studied items of history and physical examination were investigated in only in a maximum of three studies. Six studies were included. The history items dyspnoea, wheezing, previous consultation for wheezing or cough, self-reported COPD, age and smoking and the physical examination items wheezing, forced expiratory time, laryngeal height and prolonged expiration were found to have diagnostic value for COPD. These items were studied in maximally three studies and study population studies were heterogenic. The reference test for COPD in five of the six studies concerned obstructive lung disease in general and not COPD. There is insufficient evidence to assess the value of history taking and physical examination for diagnosing COPD.

  12. Correlation between physical examination and intraoperative findings in shoulder disease treated by arthroscopy. Statistical analysis of 150 patients.

    Science.gov (United States)

    García Parra, P; Anaya Rojas, M; Jiménez Bravo, B; González Oria, M O; Lisbona Muñoz, M; Gil Álvarez, J J; Cano Luis, P

    2016-01-01

    Only a few clinical exploratory manoeuvres are truly discriminatory and useful in shoulder disease. The aim of this study is to correlate the physical examination results of the shoulder with the true diagnosis found by arthroscopy. A retrospective case series of 150 patients with the most common surgical conditions of the shoulder. Data were collected on the suspicion of each pathology, the physical examination of the patient, and the actual discovery of the disease during arthroscopic surgery. The Bankart examination manoeuvres of the lesion show the best results, with a 92.1% positive prediction value (PPV), a 99.1% negative predictive value (NPV), followed by the impingement syndrome, with a PPV of 94.4%, and total cuff rupture with a PPV of 92.3%.Exploration of the superior labrum anterior to posterior (SLAP) lesion had an NPV of 99.1%. Physical examination is sufficient to diagnose or rule out Bankart. A positive physical examination provides the complete rupture of the rotator cuff, and requires further studies. The patients suspected of subacromial syndrome only need an NMR if the physical tests are negative. The conclusions drawn from this work can have a significant impact on both cost savings (by reducing forward tests), and saving time in certain cases in which, after appropriate physical examination, surgery may be indicated without losing time in intermediate steps. Copyright © 2016 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

  13. A concise evidence-based physical examination for diagnosis of acromioclavicular joint pathology: a systematic review.

    Science.gov (United States)

    Krill, Michael K; Rosas, Samuel; Kwon, KiHyun; Dakkak, Andrew; Nwachukwu, Benedict U; McCormick, Frank

    2018-02-01

    The clinical examination of the shoulder joint is an undervalued diagnostic tool for evaluating acromioclavicular (AC) joint pathology. Applying evidence-based clinical tests enables providers to make an accurate diagnosis and minimize costly imaging procedures and potential delays in care. The purpose of this study was to create a decision tree analysis enabling simple and accurate diagnosis of AC joint pathology. A systematic review of the Medline, Ovid and Cochrane Review databases was performed to identify level one and two diagnostic studies evaluating clinical tests for AC joint pathology. Individual test characteristics were combined in series and in parallel to improve sensitivities and specificities. A secondary analysis utilized subjective pre-test probabilities to create a clinical decision tree algorithm with post-test probabilities. The optimal special test combination to screen and confirm AC joint pathology combined Paxinos sign and O'Brien's Test, with a specificity of 95.8% when performed in series; whereas, Paxinos sign and Hawkins-Kennedy Test demonstrated a sensitivity of 93.7% when performed in parallel. Paxinos sign and O'Brien's Test demonstrated the greatest positive likelihood ratio (2.71); whereas, Paxinos sign and Hawkins-Kennedy Test reported the lowest negative likelihood ratio (0.35). No combination of special tests performed in series or in parallel creates more than a small impact on post-test probabilities to screen or confirm AC joint pathology. Paxinos sign and O'Brien's Test is the only special test combination that has a small and sometimes important impact when used both in series and in parallel. Physical examination testing is not beneficial for diagnosis of AC joint pathology when pretest probability is unequivocal. In these instances, it is of benefit to proceed with procedural tests to evaluate AC joint pathology. Ultrasound-guided corticosteroid injections are diagnostic and therapeutic. An ultrasound-guided AC joint

  14. Reliability and diagnostic accuracy of history and physical examination for diagnosing glenoid labral tears.

    Science.gov (United States)

    Walsworth, Matthew K; Doukas, William C; Murphy, Kevin P; Mielcarek, Billie J; Michener, Lori A

    2008-01-01

    Glenoid labral tears provide a diagnostic challenge. Combinations of items in the patient history and physical examination will provide stronger diagnostic accuracy to suggest the presence or absence of glenoid labral tear than will individual items. Cohort study (diagnosis); Level of evidence, 1. History and examination findings in patients with shoulder pain (N = 55) were compared with arthroscopic findings to determine diagnostic accuracy and intertester reliability. The intertester reliability of the crank, anterior slide, and active compression tests was 0.20 to 0.24. A combined history of popping or catching and positive crank or anterior slide results yielded specificities of 0.91 and 1.00 and positive likelihood ratios of 3.0 and infinity, respectively. A positive anterior slide result combined with either a positive active compression or crank result yielded specificities of 0.91 and positive likelihood ratio of 2.75 and 3.75, respectively. Requiring only a single positive finding in the combination of popping or catching and the anterior slide or crank yielded sensitivities of 0.82 and 0.89 and negative likelihood ratios of 0.31 and 0.33, respectively. The diagnostic accuracy of individual tests in previous studies is quite variable, which may be explained in part by the modest reliability of these tests. The combination of popping or catching with a positive crank or anterior slide result or a positive anterior slide result with a positive active compression or crank test result suggests the presence of a labral tear. The combined absence of popping or catching and a negative anterior slide or crank result suggests the absence of a labral tear.

  15. Pleural ultrasound as an adjunct to physical examination in the preoperative evaluation of lung cancer patients.

    Science.gov (United States)

    Bah, Ismaël; Goudie, Eric; Khereba, Mohamed; Ferraro, Pasquale; Duranceau, André; Martin, Jocelyne; Thiffault, Vicky; Liberman, Moishe

    2014-05-01

    Preoperative evaluation of patients with suspected or confirmed lung cancer consists of clinical and radiological staging. Malignant pleural effusion is a poor prognosticator in non-small-cell lung cancer. Pleural ultrasound (PU) allows for the assessment of pleural effusion, providing real-time guidance for its aspiration and cytological analysis. Pleural Ultrasonography in Lung Cancer (PULC) as an adjunct to physical examination has the potential to improve preoperative staging of non-small-cell lung cancer during first surgical encounter by allowing the evaluation of previously unassessed pleural effusion. This study consisted of a prospective trial of surgeon-performed PU in the preoperative evaluation of lung cancer patients. All patients evaluated in the thoracic surgery clinic with the new or presumed diagnosis of lung cancer were eligible. A portable ultrasound machine was used to evaluate pleural fluid in the bilateral costophrenic sulci with pleural fluid aspiration for cytological analysis. Forty-five patients were prospectively enrolled over a 3-month period. Thirteen patients had ultrasound evidence of a pleural effusion, of which 3 were significant enough for aspiration. Cytological analysis of these effusions yielded malignant cells in 1 patient. Positive PULC evaluation led to a change in clinical staging (M0 to M1a) in 10 patients and a change in pathological staging (pleural fluid cytology positive) in 1 patient. The time required for PULC examination was 15 ± 7 min. There were no complications related to the procedures. Preoperative pleural ultrasonography is a rapid and effective way to improve precision of staging in patients with lung cancer. More precise staging may allow for more appropriate testing, patient prognostication and operative planning.

  16. Ethics in the minutiae: examining the role of the physical laboratory environment in ethical discourse.

    Science.gov (United States)

    Bezuidenhout, Louise

    2015-02-01

    Responsibility within life science research is a highly scrutinised field. Increasingly, scientists are presented with a range of duties and expectations regarding their conduct within the research setting. In many cases, these duties are presented deontologically, forgoing extensive discussion on how these are practically implemented into the minutiae of daily research practices. This de-contextualized duty has proven problematic when it comes to practical issues of compliance, however it is not often considered as a fundamental aspect of building ethics discourse. This paper examines this issue in detail, particularly focusing on how differences in the contrasts between the ideal and real physical research environments cause conceptual problems for scientists and retard ethical engagement. Such issues are particularly pertinent in low- and middle-income countries. This paper combines theoretical and empirical analyses using the concept of "dual-use" as a focalizing topic. The data show that the research environment acts as an intimate component in the interpretation and implementation of ethical actions.

  17. Ultrasound for internal medicine physicians: the future of the physical examination.

    Science.gov (United States)

    Dulohery, Megan M; Stoven, Samantha; Kurklinsky, Andrew K; Kurklinksy, Andrew; Halvorsen, Andrew; McDonald, Furman S; Bhagra, Anjali

    2014-06-01

    With the advent of compact ultrasound (US) devices, it is easier for physicians to enhance their physical examinations through the use of US. However, although this new tool is widely available, few internal medicine physicians have US training. This study sought to understand physicians' baseline knowledge and skill, provide education in US principles, and demonstrate that proper use of compact US devices is a skill that can be quickly learned. Training was performed at the Mayo Clinic in June 2010 and June 2011. The participants consisted of internal medicine residents. The workshop included didactics and hands-on US experiences with human and cadaver models in a simulation center. Pretests and posttests of residents' knowledge, attitudes, and skills with US were completed. We reassessed the 2010 group in the spring of 2012 with a long-term retention survey for knowledge and confidence in viewing images. A total of 136 interns completed the workshop. Thirty-nine residents completed the long-term retention survey. Posttest assessments showed a statistically significant improvement in the knowledge of US imaging, confidence in identifying structures, image identification, and image acquisition (P internal medicine training and practice. © 2014 by the American Institute of Ultrasound in Medicine.

  18. Barriers and enabling factors for work-site physical activity programs: a qualitative examination.

    Science.gov (United States)

    Fletcher, Gena M; Behrens, Timothyh K; Domina, Lorie

    2008-05-01

    Work sites offer a productive setting for physical activity (PA) promoting interventions. Still, PA participation remains low. Thus, the purpose of this study was to examine the reasoning behind commonly reported barriers and enabling factors to participation in PA programs in a work-site setting. Employees from a large city government were recruited to participate in focus groups, stratified by white- and blue-collar occupations. Responses from open-ended questions about factors influencing participation in PA programs were audio recorded and transcribed verbatim. Resulting data were analyzed with open and axial coding. The sample consisted of 60 employees composing 9 focus groups. Although time was the most common barrier between both groups, white-collars workers responded that scheduling and work conflicts were the most common barrier concerning time. Blue-collar workers indicated shift work as their most common barrier. In addition, health was a significant enabling factor for both occupational categories. White-collar workers were much more concerned with appearances and were more highly motivated by weight loss and the hopefulness of quick results than were blue-collar workers. These findings are important in the understanding of PA as it relates to the reasoning behind participation in work-site programs in regard to occupational status.

  19. [Physical, chemical and morphological urine examination guidelines for the Analytical Phase from the Intersociety Urinalysis Group].

    Science.gov (United States)

    Manoni, Fabio; Gessoni, Gianluca; Fogazzi, Giovanni Battista; Alessio, Maria Grazia; Caleffi, Alberta; Gambaro, Giovanni; Epifani, Maria Grazia; Pieretti, Barbara; Perego, Angelo; Ottomano, Cosimo; Saccani, Graziella; Valverde, Sara; Secchiero, Sandra

    2016-01-01

    With these guidelines the Intersociety Urinalysis Group (GIAU) aims to stimulate the following aspects: Improvement and standardization of the analytical approach to physical, chemical and morphological urine examination (ECMU). Improvement of the chemical analysis of urine with particular regard to the reconsideration of the diagnostic significance of the parameters that are traditionally evaluated in dipstick analysis together with an increasing awareness of the limits of sensitivity and specificity of this analytical method. Increase the awareness of the importance of professional skills in the field of urinary morphology and the relationship with the clinicians. Implement a policy of evaluation of the analytical quality by using, in addition to traditional internal and external controls, a program for the evaluation of morphological competence. Stimulate the diagnostics industry to focus research efforts and development methodology and instrumental catering on the needs of clinical diagnosis. The hope is to revalue the enormous diagnostic potential of 'ECMU, implementing a urinalysis on personalized diagnostic needs for each patient. Emphasize the value added to ECMU by automated analyzers for the study of the morphology of the corpuscular fraction urine. The hope is to revalue the enormous potential diagnostic of 'ECMU, implementing a urinalysis on personalized diagnostic needs that each patient brings with it.

  20. Effects of Re-Using a Conceptual Examination Question in Physics

    Science.gov (United States)

    Sharma, Manjula D.; Sefton, Ian M.; Cole, Martyn; Whymark, Aaron; Millar, Rosemary M.; Smith, Andrew

    2005-12-01

    We report on a study of what happened when we recycled a conceptual examination question in a first-year university physics course. The question, which was used for three consecutive years, asked about an astronaut's experience of weighing in an orbiting space-craft. Our original intention was to use a phenomenographic approach to look for differences in students' descriptive answers. Having done that, we decided to add a study of the marks that were awarded to those answers. The first time that the question was re-used, the distribution of answers amongst our phenomenographic categories showed a decrease in the common conception that gravity is zero in the satellite and an increase in explanations in terms of free fall. When the question was re-used a second time, that difference was maintained but it was not significantly increased. The distribution of marks for the question was different over the three years in a way that appears to be unrelated to differences in students' conceptual understandings. Differences in the distribution of marks are more likely to be related to differences in marking procedures. We conclude that studies like this one have the potential to contribute to improvements in university assessment procedures. In particular we propose that phenomenographic analysis could be used in the design of marking schemes.

  1. Target Volume Delineation in Oropharyngeal Cancer: Impact of PET, MRI, and Physical Examination

    International Nuclear Information System (INIS)

    Thiagarajan, Anuradha; Caria, Nicola; Schöder, Heiko; Iyer, N. Gopalakrishna; Wolden, Suzanne; Wong, Richard J.; Sherman, Eric; Fury, Matthew G.; Lee, Nancy

    2012-01-01

    Introduction: Sole utilization of computed tomography (CT) scans in gross tumor volume (GTV) delineation for head-and-neck cancers is subject to inaccuracies. This study aims to evaluate contributions of magnetic resonance imaging (MRI), positron emission tomography (PET), and physical examination (PE) to GTV delineation in oropharyngeal cancer (OPC). Methods: Forty-one patients with OPC were studied. All underwent contrast-enhanced CT simulation scans (CECTs) that were registered with pretreatment PETs and MRIs. For each patient, three sets of primary and nodal GTV were contoured. First, reference GTVs (GTVref) were contoured by the treating radiation oncologist (RO) using CT, MRI, PET, and PE findings. Additional GTVs were created using fused CT/PET scans (GTVctpet) and CT/MRI scans (GTVctmr) by two other ROs blinded to GTVref. To compare GTVs, concordance indices (CI) were calculated by dividing the respective overlap volumes by overall volumes. To evaluate the contribution of PE, composite GTVs derived from CT, MRI, and PET (GTVctpetmr) were compared with GTVref. Results: For primary tumors, GTVref was significantly larger than GTVctpet and GTVctmr (p 0.75), indicating that although the modalities were complementary, the added benefit was small in the context of CECTs. In addition, PE did not aid greatly in nodal GTV delineation. Conclusion: PET and MRI are complementary and combined use is ideal. However, the low CI (ctpetmr vs. ref) particularly for primary tumors underscores the limitations of defining GTVs using imaging alone. PE is invaluable and must be incorporated.

  2. Teaching and testing physical examination skills without the use of patients.

    Science.gov (United States)

    Karnath, Bernard; Thornton, William; Frye, Ann W

    2002-07-01

    To design a cardiopulmonary physical exam curriculum that does not involve the use of patients. Bedside teaching is becoming a lost art, and the use of alternative methods of instruction such as simulation has become increasingly important. Simulators have been shown to enhance physical examination skills of students and physicians in training.(1) In 1995, a program was started to improve cardiopulmonary physical diagnosis and the teaching of auscultation at the University of Texas Medical Branch at Galveston (UTMB). The teaching manikin "Harvey" played a vital role in the development of the new curriculum. In 1997, UTMB adopted an organ-based approach to the basic science curriculum. The cardiopulmonary module in the basic science curriculum was a ten-week course taught in the second year of medical school. The physical diagnosis section of that course involved six instructional hours; four of the six hours were dedicated to cardiac auscultation and two hours to pulmonary auscultation. Only simulators and CD-ROMs were used for instruction. The 184 second-year medical students at UTMB were formed into small groups for instruction and practice. Although "Harvey" was an effective teaching tool, other simulators had to be developed for testing students' skills after instruction. It would be very difficult to administer a skills OSCE for 184 students without the development of several smaller transportable simulators. A commercially available blood pressure simulator from the Medical Plastics Laboratory, Inc., Gatesville, TX, was used to test the accuracy of students' blood pressure readings. Small auscultation transducers combined with a palpable pulse simulator, developed by one of the authors (WT) in collaboration with Andries Acoustics, Spicewood, TX, were used to efficiently test students' proficiency in cardiopulmonary auscultation. Digital simulated cardiopulmonary sounds were recorded onto a standard CD-ROM mini-disc and transmitted to the small transducers

  3. Physical activity and depression symptoms among pregnant women from the National Health and Nutrition Examination Survey 2005-2006.

    Science.gov (United States)

    Loprinzi, Paul D; Fitzgerald, Elizabeth M; Cardinal, Bradley J

    2012-03-01

    To examine the association between objectively measured physical activity and depression symptoms among a nationally representative sample of pregnant women to provide a more accurate understanding of the relationship between physical activity and depression symptoms. We employed a cross-sectional study design. Data from the National Health and Nutrition Examination Survey 2005-2006 were used for this study. One-hundred and forty-one pregnant women wore an ActiGraph accelerometer for 7 days and completed the Patient Health Questionnaire-9 to assess depression status. More than 19% of the participants experienced some depression symptoms, and compared to their counterparts not having depression symptoms, they were less physically active. An inverse association was found between physical activity and depression symptoms among pregnant women. When feasible, nurses are encouraged to help facilitate physical activity among pregnant women, assuming an uncomplicated pregnancy. © 2012 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

  4. The pattern and technique in the clinical evaluation of the adult hip: the common physical examination tests of hip specialists.

    Science.gov (United States)

    Martin, Hal D; Kelly, Bryan T; Leunig, Michael; Philippon, Marc J; Clohisy, John C; Martin, RobRoy L; Sekiya, Jon K; Pietrobon, Ricardo; Mohtadi, Nicholas G; Sampson, Thomas G; Safran, Marc R

    2010-02-01

    The purpose of this study was to systematically evaluate the technique and tests used in the physical examination of the adult hip performed by multiple clinicians who regularly treat patients with hip problems and identify common physical examination patterns. The subjects included 5 men and 6 women with a mean age (+/-SD) of 29.8 +/- 9.4 years. They underwent physical examination of the hip by 6 hip specialists with a strong interest in hip-related problems. All examiners were blind to patient radiographs and diagnoses. Patient examinations were video recorded and reviewed. It was determined that 18 tests were most frequently performed (>or=40%) by the examiners, 3 standing, 11 supine, 3 lateral, and 1 prone. Of the most frequently performed tests, 10 were performed more than 50% of the time. The tests performed in the supine position were as follows: flexion range of motion (ROM) (percentage of use, 98%), flexion internal rotation ROM (98%), flexion external rotation ROM (86%), passive supine rotation test (76%), flexion/adduction/internal rotation test (70%), straight leg raise against resistance test (61%), and flexion/abduction/external rotation test (52%). The tests performed in the standing position were the gait test (86%) and the single-leg stance phase test (77%). The 1 test in the prone position was the femoral anteversion test (58%). There are variations in the testing that hip specialists perform to examine and evaluate their patients, but there is enough commonality to form the basis to recommend a battery of physical examination maneuvers that should be considered for use in evaluating the hip. Patients presenting with groin, abdominal, back, and/or hip pain need to have a basic examination to ensure that the hip is not overlooked. A comprehensive physical examination of the hip will benefit the patient and the physician and serve as the foundation for future multicenter clinical studies. (c) 2010 Arthroscopy Association of North America. Published

  5. Examination of race disparities in physical inactivity among adults of similar social context.

    Science.gov (United States)

    Wilson-Frederick, Shondelle M; Thorpe, Roland J; Bell, Caryn N; Bleich, Sara N; Ford, Jean G; LaVeist, Thomas A

    2014-01-01

    The objective of the study was to determine whether race disparities in physical inactivity are present among urban low-income Blacks and Whites living in similar social context. This analysis included Black and White respondents ( > or = 18 years) from the Exploring Health Disparities in Integrated Communities-Southwest Baltimore (EHDIC-SWB; N=1350) Study and the National Health Interview Survey (NHIS; N = 67790). Respondents who reported no levels of moderate or vigorous physical activity, during leisure time, over a usual week were considered physically inactive. After controlling for confounders, Blacks had higher adjusted odds of physical inactivity compared to Whites in the national sample (odds ratio [OR] = 1.40; 95% confidence interval [CI] =1.30-1.51). In EHDIC-SWB, Blacks and Whites had a similar odds of physical inactivity (OR = 1.09; 95% CI .86-1.40). Social context contributes to our understanding of racial disparities in physical inactivity.

  6. Physical examination education in graduate medical education--a systematic review of the literature.

    Science.gov (United States)

    Mookherjee, Somnath; Pheatt, Lara; Ranji, Sumant R; Chou, Calvin L

    2013-08-01

    There is widespread recognition that physical examination (PE) should be taught in Graduate Medical Education (GME), but little is known regarding how to best teach PE to residents. Deliberate practice fosters expertise in other fields, but its utility in teaching PE is unknown. We systematically reviewed the literature to determine the effectiveness of methods to teach PE in GME, with attention to usage of deliberate practice. We searched PubMed, ERIC, and EMBASE for English language studies regarding PE education in GME published between January 1951 and December 2012. Seven eligibility criteria were applied to studies of PE education: (1) English language; (2) subjects in GME; (3) description of study population; (4) description of intervention; (5) assessment of efficacy; (6) inclusion of control group; and (7) report of data analysis. We extracted data regarding study quality, type of PE, study population, curricular features, use of deliberate practice, outcomes and assessment methods. Tabulated summaries of studies were reviewed for narrative synthesis. Fourteen studies met inclusion criteria. The mean Medical Education Research Study Quality Instrument (MERSQI) score was 9.0 out of 18. Most studies (n = 8) included internal medicine residents. Half of the studies used resident interaction with a human examinee as the primary means of teaching PE. Three studies "definitely" and four studies "possibly" used deliberate practice; all but one of these studies demonstrated improved educational outcomes. We used a non-validated deliberate practice assessment. Given the heterogeneity of assessment modalities, we did not perform a meta-analysis. No single strategy for teaching PE in GME is clearly superior to another. Following the principles of deliberate practice and interaction with human examinees may be beneficial in teaching PE; controlled studies including these educational features should be performed to investigate these exploratory findings.

  7. How to classify plantar plate injuries: parameters from history and physical examination.

    Science.gov (United States)

    Nery, Caio; Coughlin, Michael; Baumfeld, Daniel; Raduan, Fernando; Mann, Tania Szejnfeld; Catena, Fernanda

    2015-01-01

    To find the best clinical parameters for defining and classifying the degree of plantar plate injuries. Sixty-eight patients (100 metatarsophalangeal joints) were classified in accordance with the Arthroscopic Anatomical Classification for plantar plate injuries and were divided into five groups (0 to IV). Their medical files were reviewed and the incidence of each parameter for the respective group was correlated. These parameters were: use of high heels, sports, acute pain, local edema, Mulder's sign, widening of the interdigital space, pain in the head of the corresponding metatarsal, touching the ground, "drawer test", toe grip and toe deformities (in the sagittal, coronal and transversal planes). There were no statistically significant associations between the degree of injury and use of high-heel shoes, sports trauma, pain at the head of the metatarsal, Mulder's sign, deformity in pronation or displacement in the transversal and sagittal planes (although their combination, i.e. "cross toe", showed a statistically significant correlation). Positive correlations with the severity of the injuries were found in relation to initial acute pain, progressive widening of the interdigital space, loss of "touching the ground", positive results from the "drawer test" on the metatarsophalangeal joint, diminished grip strength and toe deformity in supination. The "drawer test" was seen to be the more reliable and precise tool for classifying the degree of plantar plate injury, followed by "touching the ground" and rotational deformities. It is possible to improve the precision of the diagnosis and the predictions of the anatomical classification for plantar plate injuries through combining the clinical history and data from the physical examination.

  8. Inadequacies of Physical Examination as a Cause of Medical Errors and Adverse Events: A Collection of Vignettes.

    Science.gov (United States)

    Verghese, Abraham; Charlton, Blake; Kassirer, Jerome P; Ramsey, Meghan; Ioannidis, John P A

    2015-12-01

    Oversights in the physical examination are a type of medical error not easily studied by chart review. They may be a major contributor to missed or delayed diagnosis, unnecessary exposure to contrast and radiation, incorrect treatment, and other adverse consequences. Our purpose was to collect vignettes of physical examination oversights and to capture the diversity of their characteristics and consequences. A cross-sectional study using an 11-question qualitative survey for physicians was distributed electronically, with data collected from February to June of 2011. The participants were all physicians responding to e-mail or social media invitations to complete the survey. There were no limitations on geography, specialty, or practice setting. Of the 208 reported vignettes that met inclusion criteria, the oversight was caused by a failure to perform the physical examination in 63%; 14% reported that the correct physical examination sign was elicited but misinterpreted, whereas 11% reported that the relevant sign was missed or not sought. Consequence of the physical examination inadequacy included missed or delayed diagnosis in 76% of cases, incorrect diagnosis in 27%, unnecessary treatment in 18%, no or delayed treatment in 42%, unnecessary diagnostic cost in 25%, unnecessary exposure to radiation or contrast in 17%, and complications caused by treatments in 4%. The mode of the number of physicians missing the finding was 2, but many oversights were missed by many physicians. Most oversights took up to 5 days to identify, but 66 took longer. Special attention and skill in examining the skin and its appendages, as well as the abdomen, groin, and genitourinary area could reduce the reported oversights by half. Physical examination inadequacies are a preventable source of medical error, and adverse events are caused mostly by failure to perform the relevant examination. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. "Shades of beauty": examining the relationship of skin color to perceptions of physical attractiveness.

    Science.gov (United States)

    Frisby, Cynthia M

    2006-08-01

    The purpose of this research project was to investigate the relationship between skin color and level of perceived physical attractiveness. Previous research suggested that skin color plays an important role in how we perceive an individual's physical attractiveness. The current study was conducted to determine how influential the role of race is on perceptions of physical attractiveness. In this study, 79 subjects were asked to evaluate images of potential endorsers to be used in an upcoming advertising campaign. The images were those of females of varying skin tones. Data were then collected and analyzed to determine whether skin tone and level of skin color can in fact influence the physical attractiveness stereotype.

  10. Physical Activity Level of Korean Adults with Chronic Diseases: The Korean National Health and Nutritional Examination Survey, 2010-2012.

    Science.gov (United States)

    Jin, Ho-Seong; An, Ah-Reum; Choi, Ho-Chun; Lee, Sang-Hyun; Shin, Dong-Heon; Oh, Seung-Min; Seo, Young-Gyun; Cho, Be-Long

    2015-11-01

    Proper physical activities are known to be helpful in the prevention and management of chronic diseases. However, the physical activity level of patients with chronic diseases is low. Therefore, this study aimed to investigate the physical activity compliance of patients with hypertension, diabetes, and dyslipidemia in Korea. This study analyzed the 2010-2012 Fifth Korean National Health and Nutrition Examination Survey data. We included 13,873 individuals in the analysis. The level of physical activity compliance was measured by performing multivariate logistic regression analyses. In the univariate analysis, the subjects with hypertension or diabetes tended to comply with the physical activity guidelines less faithfully than their healthy counterparts. The proportion of subjects with hypertension who were insufficiently physically active was 65.4% among the men and 75.8% among the women. For diabetes, the proportions were 66.7% and 76.8%, respectively. No significant difference was found between the subjects with dyslipidemia and their healthy counterparts. In the multivariate logistic regression analysis, no significant difference in physical activity compliance was observed between the subjects with hypertension, diabetes, or dyslipidemia and their healthy counterparts for both sexes. The patients with hypertension or diabetes tended to have lower physical activity prevlaence than their healthy counterparts. However, for dyslipidemia, no significant difference was found between the two groups. Given the significance of physical activities in the management of chronic diseases, the physical activities of these patients need to be improved.

  11. An Examination of Physical Education Data Sources and Collection Procedures during a Federally Funded Grant

    Science.gov (United States)

    Dauenhauer, Brian D.; Keating, Xiaofen D.; Lambdin, Dolly

    2018-01-01

    Purpose: This study aimed to conduct an in-depth investigation into physical education data sources and collection procedures in a district that was awarded a Physical Education Program (PEP) grant. Method: A qualitative, multi-site case study was conducted in which a single school district was the overarching case and eight schools served as…

  12. An Examination of the Relationship between Self-Perceived Physical Attractiveness and Social Competence.

    Science.gov (United States)

    Steward, Robbie J.; Sobczak, Joan

    This study investigated the relationship between self-perceived physical attractiveness and self-perceived social competence. Subjects were 157 male and 215 female college students who completed a consent form, demographic questionnaire, the Texas Social Behavior Inventory, and the Body Parts/Physical Attractiveness Scale. Significant correlations…

  13. Perceived neighborhood walkability and physical exercise: An examination of casual communication in a social process.

    Science.gov (United States)

    Yamamoto, Masahiro; Jo, Hyerim

    2018-05-01

    Despite the accumulated evidence for the environmental correlates of physical activity, social processes underlying this association are not entirely clear. This study positions communication characterized by weak ties as a social mechanism linking neighborhood walkability with physical exercise. Data from a survey of Chicago residents show that perceived neighborhood walkability is positively related to frequency of weak-tie communication. Frequency of weak-tie communication is related positively to perceived social cohesion and negatively to anonymity, both of which are significantly related to frequency of physical exercise in the neighborhood. Data also show a sequential indirect relationship involving perceived neighborhood walkability, weak-tie communication, anonymity, and physical exercise. Implications are discussed in terms of the role of communication in promoting locality-based physical exercise. Copyright © 2018 Elsevier Ltd. All rights reserved.

  14. A life course examination of the physical environmental determinants of physical activity behaviour: A "Determinants of Diet and Physical Activity" (DEDIPAC) umbrella systematic literature review.

    Science.gov (United States)

    Carlin, Angela; Perchoux, Camille; Puggina, Anna; Aleksovska, Katina; Buck, Christoph; Burns, Con; Cardon, Greet; Chantal, Simon; Ciarapica, Donatella; Condello, Giancarlo; Coppinger, Tara; Cortis, Cristina; D'Haese, Sara; De Craemer, Marieke; Di Blasio, Andrea; Hansen, Sylvia; Iacoviello, Licia; Issartel, Johann; Izzicupo, Pascal; Jaeschke, Lina; Kanning, Martina; Kennedy, Aileen; Lakerveld, Jeroen; Chun Man Ling, Fiona; Luzak, Agnes; Napolitano, Giorgio; Nazare, Julie-Anne; Pischon, Tobias; Polito, Angela; Sannella, Alessandra; Schulz, Holger; Sohun, Rhoda; Steinbrecher, Astrid; Schlicht, Wolfgang; Ricciardi, Walter; MacDonncha, Ciaran; Capranica, Laura; Boccia, Stefania

    2017-01-01

    Participation in regular physical activity is associated with a multitude of health benefits across the life course. However, many people fail to meet PA recommendations. Despite a plethora of studies, the evidence regarding the environmental (physical) determinants of physical activity remains inconclusive. To identify the physical environmental determinants that influence PA across the life course. An online systematic literature search was conducted using MEDLINE, ISI Web of Science, Scopus and SPORTDiscus. The search was limited to studies published in English (January 2004 to April 2016). Only systematic literature reviews (SLRs) and meta-analyses (MAs) of observational studies, that investigated the association between physical determinants and physical activity outcomes, were eligible for inclusion. The extracted data were assessed on the importance of determinants, strength of evidence and methodological quality. The literature search identified 28 SLRs and 3 MAs on 67 physical environmental characteristics potentially related to physical activity that were eligible for inclusion. Among preschool children, a positive association was reported between availability of backyard space and outdoor toys/equipment in the home and overall physical activity. The availability of physical activity programs and equipment within schools, and neighbourhood features such as pedestrian and cyclist safety structure were positively associated with physical activity in children and adolescents. Negative street characteristics, for example, lack of sidewalks and streetlights, were negatively associated with physical activity in adults. Inconsistent associations were reported for the majority of reviewed determinants in adults. This umbrella SLR provided a comprehensive overview of the physical environment determinants of physical activity across the life course and has highlighted, particularly amongst youth, a number of key determinants that may be associated with overall

  15. Visual persuasion with physically attractive models in ads: An examination of how the ad model influences product evaluations

    OpenAIRE

    Söderlund, Magnus; Lange, Fredrik

    2006-01-01

    This paper examines the prevalent advertising practice of visually juxtaposing an anonymous, physically attractive ad model and a product in terms of its effects on the attitude toward the product. In this appeal, in which there are no explicit verbal claims about how the two objects are connected, we argue that the physically attractive model sets in motion a process in which emotions and the attitude toward the ad model serve as mediating variables, and that this process ultimately results ...

  16. How well do second-year students learn physical diagnosis? Observational study of an objective structured clinical examination (OSCE

    Directory of Open Access Journals (Sweden)

    Simon Steven R

    2002-01-01

    Full Text Available Abstract Background Little is known about using the Objective Structured Clinical Examination (OSCE in physical diagnosis courses. The purpose of this study was to describe student performance on an OSCE in a physical diagnosis course. Methods Cross-sectional study at Harvard Medical School, 1997–1999, for 489 second-year students. Results Average total OSCE score was 57% (range 39–75%. Among clinical skills, students scored highest on patient interaction (72%, followed by examination technique (65%, abnormality identification (62%, history-taking (60%, patient presentation (60%, physical examination knowledge (47%, and differential diagnosis (40% (p Conclusions Students scored higher on interpersonal and technical skills than on interpretive or integrative skills. Station scores identified specific content that needs improved teaching.

  17. Diagnostic and prognostic value of history-taking and physical examination in undifferentiated peripheral inflammatory arthritis: a systematic review.

    Science.gov (United States)

    Kuriya, Bindee; Villeneuve, Edith; Bombardier, Claire

    2011-03-01

    To review the diagnostic and prognostic value of history/physical examination among patients with undifferentiated peripheral inflammatory arthritis (UPIA). We conducted a systematic review evaluating the association between history/physical examination features and a diagnostic or prognostic outcome. Nineteen publications were included. Advanced age, female sex, and morning stiffness were predictive of a diagnosis of rheumatoid arthritis (RA) from UPIA. A higher number of tender and swollen joints, small/large joint involvement in the upper/lower extremities, and symmetrical involvement were associated with progression to RA. Similar features were associated with persistent disease and erosions, while disability at baseline and extraarticular features were predictive of future disability. History/physical examination features are heterogeneously reported. Several features predict progression from UPIA to RA or a poor prognosis. Continued measurements in the UPIA population are needed to determine if these features are valid and reliable predictors of outcomes, especially as new definitions for RA and disease states emerge.

  18. The Stress-Metabolic Syndrome Relationship in Adolescents: An Examination of the Moderating Potential of Physical Activity.

    Science.gov (United States)

    Holmes, Megan E; Pivarnik, Jim; Pfeiffer, Karin; Maier, Kimberly S; Eisenmann, Joey C; Ewing, Martha

    2016-10-01

    The role of psychosocial stress in the development of obesity and metabolic syndrome is receiving increased attention and has led to examination of whether physical activity may moderate the stress-metabolic syndrome relationship. The current study examined relationships among physical activity, stress, and metabolic syndrome in adolescents. Participants (N = 126; 57 girls, 69 boys) were assessed for anthropometry, psychosocial stress, physical activity, and metabolic syndrome variables; t tests were used to examine sex differences, and regression analysis was used to assess relationships among variables controlling for sex and maturity status. Mean body mass index approached the 75th percentile for both sexes. Typical sex differences were observed for systolic blood pressure, time spent in moderate and vigorous physical activity, and perceived stress. Although stress was not associated with MetS (β = -.001, P = .82), a modest, positive relationship was observed with BMI (β = .20, P = .04). Strong relationships between physical activity and stress with MetS or BMI were not found in this sample. Results may be partially explained by overall good physical health status of the participants. Additional research in groups exhibiting varying degrees of health is needed.

  19. Do physical examination and CT-scan measures of femoral neck anteversion and tibial torsion relate to each other?

    Science.gov (United States)

    Sangeux, Morgan; Mahy, Jessica; Graham, H Kerr

    2014-01-01

    Informed clinical decision making for femoral and/or tibial de-rotation osteotomies requires accurate measurement of patient function through gait analysis and anatomy through physical examination of bony torsions. Validity of gait analysis has been extensively studied; however, controversy remains regarding the accuracy of physical examination measurements of femoral and tibial torsion. Comparison between CT-scans and physical examination measurements of femoral neck anteversion (FNA) and external tibial torsion (ETT) were retrospectively obtained for 98 (FNA) and 64 (ETT) patients who attended a tertiary hospital for instrumented gait analysis between 2007 and 2010. The physical examination methods studied for femoral neck anteversion were the trochanteric prominence angle test (TPAT) and the maximum hip rotation arc midpoint (Arc midpoint) and for external tibial torsion the transmalleolar axis (TMA). Results showed that all physical examination measurements statistically differed to the CT-scans (bias(standard deviation): -2(14) for TPAT, -10(12) for Arc midpoint and -16(9) for TMA). Bland and Altman plots showed that method disagreements increased with increasing bony torsions in all cases but notably for TPAT. Regression analysis showed that only TMA and CT-scan measurement of external tibial torsion demonstrated good (R(2)=57%) correlation. Correlations for both TPAT (R(2)=14%) and Arc midpoint (R(2)=39%) with CT-scan measurements of FNA were limited. We conclude that physical examination should be considered as screening techniques rather than definitive measurement methods for FNA and ETT. Further research is required to develop more accurate measurement methods to accompany instrumented gait analysis. Copyright © 2013. Published by Elsevier B.V.

  20. Finding the Little 'c' in Physics: A Multiple Case Study Examining the Development of Creative Activities in the Physics Classroom

    Science.gov (United States)

    Wheeler, Christopher

    This study focused on how physics teachers develop and implement activities that promote creative thinking strategies in the standards based physics classroom. A particular focus was placed on every day or little "c", creativity, which can be taught in the high school classroom. The study utilized a multiple case study design, which allows for in-depth study in a variety of settings. Four participants from various high schools were identified utilizing administrator recommendations. Data were then collected via interviews, observations, and documents. The data were coded and analyzed for emerging themes. The themes were then merged to determine findings to the stated research questions. The research demonstrated the importance of modifying activities for student interest and understanding through effective use of scientific inquiry. The past experiences and professional development of the participants served as a vital piece to the development of their educational pedagogy especially concerning inquiry and questioning strategies. It was also established that an unstructured, positive classroom environment is a vital aspect of teaching while supporting creative thinking skills.

  1. Diagnostic strategies using physical examination are minimally useful in defining carpal tunnel syndrome in population-based research studies.

    Science.gov (United States)

    Descatha, A; Dale, A-M; Franzblau, A; Coomes, J; Evanoff, B

    2010-02-01

    We evaluated the utility of physical examination manoeuvres in the prediction of carpal tunnel syndrome (CTS) in a population-based research study. We studied a cohort of 1108 newly employed workers in several industries. Each worker completed a symptom questionnaire, a structured physical examination and nerve conduction study. For each hand, our CTS case definition required both median nerve conduction abnormality and symptoms classified as "classic" or "probable" on a hand diagram. We calculated the positive predictive values and likelihood ratios for physical examination manoeuvres in subjects with and without symptoms. The prevalence of CTS in our cohort was 1.2% for the right hand and 1.0% for the left hand. The likelihood ratios of a positive test for physical provocative tests ranged from 2.0 to 3.3, and those of a negative test from 0.3 to 0.9. The post-test probability of positive testing was study found that physical examination, alone or in combination with symptoms, was not predictive of CTS in a working population. We suggest using specific symptoms as a first-level screening tool, and nerve conduction study as a confirmatory test, as a case definition strategy in research settings.

  2. International consensus on the most useful physical examination tests used by physiotherapists for patients with headache: A Delphi study.

    Science.gov (United States)

    Luedtke, K; Boissonnault, W; Caspersen, N; Castien, R; Chaibi, A; Falla, D; Fernández-de-Las-Peñas, C; Hall, T; Hirsvang, J R; Horre, T; Hurley, D; Jull, G; Krøll, L S; Madsen, B K; Mallwitz, J; Miller, C; Schäfer, B; Schöttker-Königer, T; Starke, W; von Piekartz, H; Watson, D; Westerhuis, P; May, A

    2016-06-01

    A wide range of physical tests have been published for use in the assessment of musculoskeletal dysfunction in patients with headache. Which tests are used depends on a physiotherapist's clinical and scientific background as there is little guidance on the most clinically useful tests. To identify which physical examination tests international experts in physiotherapy consider the most clinically useful for the assessment of patients with headache. Delphi survey with pre-specified procedures based on a systematic search of the literature for physical examination tests proposed for the assessment of musculoskeletal dysfunction in patients with headache. Seventeen experts completed all three rounds of the survey. Fifteen tests were included in round one with eleven additional tests suggested by the experts. Finally eleven physical examination tests were considered clinically useful: manual joint palpation, the cranio-cervical flexion test, the cervical flexion-rotation test, active range of cervical movement, head forward position, trigger point palpation, muscle tests of the shoulder girdle, passive physiological intervertebral movements, reproduction and resolution of headache symptoms, screening of the thoracic spine, and combined movement tests. Eleven tests are suggested as a minimum standard for the physical examination of musculoskeletal dysfunctions in patients with headache. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Examining Student Attitudes in Introductory Physics via the Math Attitude and Expectations Survey (MAX)

    Science.gov (United States)

    Hemingway, Deborah; Eichenlaub, Mark; Losert, Wolfgang; Redish, Edward F.

    2017-01-01

    Student often face difficulties with using math in science, and this exploratory project seeks to address the underlying mechanisms that lead to these difficulties. This mixed-methods project includes the creation of two novel assessment surveys, the Mathematical Epistemic Games Survey (MEGS) and the Math Attitude and Expectations Survey (MAX). The MAX, a 30-question Likert-scale survey, focuses on the attitudes towards using mathematics of the students in a reformed introductory physics course for the life sciences (IPLS) which is part of the National Experiment in Undergraduate Education (NEXUS/Physics) developed at the University of Maryland (UMD). Preliminary results from the MAX are discussed with specific attention given to students' attitudes towards math and physics, opinions about interdisciplinarity, and the usefulness of physics in academic settings as well as in professional biological research and modern medicine settings.

  4. Examination of ethical dilemmas experienced by adult intensive care unit nurses in physical restraint practices.

    Science.gov (United States)

    Yönt, Gülendam Hakverdioğlu; Korhan, Esra Akin; Dizer, Berna; Gümüş, Fatma; Koyuncu, Rukiye

    2014-01-01

    Nurses are more likely to face the dilemma of whether to resort to physical restraints or not and have a hard time making that decision. This is a descriptive study. A total of 55 nurses participated in the research. For data collection, a question form developed by researchers to determine perceptions of ethical dilemmas by nurses in the application of physical restraint was used. A descriptive analysis was made by calculating the mean, standard deviation, and maximum and minimum values. The nurses expressed (36.4%) having difficulty in deciding to use physical restraint. Nurses reported that they experience ethical dilemmas mainly in relation to the ethic principles of nonmaleficence, beneficence, and convenience. We have concluded that majority of nurses working in critical care units apply physical restraint to patients, although they are facing ethical dilemmas concerning harm and benefit principles during the application.

  5. The relationship between history and physical examination findings and the outcome of electrodiagnostic testing in patients with sciatica referred to physical therapy.

    Science.gov (United States)

    Savage, Nathan J; Fritz, Julie M; Thackeray, Anne

    2014-07-01

    Cross-sectional diagnostic accuracy study. To investigate the relationship between history and physical examination findings and the outcome of electrodiagnostic testing in patients with sciatica referred to physical therapy. Electrodiagnostic testing is routinely used to evaluate patients with sciatica. Recent evidence suggests that the presence of radiculopathy identified with electrodiagnostic testing may predict better functional outcomes in these patients. While some patient history and physical examination findings have been shown to predict the presence of disc herniation or neurological insult, little is known about their relationship to the results of electrodiagnostic testing. Electrodiagnostic testing was performed on 38 patients with sciatica who participated in a randomized trial that compared different physical therapy interventions. The diagnostic gold standard was the presence or absence of radiculopathy, based on the results of the needle electromyographic examination. Diagnostic sensitivity and specificity values were calculated, along with corresponding likelihood ratios, for select patient history and physical examination variables. No significant relationship was found between select patient history and physical examination findings, analyzed individually or in combination, and the outcome of electrodiagnostic testing. Diagnostic sensitivity values ranged from 0.03 (95% confidence interval [CI]: 0.00, 0.24) to a high of 0.95 (95% CI: 0.72, 0.99), and specificity values ranged from 0.10 (95% CI: 0.02, 0.34) to a high of 0.95 (95% CI: 0.72, 0.99). Positive likelihood ratios ranged from 0.15 (95% CI: 0.01, 2.87) to a high of 2.33 (95% CI: 0.71, 7.70), and negative likelihood ratios ranged from 2.00 (95% CI: 0.35, 11.48) to a low of 0.50 (95% CI: 0.03, 8.10). In this investigation, the relationship between patient history and physical examination findings and the outcome of electrodiagnostic testing among patients with sciatica was not found to be

  6. Examining physical training versus physical and mental training programmes in Swimrun semi-professional athletes: A randomised, controlled, trial

    Directory of Open Access Journals (Sweden)

    Francesco Chirico

    2016-11-01

    Full Text Available Objective: The purpose of this study was to identify the effect of two psychological interventions, named ‘Mental imagery’ and ‘Motivational self-talk’ training used in combination, on perceived excertion and flow state in a sample of Swimrun semi-professional athletes. Methods: Thirty male semi-professional athletes, enrolled for a Swimrun competition, were randomly selected into an experimental group (EXP and a control group (CON. The modified Borg Scale of Perceived Exertion (RPE and the Flow State Scale (FSS were the dependent variables. Before a Swimrun competition, the EXP Group performed both physical and mental training programs, while the CON group only performed a physical training program. Immediately after the race, we measured the dependent variables in both groups. Results: The results of unpaired-t test showed that levels of perceived exertion were less in EXP group than CON group, (t(28 = 12.87, P < .001, while levels of flow state were higher in EXP group than CON group (t(28 = 5.96, P < .001, immediately after the end of the endurance competition. The use of both mental imagery and self-talk training in order to reduce perceived exertion and improve flow state was supported (P < .001. Discussion and Conclusion: The findings of this study support the psychobiological model of endurance performance. Our research is the first to demonstrate that mental imagery used in combination with motivational self-talk can reduce the perceived exertion and improve the flow state in Swimrun athletes during their endurance performance.

  7. The Daily Physical Activity (DPA) policy in Ontario: is it working? an examination using accelerometry-measured physical activity data.

    Science.gov (United States)

    Stone, Michelle R; Faulkner, Guy E J; Zeglen-Hunt, Laura; Bonne, Jennifer Cowie

    2012-01-01

    In 2005, the Ontario Ministry of Education announced a policy requiring that all elementary students be provided with opportunities to participate in a minimum of 20 minutes of sustained moderate-to-vigorous physical activity (MVPA) each school day during instructional time. To the authors' knowledge, this policy has never been formally evaluated. In a form of natural experiment with Project BEAT, we explored within 16 Toronto District School Board schools the proportion of children who participate in DPA, and the proportion who achieve sustained MVPA within these sessions; these are the objectives of this article. Consent was given by 1027 parents/guardians for their children to participate (boys, n=478; girls, n=549). Physical activity (PA) was measured using accelerometry and classroom schedules collected to identify sessions of DPA. The frequency of DPA and number and duration of sustained bouts of MVPA (> or =5 min) were computed and explored relative to PA levels and health outcomes. Fewer than half of the participating children were provided with DPA every day and not a single child engaged in sustained MVPA for > or =20 minutes. On the more positive side, children who engaged in DPA every day were significantly more active than their peers. Those accumulating at least 1 bout of MVPA were more active and likely to meet PA guidelines, and fewer of these children were overweight. The majority of schools are not meeting the DPA policy. However, as the frequency and intensity of DPA increases, so do positive health outcomes. This paper provides supporting evidence that when this policy is implemented, the intended health benefits are achievable.

  8. Examining Attitudes of Physical Education Teacher Education Program Students Toward the Teaching Profession

    Directory of Open Access Journals (Sweden)

    Gunay Yildizer

    2017-09-01

    Full Text Available The purpose of this study was to investigate attitudes of pre-service teachers toward the teaching profession with respect to their gender, grade level, whether participants regularly participate in physical activities, and whether pre-service students have a teacher-parent in their family. Research was conducted on 469 pre-service physical education teachers (Mage=21.35, SDage= 2.49, 188 female (Mage=20.89, SDage= 2.30 and 281 male (Mage=21.66, SDage= 2.57 students from five different universities in Turkey. In this study the “Attitude Scale for the Profession of Physical Education Teaching” was used. It has two factors: “concern for profession” (CP and “affection for profession” (AP. Independent sample t-test results indicated that there were no significant differences with respect to gender or having a teacher-parent in both factors and total attitude points (p> 0.05. Pre-service physical education teachers who participate in physical activity had significantly higher points in AP and the total scale in comparison to those who do not participate in physical activity (p< 0.05. ANOVA results indicated that based on grade level there were significant differences in CP and total attitude (p< 0.05. Students’ concern about employment may be associated with differences in attitude scores between grade levels. The positive effect of physical activity participation and their professional teaching education on stress resilience might also be an important factor for increasing positive attitudes toward the teaching profession.

  9. Examining the Association between Intervention-Related Changes in Diet, Physical Activity, and Weight as Moderated by the Food and Physical Activity Environments among Rural, Southern Adults.

    Science.gov (United States)

    Jilcott Pitts, Stephanie B; Keyserling, Thomas C; Johnston, Larry F; Evenson, Kelly R; McGuirt, Jared T; Gizlice, Ziya; Whitt, Olivia R; Ammerman, Alice S

    2017-10-01

    Few studies have been conducted in rural areas assessing the influence of community-level environmental factors on residents' success improving lifestyle behaviors. Our aim was to examine whether 6-month changes in diet, physical activity, and weight were moderated by the food and physical activity environment in a rural adult population receiving an intervention designed to improve diet and physical activity. We examined associations between self-reported and objectively measured changes in diet, physical activity, and weight, and perceived and objectively measured food and physical activity environments. Participants were followed for 6 months. Participants were enrolled in the Heart Healthy Lenoir Project, a lifestyle intervention study conducted in Lenoir County, located in rural southeastern North Carolina. Sample sizes ranged from 132 to 249, depending on the availability of the data. Participants received four counseling sessions that focused on healthy eating (adapted Mediterranean diet pattern) and increasing physical activity. Density of and distance to food and physical activity venues, modified food environment index, Walk Score, crime, and perceived nutrition and physical activity neighborhood barriers were the potential mediating factors. Diet quality, physical activity, and weight loss were the outcomes measured. Statistical analyses included correlation and linear regression and controlling for potential confounders (baseline values of the dependent variables, age, race, education, and sex). In adjusted analysis, there was an inverse association between weight change and the food environment, suggesting that participants who lived in a less-healthy food environment lost more weight during the 6-month intervention period (P=0.01). Also, there was a positive association between self-reported physical activity and distance to private gyms (P=0.04) and an inverse association between private gym density and pedometer-measured steps (P=0.03), indicating

  10. Social Comparison in Physical Education: An Examination of the Relationship between Two Frames of Reference and Engagement, Disaffection, and Physical Self-Concept

    Science.gov (United States)

    Barnes, Jemima S.; Spray, Christopher M.

    2013-01-01

    Drawing from theory and research into social comparison processes, the present study sought to determine children's motives for comparison in addition to the coexistence of class and individual comparisons in school physical education. The main and interactive effects of these types of comparisons were examined in relation to pupils'…

  11. Using a socioecological approach to examine participation in sport and physical activity among rural adolescent girls.

    Science.gov (United States)

    Casey, Meghan M; Eime, Rochelle M; Payne, Warren R; Harvey, Jack T

    2009-07-01

    Adolescence is a critical time for developing lifelong healthy behaviors, including active lifestyles. Participation in sport and physical activity, however, declines during adolescence, and few studies have comprehensively identified why, particularly among rural girls. This article identifies a range of independent and interacting factors that influence sport and physical activity participation of rural adolescent girls. The socioecological model of health was used to guide four focus group discussions with Grade 7 girls (n = 34). The results showed that adolescent girls were positively influenced when sports or physical activities were fun, when they involved being with friends, and when they were supported by families and teachers through role modeling and positive feedback. A range of intrapersonal and organizational factors affected perceived self-competence, particularly the coeducational nature of school physical education classes and peer teasing, which supported social comparisons of skill level. In promoting sport and physical activity to rural adolescent girls, focus must be directed on developmentally appropriate activities that are fun, offering opportunities for single-sex classes, and generating cultural changes that encourage noncompetitive and self-referencing activities.

  12. The use of a pocket-sized ultrasound device improves physical examination: results of an in- and outpatient cohort study.

    Directory of Open Access Journals (Sweden)

    Agostino Colli

    Full Text Available The performance of pocket mobile ultrasound devices (PUDs is comparable with that of standard ultrasonography, whereas the accuracy of a physical examination is often poor requiring further tests to assess diagnostic hypotheses. Adding the use of PUD to physical examination could lead to an incremental benefit.We assessed whether the use of PUD in the context of physical examination can reduce the prescription of additional tests when used by physicians in different clinical settings.We conducted a cohort impact study in four hospital medical wards, one gastroenterological outpatient clinic, and 90 general practices in the same geographical area. The study involved 135 physicians who used PUD, after a short predefined training course, to examine 1962 consecutive patients with one of 10 diagnostic hypotheses: ascites, pleural effusion, pericardial effusion, urinary retention, urinary stones, gallstones, biliary-duct dilation, splenomegaly, abdominal mass, abdominal aortic aneurysm. According to the physicians' judgment, PUD examination could rule out or in the diagnostic hypothesis or require further testing; the concordance with the final diagnosis was assessed. The main outcome was the proportion of cases in which additional tests were required after PUD. The PUD diagnostic accuracy was assessed in patients submitted to further testing.The 1962 patients included 37% in-patients, 26% gastroenterology outpatients, 37% from general practices. Further testing after PUD examination was deemed unnecessary in 63%. Only 5% of patients with negative PUD not referred for further testing were classified false negatives with respect to the final diagnosis. In patients undergoing further tests, the sensitivity was 91%, and the specificity 83%.After a simple and short training course, a PUD examination can be used in addition to a physical examination to improve the answer to ten common clinical questions concerning in- and outpatients, and can reduce the

  13. Statistical evaluation of physical examinations conducted under atomic bomb survivors medical treatment law Nagasaki

    Energy Technology Data Exchange (ETDEWEB)

    Ohri, Shigehisa; Shimada, Daisaburo; Ishida, Morthiro; Onishi, Shigeyuki

    1961-09-19

    An evaluation was made of the reliability and validity of the information obtained by the first examination completed under the ABSMTL. Results of the analysis show clearly that the materials hardly can be utilized for studying the relationship between findings obtained from the medical examination and distance from the hypocenter. From the standpoint of clinical medicine, the lack of exactness in the examinations may be a major difficulty. However, as long as the degree of inexactness of the medical examinations is distributed equally to all sample members, comparison of the findings may be made within the limits of their accuracy. 4 references, 1 figure, 3 tables.

  14. Evaluation of the educational value of YouTube videos about physical examination of the cardiovascular and respiratory systems.

    Science.gov (United States)

    Azer, Samy A; Algrain, Hala A; AlKhelaif, Rana A; AlEshaiwi, Sarah M

    2013-11-13

    A number of studies have evaluated the educational contents of videos on YouTube. However, little analysis has been done on videos about physical examination. This study aimed to analyze YouTube videos about physical examination of the cardiovascular and respiratory systems. It was hypothesized that the educational standards of videos on YouTube would vary significantly. During the period from November 2, 2011 to December 2, 2011, YouTube was searched by three assessors for videos covering the clinical examination of the cardiovascular and respiratory systems. For each video, the following information was collected: title, authors, duration, number of viewers, and total number of days on YouTube. Using criteria comprising content, technical authority, and pedagogy parameters, videos were rated independently by three assessors and grouped into educationally useful and non-useful videos. A total of 1920 videos were screened. Only relevant videos covering the examination of adults in the English language were identified (n=56). Of these, 20 were found to be relevant to cardiovascular examinations and 36 to respiratory examinations. Further analysis revealed that 9 provided useful information on cardiovascular examinations and 7 on respiratory examinations: scoring mean 14.9 (SD 0.33) and mean 15.0 (SD 0.00), respectively. The other videos, 11 covering cardiovascular and 29 on respiratory examinations, were not useful educationally, scoring mean 11.1 (SD 1.08) and mean 11.2 (SD 1.29), respectively. The differences between these two categories were significant (P.86. A small number of videos about physical examination of the cardiovascular and respiratory systems were identified as educationally useful; these videos can be used by medical students for independent learning and by clinical teachers as learning resources. The scoring system utilized by this study is simple, easy to apply, and could be used by other researchers on similar topics.

  15. The reliability of physical examination tests for the diagnosis of anterior cruciate ligament rupture--A systematic review.

    Science.gov (United States)

    Lange, Toni; Freiberg, Alice; Dröge, Patrik; Lützner, Jörg; Schmitt, Jochen; Kopkow, Christian

    2015-06-01

    Systematic literature review. Despite their frequent application in routine care, a systematic review on the reliability of clinical examination tests to evaluate the integrity of the ACL is missing. To summarize and evaluate intra- and interrater reliability research on physical examination tests used for the diagnosis of ACL tears. A comprehensive systematic literature search was conducted in MEDLINE, EMBASE and AMED until May 30th 2013. Studies were included if they assessed the intra- and/or interrater reliability of physical examination tests for the integrity of the ACL. Methodological quality was evaluated with the Quality Appraisal of Reliability Studies (QAREL) tool by two independent reviewers. 110 hits were achieved of which seven articles finally met the inclusion criteria. These studies examined the reliability of four physical examination tests. Intrarater reliability was assessed in three studies and ranged from fair to almost perfect (Cohen's k = 0.22-1.00). Interrater reliability was assessed in all included studies and ranged from slight to almost perfect (Cohen's k = 0.02-0.81). The Lachman test is the physical tests with the highest intrarater reliability (Cohen's k = 1.00), the Lachman test performed in prone position the test with the highest interrater reliability (Cohen's k = 0.81). Included studies were partly of low methodological quality. A meta-analysis could not be performed due to the heterogeneity in study populations, reliability measures and methodological quality of included studies. Systematic investigations on the reliability of physical examination tests to assess the integrity of the ACL are scarce and of varying methodological quality. Copyright © 2014 Elsevier Ltd. All rights reserved.

  16. Diagnostic validity of physical examination tests for common knee disorders: An overview of systematic reviews and meta-analysis.

    Science.gov (United States)

    Décary, Simon; Ouellet, Philippe; Vendittoli, Pascal-André; Roy, Jean-Sébastien; Desmeules, François

    2017-01-01

    More evidence on diagnostic validity of physical examination tests for knee disorders is needed to lower frequently used and costly imaging tests. To conduct a systematic review of systematic reviews (SR) and meta-analyses (MA) evaluating the diagnostic validity of physical examination tests for knee disorders. A structured literature search was conducted in five databases until January 2016. Methodological quality was assessed using the AMSTAR. Seventeen reviews were included with mean AMSTAR score of 5.5 ± 2.3. Based on six SR, only the Lachman test for ACL injuries is diagnostically valid when individually performed (Likelihood ratio (LR+):10.2, LR-:0.2). Based on two SR, the Ottawa Knee Rule is a valid screening tool for knee fractures (LR-:0.05). Based on one SR, the EULAR criteria had a post-test probability of 99% for the diagnosis of knee osteoarthritis. Based on two SR, a complete physical examination performed by a trained health provider was found to be diagnostically valid for ACL, PCL and meniscal injuries as well as for cartilage lesions. When individually performed, common physical tests are rarely able to rule in or rule out a specific knee disorder, except the Lachman for ACL injuries. There is low-quality evidence concerning the validity of combining history elements and physical tests. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. Association between psoriasis and leisure-time physical activity: findings from the National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Do, Young Kyung; Lakhani, Naheed; Malhotra, Rahul; Halstater, Brian; Theng, Colin; Østbye, Truls

    2015-02-01

    Despite evidence that physical activity can reduce the cardiometabolic risk of patients with psoriasis, these patients may engage in less physical activity than those without psoriasis. The aim of this study was to examine the association of the extent of psoriatic skin lesions with the likelihood of participating in leisure-time moderate to vigorous physical activity (MVPA) and metabolic equivalent task (MET)-minutes of MVPA amongst those who participated. The National Health and Nutrition Examination Survey (NHANES) is a population-based survey among U.S. adults. A total of 6549 persons aged 20-59 years responded to the 2003-2006 NHANES dermatology questionnaires, which asked about participation in leisure-time MVPA and MET-minutes of MVPA amongst those who participated. Compared with individuals without psoriasis, those with psoriasis were less likely to have engaged in leisure MVPA in the past 30 days, although this association was not statistically significant. Amongst those who participated in leisure-time MVPA, MET-minutes of leisure-time MVPA were lower on average for patients currently having few to extensive cutaneous lesions (but not for those currently having little or no psoriatic patches), relative to individuals never diagnosed with psoriasis by approximately 30%. Clinicians should encourage patients with psoriasis, especially those with more severe disease, to be more physically active; they should help identify and address possible psychological and physical barriers to their patients' physical activity. © 2014 Japanese Dermatological Association.

  18. Examining Primary Schools' Physical Education Coordinators' Pedagogical Content Knowledge of Games: Are We Just Playing as This?

    Science.gov (United States)

    Ward, Gavin

    2013-01-01

    A detailed insight into how the current educational climate influences the pedagogical decisions made by primary school teachers when teaching games is limited. Studies examining the pedagogical content knowledge (PCK) of teachers within physical education have revealed its close relationship with specific forms of subject knowledge. In…

  19. Reliability of specific physical examination tests for the diagnosis of shoulder pathologies: a systematic review and meta-analysis.

    Science.gov (United States)

    Lange, Toni; Matthijs, Omer; Jain, Nitin B; Schmitt, Jochen; Lützner, Jörg; Kopkow, Christian

    2017-03-01

    Shoulder pain in the general population is common and to identify the aetiology of shoulder pain, history, motion and muscle testing, and physical examination tests are usually performed. The aim of this systematic review was to summarise and evaluate intrarater and inter-rater reliability of physical examination tests in the diagnosis of shoulder pathologies. A comprehensive systematic literature search was conducted using MEDLINE, EMBASE, Allied and Complementary Medicine Database (AMED) and Physiotherapy Evidence Database (PEDro) through 20 March 2015. Methodological quality was assessed using the Quality Appraisal of Reliability Studies (QAREL) tool by 2 independent reviewers. The search strategy revealed 3259 articles, of which 18 finally met the inclusion criteria. These studies evaluated the reliability of 62 test and test variations used for the specific physical examination tests for the diagnosis of shoulder pathologies. Methodological quality ranged from 2 to 7 positive criteria of the 11 items of the QAREL tool. This review identified a lack of high-quality studies evaluating inter-rater as well as intrarater reliability of specific physical examination tests for the diagnosis of shoulder pathologies. In addition, reliability measures differed between included studies hindering proper cross-study comparisons. PROSPERO CRD42014009018. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  20. Diagnostic accuracy of history taking and physical examination for assessing anterior cruciate ligament lesions of the knee in primary care

    NARCIS (Netherlands)

    Wagemakers, H.P.; Luijsterburg, P.A.; Boks, S.S.; Heintjes, E.M.; Berger, M.Y.; Verhaar, J.A.; Koes, B.W.; Bierma-Zeinstra, S.M.

    2010-01-01

    Wagemakers HP, Luijsterburg PA, Boks SS, Heintjes EM, Berger MY, Verhaar JA, Koes BK, Bierma-Zeinstra SM. Diagnostic accuracy of history taking and physical examination for assessing anterior cruciate ligament lesions of the knee in primary care. Arch Phys Med Rehabil 2010;91:1452-9. Objective: To

  1. Examining the Job-Related, Psychological, and Physical Outcomes of Workplace Sexual Harassment: A Meta-Analytic Review

    Science.gov (United States)

    Chan, Darius K-S.; Lam, Chun Bun; Chow, Suk Yee; Cheung, Shu Fai

    2008-01-01

    This study was designed to examine the job-related, psychological, and physical outcomes of sexual harassment in the workplace. Using a meta-analytic approach, we analyzed findings from 49 primary studies, with a total sample size of 89,382, to obtain estimates of the population mean effect size of the association between sexual harassment and…

  2. An Examination of Barriers to Physical Education for Christian and Muslim Girls Attending Comprehensive Secondary Schools in the UK

    Science.gov (United States)

    Elliott, Dave; Hoyle, Kathryn

    2014-01-01

    This study examined barriers to Physical Education (PE) in a sample of Christian and Muslim schoolgirls attending UK comprehensive secondary schools. Also assessed was whether religion and school year (age) had any impact upon barrier strength and if school year × religion interactions existed. A questionnaire was developed and exploratory factor…

  3. An Overlooked Factor in Sexual Abuse: Psychological and Physical Force Examined.

    Science.gov (United States)

    Johnson, Scott A.

    1998-01-01

    Separate studies of sex offenders in treatment while serving prison sentences and placed on probation suggest that psychological force is more commonly used in sexual assault than physical force. Seven types of psychological force are described, and the conceptual validity of this schematic for use in treatment is evaluated. (Author/EMK)

  4. An Examination of Physical and Mental Health Problems of the Homeless.

    Science.gov (United States)

    Solarz, Andrea; Mowbray, Carol

    Homelessness is a significant social problem in the United States and it has been estimated that there may be as many as 2.5 million homeless people in this country today. For these people, poverty, substance abuse, and harsh living conditions may further contribute to the development of physical and mental health problems. A study was conducted…

  5. Youths with Migration Backgrounds and Their Experiences of Physical Education: An Examination of Three Cases

    Science.gov (United States)

    Barker, D.; Barker-Ruchti, N.; Gerber, M.; Gerlach, E.; Sattler, S.; Pühse, U.

    2014-01-01

    While understanding young people has never been easy, migration trends make it increasingly difficult. Many classrooms have become culturally heterogeneous and teachers are often faced with pupils with diverse linguistic and cultural heritages. Current scholarship suggests that as a discipline, physical education has not adapted to this diversity.…

  6. Examination of Occupational Anxiety Levels and Academic Self-Efficacy of Physical Education Teacher Candidates

    Science.gov (United States)

    Pehlevan, Zeka; Mustu,Eda; Çepikkurt, Fatma

    2017-01-01

    This study aims at determining the occupational anxiety level of pre-service physical education teachers according to variables, and revealing the correlation between occupational anxiety and academic self-efficacy. Study group consists of 586 pre-service teachers from 10 different universities in Turkey. Data is collected by "Occupational…

  7. The use of quizStar application for online examination in basic physics course

    Science.gov (United States)

    Kustijono, R.; Budiningarti, H.

    2018-03-01

    The purpose of the study is to produce an online Basic Physics exam system using the QuizStar application. This is a research and development with ADDIE model. The steps are: 1) analysis; 2) design; 3) development; 4) implementation; 5) evaluation. System feasibility is reviewed for its validity, practicality, and effectiveness. The subjects of research are 60 Physics Department students of Universitas Negeri Surabaya. The data analysis used is a descriptive statistic. The validity, practicality, and effectiveness scores are measured using a Likert scale. Criteria feasible if the total score of all aspects obtained is ≥ 61%. The results obtained from the online test system by using QuizStar developed are 1) conceptually feasible to use; 2) the system can be implemented in the Basic Physics assessment process, and the existing constraints can be overcome; 3) student's response to system usage is in a good category. The results conclude that QuizStar application is eligible to be used for online Basic Physics exam system.

  8. Examining a conceptual model of parental nurturance, parenting practices and physical activity among 5-6 year olds.

    Science.gov (United States)

    Sebire, Simon J; Jago, Russell; Wood, Lesley; Thompson, Janice L; Zahra, Jezmond; Lawlor, Deborah A

    2016-01-01

    Parenting is an often-studied correlate of children's physical activity, however there is little research examining the associations between parenting styles, practices and the physical activity of younger children. This study aimed to investigate whether physical activity-based parenting practices mediate the association between parenting styles and 5-6 year-old children's objectively-assessed physical activity. 770 parents self-reported parenting style (nurturance and control) and physical activity-based parenting practices (logistic and modeling support). Their 5-6 year old child wore an accelerometer for five days to measure moderate-to-vigorous physical activity (MVPA). Linear regression was used to examine direct and indirect (mediation) associations. Data were collected in the United Kingdom in 2012/13 and analyzed in 2014. Parent nurturance was positively associated with provision of modeling (adjusted unstandardized coefficient, β = 0.11; 95% CI = 0.02, 0.21) and logistic support (β = 0.14; 0.07, 0.21). Modeling support was associated with greater child MVPA (β = 2.41; 0.23, 4.60) and a small indirect path from parent nurturance to child's MVPA was identified (β = 0.27; 0.04, 0.70). Physical activity-based parenting practices are more strongly associated with 5-6 year old children's MVPA than parenting styles. Further research examining conceptual models of parenting is needed to understand in more depth the possible antecedents to adaptive parenting practices beyond parenting styles. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  9. Examining a conceptual model of parental nurturance, parenting practices and physical activity among 5–6 year olds

    Science.gov (United States)

    Sebire, Simon J.; Jago, Russell; Wood, Lesley; Thompson, Janice L.; Zahra, Jezmond; Lawlor, Deborah A.

    2016-01-01

    Rationale Parenting is an often-studied correlate of children's physical activity, however there is little research examining the associations between parenting styles, practices and the physical activity of younger children. Objective This study aimed to investigate whether physical activity-based parenting practices mediate the association between parenting styles and 5–6 year-old children's objectively-assessed physical activity. Methods 770 parents self-reported parenting style (nurturance and control) and physical activity-based parenting practices (logistic and modeling support). Their 5–6 year old child wore an accelerometer for five days to measure moderate-to-vigorous physical activity (MVPA). Linear regression was used to examine direct and indirect (mediation) associations. Data were collected in the United Kingdom in 2012/13 and analyzed in 2014. Results Parent nurturance was positively associated with provision of modeling (adjusted unstandardized coefficient, β = 0.11; 95% CI = 0.02, 0.21) and logistic support (β = 0.14; 0.07, 0.21). Modeling support was associated with greater child MVPA (β = 2.41; 0.23, 4.60) and a small indirect path from parent nurturance to child's MVPA was identified (β = 0.27; 0.04, 0.70). Conclusions Physical activity-based parenting practices are more strongly associated with 5–6 year old children's MVPA than parenting styles. Further research examining conceptual models of parenting is needed to understand in more depth the possible antecedents to adaptive parenting practices beyond parenting styles. PMID:26647364

  10. Yazd Breast Cancer Project Profile; A Community Based Trial for the Evaluation of Self-Examination and Physical Examination of the Breast Cancer Disease

    Directory of Open Access Journals (Sweden)

    Anthony B Miller

    2015-11-01

    Full Text Available There is some evidence to suggest that a benefit might be derived from a program that incorporated both annual physical examination of the breast (BPx and the teaching of breast self-examination (BSE. Current investigation presents the profile of a multicenter community based intervention for evaluating the effect of BSE+BPx on the reduction of morbidity and mortality due to breast cancer amongst women residing in urban areas of Yazd (Iran from 2008 to 2018. There were three distinctive phases in this trial with 10 years duration: pilot phase with the duration of 1 year, active intervention phase with 4 rounds of annual screening of BPx+BSE and follow up phase with 5 years duration. Tools of enquiry included a pre-tested questionnaire, repeated annual physical examination of the breast and more importantly mammography, sonography, and fine needle aspiration (FNA. Data were analyzed using descriptive statistics such as frequencies, percent, mean (SD, tests of chi-square and student t-test with 95% confidence level. Comparison of socio-demographic and socio-economic factors such as age, age at marriage, family size, number of live births, occupation, education level, total family income and marital status showed that no significant difference was seen between the groups (P>0.05. A response rate of 84.5% was seen by participants of the experiment group visiting the health centers for the first BPx. Our results showed that except for the education and marital status, the difference in other main demographic and socio-economic factors between the groups were not significant, and the response rate of individuals in the experiment group was at an acceptable level.

  11. Simulation training for breast and pelvic physical examination: a systematic review and meta-analysis.

    Science.gov (United States)

    Dilaveri, C A; Szostek, J H; Wang, A T; Cook, D A

    2013-09-01

    Breast and pelvic examinations are challenging intimate examinations. Technology-based simulation may help to overcome these challenges. To synthesise the evidence regarding the effectiveness of technology-based simulation training for breast and pelvic examination. Our systematic search included MEDLINE, EMBASE, CINAHL, PsychINFO, Scopus, and key journals and review articles; the date of the last search was January 2012. Original research studies evaluating technology-enhanced simulation of breast and pelvic examination to teach learners, compared with no intervention or with other educational activities. The reviewers evaluated study eligibility and abstracted data on methodological quality, learners, instructional design, and outcomes, and used random-effects models to pool weighted effect sizes. In total, 11 272 articles were identified for screening, and 22 studies were eligible, enrolling 2036 trainees. In eight studies comparing simulation for breast examination training with no intervention, simulation was associated with a significant improvement in skill, with a pooled effect size of 0.86 (95% CI 0.52-1.19; P < 0.001). Four studies comparing simulation training for pelvic examination with no intervention had a large and significant benefit, with a pooled effect size of 1.18 (95% CI 0.40-1.96; P = 0.003). Among breast examination simulation studies, dynamic models providing feedback were associated with improved outcomes. In pelvic examination simulation studies, the addition of a standardised patient to the simulation model and the use of an electronic model with enhanced feedback improved outcomes. In comparison with no intervention, breast and pelvic examination simulation training is associated with moderate to large effects for skills outcomes. Enhanced feedback appears to improve learning. © 2013 RCOG.

  12. Risk factors for rape, physical assault, and posttraumatic stress disorder in women: examination of differential multivariate relationships.

    Science.gov (United States)

    Acierno, R; Resnick, H; Kilpatrick, D G; Saunders, B; Best, C L

    1999-01-01

    The National Women's Study, a 2-year, three-wave longitudinal investigation, employed a national probability sample of 3,006 adult women to: (a) identify separate risk factors for rape and physical assault, and (b) identify separate risk factors associated with post-rape posttraumatic stress disorder (PTSD) and post-physical assault PTSD. This investigation differed from previous studies in that it prospectively examined risk factors at the multivariate, as opposed to univariate level. Overall, past victimization, young age, and a diagnosis of active PTSD increased women's risk of being raped. By contrast, past victimization, minority ethnic status, active depression, and drug use were associated with increased risk of being physically assaulted. Risk factors for PTSD following rape included a history of depression, alcohol abuse, or experienced injury during the rape. However, risk factors for PTSD following physical assault included only a history of depression and lower education.

  13. Examination of contraction-induced muscle pain as a behavioral correlate of physical activity in women with and without fibromyalgia.

    Science.gov (United States)

    Umeda, Masataka; Corbin, Lisa W; Maluf, Katrina S

    2015-01-01

    This study aimed to compare muscle pain intensity during a sustained isometric contraction in women with and without fibromyalgia (FM), and examine the association between muscle pain and self-reported levels of physical activity. Fourteen women with FM and 14 healthy women completed the study, where muscle pain ratings (MPRs) were obtained every 30 s during a 3 min isometric handgrip task at 25% maximal strength, and self-reported physical activity was quantified using the Baecke Physical Activity Questionnaire. Women with FM were less physically active than healthy controls. During the isometric contraction, MPR progressively increased in both groups at a comparable rate, but women with FM generally reported a greater intensity of muscle pain than healthy controls. Among all women, average MPR scores were inversely associated with self-reported physical activity levels. Women with FM exhibit augmented muscle pain during isometric contractions and reduced physical activity than healthy controls. Furthermore, contraction-induced muscle pain is inversely associated with physical activity levels. These observations suggest that augmented muscle pain may serve as a behavioral correlate of reduced physical activity in women with FM. Implications for Rehabilitation Women with fibromyalgia experience a greater intensity of localized muscle pain in a contracting muscle compared to healthy women. The intensity of pain during muscle contraction is inversely associated with the amount of physical activity in women with and without fibromyalgia. Future studies should determine whether exercise adherence can be improved by considering the relationship between contraction-induced muscle pain and participation in routine physical activity.

  14. Systematic review of patient history and physical examination to diagnose chronic low back pain originating from the facet joints.

    Science.gov (United States)

    Maas, E T; Juch, J N S; Ostelo, R W J G; Groeneweg, J G; Kallewaard, J W; Koes, B W; Verhagen, A P; Huygen, F J P M; van Tulder, M W

    2017-03-01

    Patient history and physical examination are frequently used procedures to diagnose chronic low back pain (CLBP) originating from the facet joints, although the diagnostic accuracy is controversial. The aim of this systematic review is to determine the diagnostic accuracy of patient history and/or physical examination to identify CLBP originating from the facet joints using diagnostic blocks as reference standard. We searched MEDLINE, EMBASE, CINAHL, Web of Science and the Cochrane Collaboration database from inception until June 2016. Two review authors independently selected studies for inclusion, extracted data and assessed the risk of bias. We calculated sensitivity and specificity values, with 95% confidence intervals (95% CI). Twelve studies were included, in which 129 combinations of index tests and reference standards were presented. Most of these index tests have only been evaluated in single studies with a high risk of bias. Four studies evaluated the diagnostic accuracy of the Revel's criteria combination. Because of the clinical heterogeneity, results were not pooled. The published sensitivities ranged from 0.11 (95% CI 0.02-0.29) to 1.00 (95% CI 0.75-1.00), and the specificities ranged from 0.66 (95% CI 0.46-0.82) to 0.91 (95% CI 0.83-0.96). Due to clinical heterogeneity, the evidence for the diagnostic accuracy of patient history and/or physical examination to identify facet joint pain is inconclusive. Patient history and physical examination cannot be used to limit the need of a diagnostic block. The validity of the diagnostic facet joint block should be studied, and high quality studies are required to confirm the results of single studies. Patient history and physical examination cannot be used to limit the need of a diagnostic block. The validity of the diagnostic facet joint block should be studied, and high quality studies are required to confirm the results of single studies. © 2016 European Pain Federation - EFIC®.

  15. Utility of physical examination and comparison to echocardiography for cardiac diagnosis

    Directory of Open Access Journals (Sweden)

    Ashish Patel

    2017-03-01

    Conclusion: Careful clinical auscultation using a stethoscope remains a valuable tool for cardiac diagnosis. Decision on initial diagnosis and management of valvular and congenital heart diseases should be based on clinical examination and integrating such information with echocardiography as required.

  16. Cardiovascular pre-participation screening does not distress professional football players.

    Science.gov (United States)

    Solberg, E E; Bjørnstad, T H; Andersen, T E; Ekeberg, Ø

    2012-06-01

    It has been debated whether cardiovascular screening of athletes creates negative psychological reactions in those being screened. Neither the athletes' level of distress towards, nor their opinion about screening has actually been examined. Therefore, the aim of this study was to assess the level of distress among Norwegian elite male football players and their experiences of screening. After screening, players completed a 10-item scale assessing their experience on a Likert scale. Their level of distress was measured with the intrusion sub-scale of Impact of Event Scale (IES) (7 items) on a six-point scale (grade 0-5). A sum score of ≥19 indicates a clinical stress problem. Twenty-five out of 28 teams, 441 of 591 players (75%, mean age 26 [18-39] years) consented to participate. Sixty-four percent felt more confident when playing football and 88% were satisfied having completed the screening. The majority (77%) felt a need for the screening and 84% would strongly recommend it to others. Sixteen percent were afraid that the screening result might have consequences for their own health, and 13% were afraid of losing their license to play football. Less than 3% experienced distress (IES ≥ 19). The majority of the players were satisfied having completed the screening, felt more confident and would recommend it to other players. Only a marginal proportion of the players were distressed by the screening, but were at least as likely to recommend it.

  17. An Examination of the Relationship between Family and U.S. Latinos’ Physical Health

    Directory of Open Access Journals (Sweden)

    Georgiana Bostean

    2010-10-01

    Full Text Available Latinos, especially immigrant Latinos, have lower mortality rates and some better health outcomes than U.S.-born Latinos and whites, a situation called the Latino Paradox. One explanation for the advantage is that Latinos’ family orientation protects health. However, because few large-scale studies examine Latinos’ family relationships by nativity, the extent to which family factors contribute to Latinos’ health outcomes is unclear. Additionally, while a large literature focuses on family cohesion, fewer studies address both cohesion and conflict, which may be particularly important among immigrants, whose migration and adaptation experiences can strain family relations. This study examines the relationship between family context and U.S. Latinos’ physical health outcomes. Using nationally representative data on Latinos, it explores the relationship between chronic conditions and activity limitation and nativity, ethnicity, and family factors—both subjective, such as cohesion and conflict, and objective, such as household size, marital status, and language spoken with family. Results reveal that family conflict in particular is related to poorer health. Furthermore, objective measures of family context, such as marital status and household size, do not capture the effects of family relationships (cohesion, conflict, social support. These findings emphasize the importance of family relationships and the need for makers of both immigration and health policy to take into account the complex effects of these relationships on society from a public health perspective.Les Latinos, et en particulier les immigrants latinos, affichent des taux de mortalité plus faibles et un meilleur état de santé que les Blancs et les Latinos nés aux Etats-Unis. Cette situation est connue sous le nom de Paradoxe latino. L’une des explications à ce paradoxe est que la cohésion familiale des Latinos aurait un effet bénéfique sur la santé. Toutefois,

  18. Adolescent vigorous physical activity and the neighborhood school environment: examinations by family social class

    DEFF Research Database (Denmark)

    Svastisalee, Chalida; Schipperijn, Jasper; Holstein, Bjørn Evald

    Purpose: To investigate whether associations between daily vigorous physical activity (VPA) and the built environment are patterned according to family social class. Methods: We used self-reported daily VPA measured in 6046 11 to 15-year-old boys and girls in 80 schools. Multi-level stratified...... likely to achieve daily VPA than boys. Among children from low family social class backgrounds, girls were less likely to achieve daily VPA than boys (OR = 0.40; CI: 0.28-0.57). Additionally, children from low family social class backgrounds attending schools with low exposure to walking and cycling...... paths had the lowest odds (OR =0.51; CI: 0.29-0.88) of achieving daily VPA than those attending schools with higher exposure to paths. Conclusions: Findings of this study suggest that a lack of supportive physical activity support in school surroundings may have a greater impact on children of low...

  19. Examining gender differences on FCI performance in algebra and calculus based physics courses

    Science.gov (United States)

    Kreutzer, Kimberley; Boudreaux, Andrew

    2009-05-01

    The Force Concept Inventory (FCI) has been widely used to asses student understanding of Newtonian principles. Studies have shown a marked difference in the performance of men and women on both pre- and post-tests [1,2] and also indicate that experiential based instruction may lead to a reduction in this gender gap [1,3]. This poster presents FCI data collected at Western Washington University. Initial analysis of gender differences are consistent with those reported nationally. We also discuss factors that may contribute to the differences in performance and propose instructional strategies that are designed to address the gender gap. [4pt] [1] M. Lorenzo, et. al., ``Reducing the gender gap in the physics classroom,'' AJP 74(2), 118-122 (2006) [0pt] [2] J. Docktor and K. Heller, ``Gender Differences in Both Force Concept Inventory and Introductory Physics Performance,'' Proceedings at the 2008 PERC [0pt] [3] S. Pollack, et. al., ``Reducing the gender gap in the physics classroom: How sufficient is interactive engagement?'' PRST-PER 3 (2007)

  20. Leveraging geotagged Twitter data to examine neighborhood happiness, diet, and physical activity

    Science.gov (United States)

    Nguyen, Quynh C; Kath, Suraj; Meng, Hsien-Wen; Li, Dapeng; Smith, Ken Robert; VanDerslice, James A.; Wen, Ming; Li, Feifei

    2016-01-01

    Objectives Using publicly available, geotagged Twitter data, we created neighborhood indicators for happiness, food and physical activity for three large counties: Salt Lake, San Francisco and New York. Methods We utilize 2.8 million tweets collected between February-August 2015 in our analysis. Geo-coordinates of where tweets were sent allow us to spatially join them to 2010 census tract locations. We implemented quality control checks and tested associations between Twitter-derived variables and sociodemographic characteristics. Results For a random subset of tweets, manually labeled tweets and algorithm labeled tweets had excellent levels of agreement: 73% for happiness; 83% for food, and 85% for physical activity. Happy tweets, healthy food references, and physical activity references were less frequent in census tracts with greater economic disadvantage and higher proportions of racial/ethnic minorities and youths. Conclusions Social media can be leveraged to provide greater understanding of the well-being and health behaviors of communities—information that has been previously difficult and expensive to obtain consistently across geographies. More open access neighborhood data can enable better design of programs and policies addressing social determinants of health. PMID:28533568

  1. Intraoperative Physical Examination for Diagnosis of Interosseous Ligament Rupture-Cadaveric Study.

    Science.gov (United States)

    Kachooei, Amir Reza; Rivlin, Michael; Wu, Fei; Faghfouri, Aram; Eberlin, Kyle R; Ring, David

    2015-09-01

    To study the intraobserver and interobserver reliability of the diagnosis of interosseous ligament (IOL) rupture in a cadaver model. On 12 fresh frozen cadavers, radial heads were cut using an identical incision and osteotomy. After randomization, the soft tissues of the limbs were divided into 4 groups: both IOL and triangular fibrocartilage (TFCC) intact; IOL disruption but TFCC intact; both IOL and TFCC divided; and IOL intact but TFCC divided. All incisions had identical suturing. After standard instruction and demonstration of radius pull-push and radius lateral pull tests, 10 physician evaluators with different levels of experience examined the cadaver limbs in a standardized way (elbow at 90° with the forearm held in both supination and pronation) and were asked to classify them into one of the 4 groups. Next, the same examiners were asked to re-examine the limbs after randomly changing the order of examination. The interobserver reliability of agreement for the diagnosis of IOL injury (groups 2 and 3) was fair in both rounds of examination and the intraobserver reliability was moderate. The intra- and interobserver reliabilities of agreement for the 4 groups of injuries among the examiners were fair in both rounds of examination. The sensitivity, specificity, accuracy, positive, and negative predictive values were all around 70%. The likelihood of a positive test corresponding with the presence of IOL rupture (positive likelihood ratio) was 2.2. The likelihood of a negative test correctly diagnosing an intact IOL was 0.40. In cadavers, intraoperative tests had fair reliability and 70% accuracy for the diagnosis of IOL rupture using the push-pull and lateral pull maneuvers. The level of experience did not have any effect on the correct diagnosis of intact versus disrupted IOL. Although not common, some failure of surgeries for traumatic elbow fracture-dislocations is because of failure in timely diagnosis of IOL disruption. Copyright © 2015 American

  2. Clinical diagnosis of partial or complete anterior cruciate ligament tears using patients' history elements and physical examination tests.

    Science.gov (United States)

    Décary, Simon; Fallaha, Michel; Belzile, Sylvain; Martel-Pelletier, Johanne; Pelletier, Jean-Pierre; Feldman, Debbie; Sylvestre, Marie-Pierre; Vendittoli, Pascal-André; Desmeules, François

    2018-01-01

    To assess the diagnostic validity of clusters combining history elements and physical examination tests to diagnose partial or complete anterior cruciate ligament (ACL) tears. Prospective diagnostic study. Orthopaedic clinics (n = 2), family medicine clinics (n = 2) and community-dwelling. Consecutive patients with a knee complaint (n = 279) and consulting one of the participating orthopaedic surgeons (n = 3) or sport medicine physicians (n = 2). Not applicable. History elements and physical examination tests performed independently were compared to the reference standard: an expert physicians' composite diagnosis including history elements, physical tests and confirmatory magnetic resonance imaging. Penalized logistic regression (LASSO) was used to identify history elements and physical examination tests associated with the diagnosis of ACL tear and recursive partitioning was used to develop diagnostic clusters. Diagnostic accuracy measures including sensitivity (Se), specificity (Sp), predictive values and positive and negative likelihood ratios (LR+/-) with associated 95% confidence intervals (CI) were calculated. Forty-three individuals received a diagnosis of partial or complete ACL tear (15.4% of total cohort). The Lachman test alone was able to diagnose partial or complete ACL tears (LR+: 38.4; 95%CI: 16.0-92.5). Combining a history of trauma during a pivot with a "popping" sensation also reached a high diagnostic validity for partial or complete tears (LR+: 9.8; 95%CI: 5.6-17.3). Combining a history of trauma during a pivot, immediate effusion after trauma and a positive Lachman test was able to identify individuals with a complete ACL tear (LR+: 17.5; 95%CI: 9.8-31.5). Finally, combining a negative history of pivot or a negative popping sensation during trauma with a negative Lachman or pivot shift test was able to exclude both partial or complete ACL tears (LR-: 0.08; 95%CI: 0.03-0.24). Diagnostic clusters combining history elements and physical

  3. Physical examination of dizziness in athletes after a concussion: A descriptive study.

    Science.gov (United States)

    Reneker, Jennifer C; Cheruvu, Vinay K; Yang, Jingzhen; James, Mark A; Cook, Chad E

    2018-04-01

    Dizziness is commonly reported after concussion. With the forces experienced at the time of the injury, several anatomical locations may have been altered, causing dizziness. Describe an objective examination and the types of impairment/dysfunction implicated by the results of clinical examination tests in subjects with dizziness after a concussion. Cross-Sectional. Athletes between ages 10-23 were enrolled with a diagnosis of concussion. An examination was completed to identify areas potentially contributing to dizziness, including tests of oculomotor control, the vestibular system, neuromotor control, and musculoskeletal components of the cervical spine. Descriptive analyses were completed to define the anatomical areas/types of dysfunction identified by positive findings of the examination tests. All (n = 41; 100%) subjects had examination findings consistent with central dysfunction. Of these, 36 (97.8%) had oculomotor control deficits; 29 (70.7%) demonstrated motion sensitivity; and 6 (15%) had central vestibular deficits. Nineteen (46.3%) had peripheral dysfunction, including 18 (43.9%) with unilateral hypofunction, and 2 (4.9%) with Benign Paroxysmal Positional Vertigo. Thirty-four (82.9%) had cervical dysfunction, with 11 (26.8%) presenting with cervicogenic dizziness, and 31 (75.6%) with altered neuromotor control. Functional injury to centrally-mediated pathways, specifically oculomotor control, and afferent and efferent pathways in the cervical spine are commonly identified through clinical examination tests in individuals with a complaint of dizziness post-concussion. According to results presented here, a high majority (90%) of the participants demonstrated dizziness that appeared to be multifactorial in nature and was not attributable to one main type of dysfunction. The common pathways between the systems make it difficult to isolate only one anatomical area as a contributor to dizziness. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. Ulnar-sided wrist pain. Part I: anatomy and physical examination

    International Nuclear Information System (INIS)

    Vezeridis, Peter S.; Blazar, Philip; Yoshioka, Hiroshi; Han, Roger

    2010-01-01

    Ulnar-sided wrist pain is a common complaint, and it presents a diagnostic challenge for hand surgeons and radiologists. The complex anatomy of this region, combined with the small size of structures and subtle imaging findings, compound this problem. A thorough understanding of ulnar-sided wrist anatomy and a systematic clinical examination of this region are essential in arriving at an accurate diagnosis. In part I of this review, ulnar-sided wrist anatomy and clinical examination are discussed for a more comprehensive understanding of ulnar-sided wrist pain. (orig.)

  5. Effects of physical and mental health on relationship satisfaction: a dyadic, longitudinal examination of couples facing prostate cancer.

    Science.gov (United States)

    Ross, Kaile M; Ranby, Krista W; Wooldridge, Jennalee S; Robertson, Cary; Lipkus, Isaac M

    2016-08-01

    Prostate cancer may affect quality of life in men diagnosed as well as their spouses. Changes in health may disrupt the couple's relationship functioning which disrupts recovery. This study examined how mental and physical health relates to relationship satisfaction for couples at diagnosis through the year following treatment. Patients with stage I-II prostate cancer and their spouses (N = 159 couples) were recruited from a urology clinic and completed questionnaires at diagnosis, 1 month, 6 months, and 12 months post prostatectomy on demographics, mental and physical health quality of life, and relationship satisfaction. The Actor-Partner Interdependence Model was employed to examine effects of each partners' mental and physical health on their own and their partner's relationship satisfaction. Patients and spouses had declined mental and physical health at 1 month post-surgery. Health improved at 6 and 12 months but did not fully return to pre-surgery levels. Actor effects showed that patient's physical health consistently predicted own relationship satisfaction. Both patient's and spouse's mental health consistently related to their own relationship satisfaction. Partner effects showed that patient's and spouse's physical health had an effect on each other's relationship satisfaction at 1 month. Spouse's mental health predicted patient's relationship satisfaction throughout the year following treatment. The effects of patient and spouse mental and physical health quality of life on their own as well as their partner's relationship satisfaction differed across time which will inform psychosocial interventions for couples with prostate cancer. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

  6. Performance of Physical Examination Skills in Medical Students during Diagnostic Medicine Course in a University Hospital of Northwest China

    Science.gov (United States)

    Li, Yan; Li, Na; Han, Qunying; He, Shuixiang; Bae, Ricard S.; Liu, Zhengwen; Lv, Yi; Shi, Bingyin

    2014-01-01

    This study was conducted to evaluate the performance of physical examination (PE) skills during our diagnostic medicine course and analyze the characteristics of the data collected to provide information for practical guidance to improve the quality of teaching. Seventy-two fourth-year medical students were enrolled in the study. All received an assessment of PE skills after receiving a 17-week formal training course and systematic teaching. Their performance was evaluated and recorded in detail using a checklist, which included 5 aspects of PE skills: examination techniques, communication and care skills, content items, appropriateness of examination sequence, and time taken. Error frequency and type were designated as the assessment parameters in the survey. The results showed that the distribution and the percentage in examination errors between male and female students and among the different body parts examined were significantly different (pexaminations was higher than in abdominal (0.867) and head, neck and nervous system examinations (0.917). Female students had a lower average error frequency than males in cardiac examinations (p = 0.041). Additionally, error in examination techniques was the highest type of error among the 5 aspects of PE skills irrespective of participant gender and assessment content (pexaminations and examination techniques may be included in the main focus of improving the teaching of diagnostics in these medical students. PMID:25329685

  7. Examining the links between employed mothers' work characteristics, physical activity, and child health.

    Science.gov (United States)

    Johnson, Ryan C; Allen, Tammy D

    2013-01-01

    The present study tested a process model through which the strain-based (job control and role ambiguity) and time-based (work hours) job demands of employed mothers relate to child health via child modeling of mother's physical activity. Support was found for a model of these relationships using dyadic mother-child data (N = 359) from a large, multi-wave nationwide data set and job demands data from the Occupational Information Network (O*Net). Theoretical and practical implications, as well as future research directions, are also discussed. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  8. Analysis of Science Process Skills in West African Senior Secondary School Certificate Physics Practical Examinations in Nigeria

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    A.O. Akinbobola

    2010-06-01

    Full Text Available This study analyzes the science process skills in West African senior secondary school certificate physics practical examinations in Nigeria for a period of 10 years (1998-2007. Ex-post facto design was adopted for the study. The 5 prominent science process skills identified out of the 15 used in the study are: manipulating (17%, calculating (14%, recording (14%, observing (12% and communicating (11%. The results also show high percentage rate of basic (lower order science process skills (63% as compared to the integrated (higher order science process skills (37%. The results also indicate that the number of basic process skills is significantly higher than the integrated process skills in the West African senior secondary school certificate physics practical examinations in Nigeria. It is recommended that the examination bodies in Nigeria should include more integrated science process skills into the senior secondary school physics practical examinations so as to enable the students to be prone to creativity, problem solving, reflective thinking, originality and invention which are vital ingredients for science and technological development of any nation.

  9. Does Ultrasound-Enhanced Instruction of Musculoskeletal Anatomy Improve Physical Examination Skills of First-Year Medical Students?

    Science.gov (United States)

    Walrod, Bryant J; Schroeder, Allison; Conroy, Mark J; Boucher, Laura C; Bockbrader, Marcia; Way, David P; McCamey, Kendra L; Hartz, Clinton A; Jonesco, Michael A; Bahner, David P

    2018-01-01

    Ultrasound imaging is commonly used to teach basic anatomy to medical students. The purpose of this study was to determine whether learning musculoskeletal anatomy with ultrasound improved performance on medical students' musculoskeletal physical examination skills. Twenty-seven first-year medical students were randomly assigned to 1 of 2 instructional groups: either shoulder or knee. Both groups received a lecture followed by hands-on ultrasound scanning on live human models of the assigned joint. After instruction, students were assessed on their ability to accurately palpate 4 anatomic landmarks: the acromioclavicular joint, the proximal long-head biceps tendon, and the medial and lateral joint lines of the knee. Performance scores were based on both accuracy and time. A total physical examination performance score was derived for each joint. Scores for instructional groups were compared by a 2-way analysis of variance with 1 repeated measure. Significant findings were further analyzed with post hoc tests. All students performed significantly better on the knee examination, irrespective of instructional group (F = 14.9; df = 1.25; P = .001). Moreover, the shoulder instruction group performed significantly better than the knee group on the overall assessment (t = -3.0; df = 25; P soft tissue landmark. Both groups performed similarly on palpation of all other anatomic structures. The use of ultrasound appears to provide an educational advantage when learning musculoskeletal physical examination of soft tissue landmarks. © 2017 by the American Institute of Ultrasound in Medicine.

  10. Is it possible to teach history taking and physical examination by training?

    Directory of Open Access Journals (Sweden)

    Kopp, Veronika

    2005-01-01

    Full Text Available Based on the criticism concerning traditional teaching methods, problem-based courses were introduced in the medical education of the University of Munich to foster the acquistion of action knowledge. One of these courses is the so-called MuSkel-course (course of musculosceletal diseases and injury. This course ends with a Triple Jump examination, the first step of which is an examination with a standardized patient in an OSCE-format (Objective Strutured Clinical Examination. In order to prepare the students for this exam, an OSCE-training was introduced with the fourth MuSkel-course. This study aimed at answering the question, to what extent this training exhibited a better knowledge. For that, the performance of students without training (control group was compared with that of students having received two training sessions (experimental group. The results demonstrated that the experimental group performed better than the control group in only a few but important tests (identification of important points in medical history taking and clinical examination, the attitude towards the patient, the call for further diagnostic tests.

  11. Violence in Music Videos: Examining the Prevalence and Context of Physical Aggression.

    Science.gov (United States)

    Smith, Stacy L.; Boyson, Aaron R.

    2002-01-01

    Examines violence in music video programming. Reveals that 15% of music videos feature violence, and most of that aggression is sanitized, not chastised, and presented in realistic contexts. Discusses the findings in terms of the risk that exposure to violence in each channel and genre may be posing to viewers' learning of aggression, fear, and…

  12. Diagnostic Validity of Combining History Elements and Physical Examination Tests for Traumatic and Degenerative Symptomatic Meniscal Tears.

    Science.gov (United States)

    Décary, Simon; Fallaha, Michel; Frémont, Pierre; Martel-Pelletier, Johanne; Pelletier, Jean-Pierre; Feldman, Debbie E; Sylvestre, Marie-Pierre; Vendittoli, Pascal-André; Desmeules, François

    2017-10-27

    The current approach to the clinical diagnosis of traumatic and degenerative symptomatic meniscal tears (SMTs) proposes combining history elements and physical examination tests without systematic prescription of imaging investigations, yet the evidence to support this diagnostic approach is scarce. To assess the validity of diagnostic clusters combining history elements and physical examination tests to diagnose or exclude traumatic and degenerative SMT compared with other knee disorders. Prospective diagnostic accuracy study. Patients were recruited from 2 orthopedic clinics, 2 family medicine clinics, and from a university community. A total of 279 consecutive patients who underwent consultation for a new knee complaint. Each patient was assessed independently by 2 evaluators. History elements and standardized physical examination tests performed by a physiotherapist were compared with the reference standard: an expert physicians' composite diagnosis including a clinical examination and confirmatory magnetic resonance imaging. Participating expert physicians were orthopedic surgeons (n = 3) or sport medicine physicians (n = 2). Penalized logistic regression (least absolute shrinkage and selection operator) was used to identify history elements and physical examination tests associated with the diagnosis of SMT and recursive partitioning was used to develop diagnostic clusters. Diagnostic accuracy measures were calculated including sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios (LR+/-) with associated 95% confidence intervals (CIs). Eighty patients had a diagnosis of SMT (28.7%), including 35 traumatic tears and 45 degenerative tears. The combination a history of trauma during a pivot, medial knee pain location, and a positive medial joint line tenderness test was able to diagnose (LR+ = 8.9; 95% CI 6.1-13.1) or exclude (LR- = 0.10; 95% CI 0.03-0.28) a traumatic SMT. Combining a history of

  13. An examination of eating attitudes and physical activity levels of Turkish university students with regard to self-presentational concern.

    Science.gov (United States)

    Aşçi, F Hülya; Tüzün, Macide; Koca, Canan

    2006-11-01

    This study aimed to examine eating attitudes and physical activity level of young women and men university students with regard to social physique anxiety level. 482 university students participated in this study voluntarily. "Eating Attitude Test (EAT-40)", "Social Physique Anxiety Scale" and "Physical Activity Assessment Questionnaire" were used to assess the eating attitude, social physique anxiety and physical activity level of participants, respectively. Women and men participants in this study were assigned to high (HSPA) and low (LSPA) social physique anxiety groups with respect to their median scores. Men had favorable eating attitudes and higher physical activity level than women. In addition, participants in the HSPA group had unfavorable eating attitudes and higher physical activity MET values than participants in the LSPA group. On the other hand, groupxgender interaction was only significant for the eating attitudes scores but, not for physical activity level. Women in the HSPA group scored higher on the EAT-40 than men in HSPA and women and men in the LSPA groups.

  14. Monitoring and assessment activities and indications of empathic behavior of the examined teachers during physical education lessons

    Directory of Open Access Journals (Sweden)

    Radoslaw Muszkieta

    2015-12-01

    The material of the studies was the physical education teachers of randomly chosen Poznań (Poland schools: primary, grammar, and secondary schools. The studies involved 584 physical education teachers. The studies were conducted in the school year of 1999-2000. For the studies, an observation method was applied consisting in lesson observations during physical education lessons carried out by physical education teachers. The results of the studies form characteristic upward or downward tendencies. The higher the educational stage the higher the percentage value for the teachers who: a assess attitudes and behavior of the students; b monitor and assess knowledge of the students in the field of physical culture; c assess with grades or points motor and organizational skills; d assess verbally tasks’ achievement; e apply and introduce self-monitoring and self-assessment of knowledge, skills, attitudes, and physical fitness of the students. The downward tendencies were observed exclusively for monitoring attitudes and behavior of the students (i.e. having sports outfit, activity, involvement, attendance, etc.. The examined women were characterized by better and more positive empathic behavior. For all parameters, the women appeared to be better.

  15. Examining the physical meaning of the bank erosion coefficient used in meander migration modeling

    Science.gov (United States)

    Constantine, Candice R.; Dunne, Thomas; Hanson, Gregory J.

    2009-05-01

    Widely used models of meander evolution relate migration rate to vertically averaged near-bank velocity through the use of a coefficient of bank erosion ( E). In applications to floodplain management problems, E is typically determined through calibration to historical planform changes, and thus its physical meaning remains unclear. This study attempts to clarify the extent to which E depends on measurable physical characteristics of the channel boundary materials using data from the Sacramento River, California, USA. Bend-average values of E were calculated from measured long-term migration rates and computed near-bank velocities. In the field, unvegetated bank material resistance to fluvial shear ( k) was measured for four cohesive and noncohesive bank types using a jet-test device. At a small set of bends for which both E and k were obtained, we discovered that variability in k explains much of the variability in E. The form of this relationship suggests that when modeling long-term meander migration of large rivers, E depends largely on bank material properties. This finding opens up the possibility that E may be estimated directly from field data, enabling prediction of meander migration rates for systems where historical data are unavailable or controlling conditions have changed. Another implication is that vegetation plays a limited role in affecting long-term meander migration rates of large rivers like the Sacramento River. These hypotheses require further testing with data sets from other large rivers.

  16. Aging, physical activity, and cognitive processing: an examination of P300.

    Science.gov (United States)

    McDowell, K; Kerick, S E; Santa Maria, D L; Hatfield, B D

    2003-01-01

    Physical activity appears to attenuate the decline of cognitive function typically observed in older men and women. The P300 component of the event-related potential (ERP) is particularly affected by aging and allows for basic neurobiological assessment of cognitive function. Three aspects of the P300 component (i.e. latency, amplitude, and area under the curve (AUC)), elicited by an oddball task, were derived to assess cognitive function in young and older participants (N=73) who were further classified as high- and low-active. The low-active elderly participants exhibited larger AUC values than those observed in all other groups which were undifferentiated. That is, the high-active elderly and the young participants exhibited smaller AUC values than the low-active older group. In conclusion, higher levels of physical activity in the elderly may be associated with a reduction in the neural resources allocated in response to simple cognitive challenge. This interpretation is consistent with the concept of psychomotor efficiency proposed by Hatfield and Hillman [The psychophysiology of sport: a mechanistic understanding of the psychology of superior performance. In: Singer RN, Hausenbias HA, Janelle CM, editors. Handbook of sport psychology. 2nd ed. New York: Wiley; 2001, p. 362-88].

  17. Examining the postural awareness and flexibility changes in physical therapy students who took clinical Pilates class.

    Science.gov (United States)

    Atilgan, Esra; Tarakci, Devrim; Mutluay, Fatma

    2017-01-01

    This study aimed to evaluate postural awareness and changes in posture and flexibility of students who took Clinical Pilates class as an elective course at the undergraduate level. The study conducted from 2013-2016 included 98 students who took Clinical Pilates class at the Department of Physical Therapy and Rehabilitation, School of Health Sciences, Istanbul Medipol University, Turkey. The flexibility levels of the study participants were measured before and after the Clinical Pilates education using finger-to-floor test and modified Schober's test. Observational posture analysis and postural awareness were recorded using the scale prepared by the researchers. The post-education evaluations showed that postural distortions were fixed, and a significant increase in the postural awareness of the students was observed compared with the pre-education period. The results of both modified Schober's test and finger-to-floor test, which were used to measure the flexibility levels, showed a statistically significant increase in post-education scores compared with those of the pre-education period. This study showed that the Clinical Pilates course increased postural awareness and flexibility of physical therapy students and fixed postural distortions. Thus, the inclusion of Clinical Pilates class in the undergraduate education is considered to be important.

  18. Modifiable variables in physical therapy education programs associated with first-time and three-year National Physical Therapy Examination pass rates in the United States

    Directory of Open Access Journals (Sweden)

    Chad Cook

    2015-09-01

    Full Text Available Purpose: This study aimed to examine the modifiable programmatic characteristics reflected in the Commission on Accreditation in Physical Therapy Education (CAPTE Annual Accreditation Report for all accredited programs that reported pass rates on the National Physical Therapist Examination, and to build a predictive model for first-time and three-year ultimate pass rates. Methods: This observational study analyzed programmatic information from the 185 CAPTE-accredited physical therapy programs in the United States and Puerto Rico out of a total of 193 programs that provided the first-time and three-year ultimate pass rates in 2011. Fourteen predictive variables representing student selection and composition, clinical education length and design, and general program length and design were analyzed against first-time pass rates and ultimate pass rates on the NPTE. Univariate and multivariate multinomial regression analysis for first-time pass rates and logistic regression analysis for three-year ultimate pass rates were performed. Results: The variables associated with the first-time pass rate in the multivariate analysis were the mean undergraduate grade point average (GPA and the average age of the cohort. Multivariate analysis showed that mean undergraduate GPA was associated with the three-year ultimate pass rate. Conclusions: Mean undergraduate GPA was found to be the only modifiable predictor for both first-time and three-year pass rates among CAPTE-accredited physical therapy programs.

  19. Technical committee on reactor physics of next generation. Examination of MA recycling by using PWRs

    International Nuclear Information System (INIS)

    Mori, Masaaki

    1995-01-01

    It is an important subject to be examined that during the period till full scale nuclear fuel recycling including the adoption of FBRs will be realized, we never have excess Pu. As the realistic examination considering the nuclear fuel recycling for the time being, the MOX fuel for PWRs of actinide recycling, ultralong life, placing emphasis on the concentrated charging of Pu and the confinement of MA in nuclear fuel cycling was examined. The change of the infinite multiplication rate of actinide recycling fuel is small throughout the burning, and there is the possibility of attaining the high burnup about twice of that of UO 2 fuel. The merit of the case of adding MA in small amount by recycling MA together with Pu at the proportion in spent fuel is shown. The amount of MA accumulation in Japan until 2050 was evaluated by the survey of the electric power generation of every reactor type using the long term reactor type strategy evaluation code LSER. By comparing the amount of MA accumulation in four MA recycling cases with the basic case without MA recycling, the amount of MA annihilation was evaluated. It was found that the MA recycling using PWRs only is not inferior to the multi-recycling of MA using FBRs. (K.I.)

  20. Development of age-specific Japanese physical phantoms for dose evaluation in infant CT examinations

    International Nuclear Information System (INIS)

    Yamauchi-Kawaura, C.; Fujii, K.; Imai, K.; Ikeda, M.; Akahane, K.; Obara, S.; Yamauchi, M.; Narai, K.; Katsu, T.

    2016-01-01

    Secondary to the previous development of age-specific Japanese head phantoms, the authors designed Japanese torso phantoms for dose assessment in infant computed tomography (CT) examinations and completed a Japanese 3-y-old head-torso phantom. For design of age-specific torso phantoms (0, 0.5, 1 and 3 y old), anatomical structures were measured from CT images of Japanese infant patients. From the CT morphometry, it was found that rib cages of Japanese infants were smaller than those in Europeans and Americans. Radiophotoluminescence glass dosemeters were used for dose measurement of a 3-y-old head-torso phantom. To examine the validity of the developed phantom, organ and effective doses by the in-phantom dosimetry system were compared with simulation values in a web-based CT dose calculation system (WAZA-ARI). The differences in doses between the two systems were <20 % at the doses of organs within scan regions and effective doses in head, chest and abdomino-pelvic CT examinations. (authors)

  1. A pilot examination of social context and everyday physical activity among adults receiving Community Mental Health Services.

    Science.gov (United States)

    McCormick, B P; Frey, G C; Lee, C-T; Gajic, T; Stamatovic-Gajic, B; Maksimovic, M

    2009-03-01

    Community mental health center (CMHC) clients include a variety of people with moderate to severe mental illnesses who also report a number of physical health problems. Physical activity (PA) has been identified as one intervention to improve health among this population; however, little is known about the role of social context in PA. The purpose of this study was to examine the role of social context in everyday PA among CMHC clients. Data were collected from CMHC clients in two cultures using accelerometery and experience sampling methods. Data were analyzed using hierarchical linear modeling. Independence in housing nor culture was significantly associated with levels of PA. Being alone was significantly negatively related to PA level. Social isolation appears to be negatively related to PA at the level of everyday life. Physical activity interventions with this population should consider including social components as a part of PA.

  2. Examining social, physical, and environmental dimensions of tornado vulnerability in Texas.

    Science.gov (United States)

    Siebeneck, Laura

    2016-01-01

    To develop a vulnerability model that captures the social, physical, and environmental dimensions of tornado vulnerability of Texas counties. Guided by previous research and methodologies proposed in the hazards and emergency management literature, a principle components analysis is used to create a tornado vulnerability index. Data were gathered from open source information available through the US Census Bureau, American Community Surveys, and the Texas Natural Resources Information System. Texas counties. The results of the model yielded three indices that highlight geographic variability of social vulnerability, built environment vulnerability, and tornado hazard throughout Texas. Further analyses suggest that counties with the highest tornado vulnerability include those with high population densities and high tornado risk. This article demonstrates one method for assessing statewide tornado vulnerability and presents how the results of this type of analysis can be applied by emergency managers towards the reduction of tornado vulnerability in their communities.

  3. Examining the Effects of Oxygen Plasma on Physical and Dyeing Properties of Some Cellulose Fibers

    Directory of Open Access Journals (Sweden)

    Dilara KOCAK

    2016-09-01

    Full Text Available Cotton, Agava Americana and artichoke fibers were treated with plasma with oxygen gas in Diener Vacuum Plasma for 1, 3 and 5 minutes, with 40 kHz low frequency and at 0.3 mbar pressure. After the plasma treatment, fibers' weight loss %, tensile strength, elongation, fiber diameter, surface topography (SEM, colour changes, and light and washing fastness properties were investigated. A positive increase was observed for mechanical and fastness properties after 5 min plasma treatment. The effects of plasma treatments on dyeing properties of fibers were studied. Dyeing properties of plasma treated fibers were improved after 3 min. treatment. SEM results were also proved the improved physical properties and colour changes due to the rough surface structure.DOI: http://dx.doi.org/10.5755/j01.ms.22.3.9368

  4. Perceived influence and college students' diet and physical activity behaviors: an examination of ego-centric social networks.

    Science.gov (United States)

    Harmon, Brook E; Forthofer, Melinda; Bantum, Erin O; Nigg, Claudio R

    2016-06-06

    Obesity is partially a social phenomenon, with college students particularly vulnerable to changes in social networks and obesity-related behaviors. Currently, little is known about the structure of social networks among college students and their potential influence on diet and physical activity behaviors. The purpose of the study was to examine social influences impacting college students' diet and physical activity behaviors, including sources of influence, comparisons between sources' and students' behaviors, and associations with meeting diet and physical activity recommendations. Data was collected from 40 students attending college in Hawaii. Participants completed diet and physical activity questionnaires and a name generator. Participants rated nominees' influence on their diet and physical activity behaviors as well as compared nominees' behaviors to their own. Descriptive statistics were used to look at perceptions of influence across network groups. Logistic regression models were used to examine associations between network variables and odds of meeting recommendations. A total of 325 nominations were made and included: family (n = 116), college friends (n = 104), high school friends (n = 87), and significant others (n = 18). Nearly half of participants were not from Hawaii. Significant others of non-Hawaii students were perceived to be the most influential (M(SD) = 9(1.07)) and high school friends the least influential (M(SD) = 1.31(.42)) network. Overall, perceived influence was highest for diet compared to physical activity, but varied based on comparisons with nominees' behaviors. Significant others were most often perceived has having similar (44 %) or worse (39 %) eating behaviors than participants, and those with similar eating behaviors were perceived as most influential (M(SD) = 9.25(1.04)). Few associations were seen between network variables and odds of meeting recommendations. Among the groups nominated, high

  5. Perceived influence and college students’ diet and physical activity behaviors: an examination of ego-centric social networks

    Directory of Open Access Journals (Sweden)

    Brook E. Harmon

    2016-06-01

    Full Text Available Abstract Background Obesity is partially a social phenomenon, with college students particularly vulnerable to changes in social networks and obesity-related behaviors. Currently, little is known about the structure of social networks among college students and their potential influence on diet and physical activity behaviors. The purpose of the study was to examine social influences impacting college students’ diet and physical activity behaviors, including sources of influence, comparisons between sources’ and students’ behaviors, and associations with meeting diet and physical activity recommendations. Methods Data was collected from 40 students attending college in Hawaii. Participants completed diet and physical activity questionnaires and a name generator. Participants rated nominees’ influence on their diet and physical activity behaviors as well as compared nominees' behaviors to their own. Descriptive statistics were used to look at perceptions of influence across network groups. Logistic regression models were used to examine associations between network variables and odds of meeting recommendations. Results A total of 325 nominations were made and included: family (n = 116, college friends (n = 104, high school friends (n = 87, and significant others (n = 18. Nearly half of participants were not from Hawaii. Significant others of non-Hawaii students were perceived to be the most influential (M(SD = 9(1.07 and high school friends the least influential (M(SD = 1.31(.42 network. Overall, perceived influence was highest for diet compared to physical activity, but varied based on comparisons with nominees’ behaviors. Significant others were most often perceived has having similar (44 % or worse (39 % eating behaviors than participants, and those with similar eating behaviors were perceived as most influential (M(SD = 9.25(1.04. Few associations were seen between network variables and odds of meeting

  6. Examining the Relationship Between Mental, Physical, and Organizational Factors Associated With Attrition During Maritime Forces Training.

    Science.gov (United States)

    Binsch, Olaf; Banko, Katherine M; Veenstra, Bertil J; Valk, Pierre J L

    2015-11-01

    For infantry units of the Dutch Ministry of Defence, high attrition rates (varying from 42 to 68%) during initial training are a persisting problem. The reasons for this attrition are diverse. Having better insight into the causes of attrition is a prerequisite for implementing preventive measures. To achieve this, a monitoring assessment system was developed that integrated the effects of physical, mental, and organizational determinants on operational readiness. The aim of this study was to implement the monitoring tools and to establish the set of determinants that best predicted attrition during infantry training of new recruits. Eighty-five recruits were monitored over a 24-week infantry training course. Before the training, recruits were screened for medical, psychological, and physical wellness. During the monitoring phase, mental, physiological, and organizational indicants were obtained using an array of tools such as questionnaires, chest belt monitors (for heart rate, acceleration, and skin temperature measurements), and computerized tests (e.g., vigilance, long-term memory). Survival analyses were used to tease out the determinants of individual and grouped predictors of attrition. Nearly half the recruits (47%) failed the training. Attrition was predicted by both physiological and mental determinants. However, the organizational determinant "trainers' judgment" on the "recruits' military quality" dominated the physiological and mental determinants. It was concluded that the monitoring system was successfully implemented during infantry training, and that the survival analysis method emphasized on single effects and interactions between the different determinants. Based on the current findings, we recommend several steps to successfully implement a monitoring method in settings with high demands.

  7. Examining Dark Triad traits in relation to mental toughness and physical activity in young adults

    Directory of Open Access Journals (Sweden)

    Sabouri S

    2016-01-01

    Full Text Available Sarah Sabouri,1 Markus Gerber,2 Dena Sadeghi Bahmani,3 Sakari Lemola,4 Peter J Clough,5 Nadeem Kalak,3 Mahin Shamsi,1 Edith Holsboer-Trachsler,3 Serge Brand2,3 1Faculty of Educational Sciences and Psychology, AllamehTabataba’i University, Tehran, Iran; 2Department of Sport, Exercise and Health, Sport Science Section, University of Basel, 3Center for Affective, Stress and Sleep Disorders, Psychiatric Clinics of the University of Basel, 4Faculty of Psychology, University of Basel, Basel, Switzerland; 5Department of Psychology, Manchester Metropolitan University, Manchester, UK Objective: The Dark Triad (DT describes a set of three closely related personality traits: Machiavellianism, narcissism, and psychopathy. Mental toughness (MT refers to a psychological construct combining confidence, commitment, control, and challenge. High MT is related to greater physical activity (PA and, relative to men, women have lower MT scores. The aims of the present study were 1 to investigate the association between DT, MT, and PA, and 2 to compare the DT, MT, and PA scores of men and women.Methods: A total of 341 adults (M=29 years; 51.6% women; range: 18–37 years took part in the study. Participants completed a series of questionnaires assessing DT, MT, and PA.Results: Machiavellianism, narcissism, and psychopathy were all significantly associated with higher MT scores (rs =0.45, 0.50, and 0.20, respectively. DT traits and MT were associated with more vigorous PA. Compared to men, women participants had lower scores for DT traits (overall score and psychopathy, while no differences were found for MT or PA in both sexes.Conclusion: DT traits, high MT, and vigorous PA are interrelated. This pattern of results might explain why, for instance, successful professional athletes can at the same time be tough and ruthless. Keywords: dark triad, mental toughness, physical activity, young adults, sex

  8. Talking the talk, walking the walk: examining the effect of neighbourhood walkability and social connectedness on physical activity.

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    Kaczynski, Andrew T; Glover, Troy D

    2012-08-01

    Few studies have considered the joint effects of social and physical environments on physical activity (PA). The primary purpose of this study was to examine the compounding effects of neighbourhood walkability and social connectedness on PA. Data were collected from adults (n = 380) in Waterloo, Ontario, Canada. Perceptions of neighbourhood social connectedness and walkability were measured via survey. Minutes of neighbourhood PA for recreation and transportation were captured with a detailed 7-day log booklet. Four groups were created (e.g. high walkability/low social connectedness) and two factorial ANOVAs examined group differences in minutes of recreational and transport-related PA. There were significant differences across the four walkability/social connectedness groups for both recreational (F = 11.36, P walkability and social connectedness displayed the greatest levels of both recreational (130.6 min) and transport-related PA (24.5 min). The high walkability/low social connectedness group had greater transport-related PA than the two low walkability groups, while the high social connectedness/low walkability group had greater recreational PA than the two low social connectedness groups. These findings underscore the relationship between physical and social dimensions of urban form and their association with health behaviours. PA promotion efforts should take into account both physical (e.g. land-use planning) and social (e.g. walking group) environments.

  9. Special physical examination tests for superior labrum anterior posterior shoulder tears are clinically limited and invalid: a diagnostic systematic review.

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    Calvert, Eric; Chambers, Gordon Keith; Regan, William; Hawkins, Robert H; Leith, Jordan M

    2009-05-01

    The diagnosis of a superior labrum anterior posterior (SLAP) lesion through physical examination has been widely reported in the literature. Most of these studies report high sensitivities and specificities, and claim to be accurate, valid, and reliable. The purpose of this study was to critically evaluate these studies to determine if there was sufficient evidence to support the use of the SLAP physical examination tests as valid and reliable diagnostic test procedures. Strict epidemiologic methodology was used to obtain and collate all relevant articles. Sackett's guidelines were applied to all articles. Confidence intervals and likelihood ratios were determined. Fifteen of 29 relevant studies met the criteria for inclusion. Only one article met all of Sackett's critical appraisal criteria. Confidence intervals for both the positive and negative likelihood ratios contained the value 1. The current literature being used as a resource for teaching in medical schools and continuing education lacks the validity necessary to be useful. There are no good physical examination tests that exist for effectively diagnosing a SLAP lesion.

  10. The reach of Spanish-language YouTube videos on physical examinations made by undergraduate medical students

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    José M. Ramos-Rincón

    2017-12-01

    Full Text Available This study was conducted to evaluate the performance and reach of YouTube videos on physical examinations made by Spanish university students. We analyzed performance metrics for 4 videos on physical examinations in Spanish that were created by medical students at Miguel Hernández University (Elche, Spain and are available on YouTube, on the following topics: the head and neck (7:30, the cardiovascular system (7:38, the respiratory system (13:54, and the abdomen (11:10. We used the Analytics application offered by the YouTube platform to analyze the reach of the videos from the upload date (February 17, 2015 to July 28, 2017 (2 years, 5 months, and 11 days. The total number of views, length of watch-time, and the mean view duration for the 4 videos were, respectively: 164,403 views (mean, 41,101 views; range, 12,389 to 94,573 views, 425,888 minutes (mean, 106,472 minutes; range, 37,889 to 172,840 minutes, and 2:56 minutes (range, 1:49 to 4:03 minutes. Mexico was the most frequent playback location, followed by Spain, Colombia, and Venezuela. Uruguay, Ecuador, Mexico, and Puerto Rico had the most views per 100,000 population. Spanish-language tutorials are an alternative tool for teaching physical examination skills to students whose first language is not English. The videos were especially popular in Uruguay, Ecuador, and Mexico.

  11. The reach of Spanish-language YouTube videos on physical examinations made by undergraduate medical students

    Science.gov (United States)

    2017-01-01

    This study was conducted to evaluate the performance and reach of YouTube videos on physical examinations made by Spanish university students. We analyzed performance metrics for 4 videos on physical examinations in Spanish that were created by medical students at Miguel Hernández University (Elche, Spain) and are available on YouTube, on the following topics: the head and neck (7:30), the cardiovascular system (7:38), the respiratory system (13:54), and the abdomen (11:10). We used the Analytics application offered by the YouTube platform to analyze the reach of the videos from the upload date (February 17, 2015) to July 28, 2017 (2 years, 5 months, and 11 days). The total number of views, length of watch-time, and the mean view duration for the 4 videos were, respectively: 164,403 views (mean, 41,101 views; range, 12,389 to 94,573 views), 425,888 minutes (mean, 106,472 minutes; range, 37,889 to 172,840 minutes), and 2:56 minutes (range, 1:49 to 4:03 minutes). Mexico was the most frequent playback location, followed by Spain, Colombia, and Venezuela. Uruguay, Ecuador, Mexico, and Puerto Rico had the most views per 100,000 population. Spanish-language tutorials are an alternative tool for teaching physical examination skills to students whose first language is not English. The videos were especially popular in Uruguay, Ecuador, and Mexico. PMID:29278903

  12. The reach of Spanish-language YouTube videos on physical examinations made by undergraduate medical students.

    Science.gov (United States)

    Ramos-Rincón, José M; Belinchón-Romero, Isabel; Sánchez-Ferrer, Francisco; Torre, Guillermo Martínez-de la; Harris, Meggan; Sánchez-Fernández, Javier

    2017-01-01

    This study was conducted to evaluate the performance and reach of YouTube videos on physical examinations made by Spanish university students. We analyzed performance metrics for 4 videos on physical examinations in Spanish that were created by medical students at Miguel Hernández University (Elche, Spain) and are available on YouTube, on the following topics: the head and neck (7:30), the cardiovascular system (7:38), the respiratory system (13:54), and the abdomen (11:10). We used the Analytics application offered by the YouTube platform to analyze the reach of the videos from the upload date (February 17, 2015) to July 28, 2017 (2 years, 5 months, and 11 days). The total number of views, length of watch-time, and the mean view duration for the 4 videos were, respectively: 164,403 views (mean, 41,101 views; range, 12,389 to 94,573 views), 425,888 minutes (mean, 106,472 minutes; range, 37,889 to 172,840 minutes), and 2:56 minutes (range, 1:49 to 4:03 minutes). Mexico was the most frequent playback location, followed by Spain, Colombia, and Venezuela. Uruguay, Ecuador, Mexico, and Puerto Rico had the most views per 100,000 population. Spanish-language tutorials are an alternative tool for teaching physical examination skills to students whose first language is not English. The videos were especially popular in Uruguay, Ecuador, and Mexico.

  13. Additional prognostic value of physical examination, exercise testing, and arterial ultrasonography for coronary risk assessment in primary prevention.

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    Cournot, Maxime; Taraszkiewicz, Dorota; Cambou, Jean-Pierre; Galinier, Michel; Boccalon, Henri; Hanaire-Broutin, Hélène; Chamontin, Bernard; Carrié, Didier; Ferrières, Jean

    2009-11-01

    The choice of noninvasive tests used in primary prevention of cardiovascular diseases must be based on medical evidence. The aim of this study was to assess the additional prognostic value, over conventional risk factors, of physical examination, exercise testing, and arterial ultrasonography, in predicting a first coronary event. A prospective cohort study was conducted between 1996 and 2004 (n = 2,709), with follow-up in 2006 (response rate 96.6%). Participants had no history or symptoms of cardiovascular disease and had a standardized physical examination, a cardiac exercise testing, and carotid and femoral ultrasonography at baseline. Incident cases of definite coronary events were recorded during follow-up. Over the Framingham risk score, femoral bruit, positive exercise test, intima-media thickness >0.63 mm, and a femoral plaque provided significant additional information to the prediction model. The addition of the exercise test to the traditional risk factors, then the intima-media thickness and lastly the presence of femoral plaques, produces incremental increases in the area under the receiver operating characteristic curve (0.73-0.78, P = .02) and about a 50% increase in the positive predictive value (15.8%-31.4%), with no effect on the negative predictive value (96.4%-96.9%). Physical examination, exercise testing, and arterial ultrasonography provide incremental information on the risk of coronary event in asymptomatic adults. Exercise testing and femoral ultrasonography also improve the accuracy of the risk stratification.

  14. Examining individual, interpersonal, and environmental influences on children’s physical activity levels

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    Piotr Wilk

    2018-04-01

    Full Text Available The purpose of this study was to explore individual-level socio-demographic factors and interpersonal-level factors related to social support, as well as the potential role of neighborhood and school environments that may influence the physical activity (PA levels of children (ages 9–11. Child and parent questionnaires included individual and interpersonal factors, and PA behaviour. Home postal codes were used to determine the neighbourhood the child resides within, as well as their geographic accessibility to recreation opportunities. The models were assessed using a series of cross-classified random-intercept multi-level regression models as children’s PA may be affected by both the school they attend and the neighbourhood in which they live. In the unadjusted model, PA varied significantly across school environments (γ = 0.023; CI: 0.003–0.043, but not across neighbourhoods (γ = 0.007; CI: -0.008 to 0.021. Boys were found to be more active compared to girls (b = 0.183; CI: 0.092–0.275, while the level of PA was lower for children whose fathers achieved post-secondary education (b = - 0.197; CI: -0.376 to 0.018 than for those whose parents completed only high school. The addition of the individual-level correlates did not have a substantial effect on level 2 variances and the level 2 variance associated with school environment remained statistically significant. At the interpersonal level, children’s perception of parental support (b = 0.117; CI: 0.091–0.143 and peer support (b = 0.111; CI: 0.079–0.142 were positively related to PA. The level 2 variance for the school environment became statistically non-significant when the interpersonal factors were added to the model. At the environmental level, geographic accessibility did not have a significant association with PA and they did not significantly affect level 1 or 2 variance. As many children do not accrue sufficient levels of PA, identifying modifiable determinants is

  15. Which physical examination tests provide clinicians with the most value when examining the shoulder? Update of a systematic review with meta-analysis of individual tests.

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    Hegedus, Eric J; Goode, Adam P; Cook, Chad E; Michener, Lori; Myer, Cortney A; Myer, Daniel M; Wright, Alexis A

    2012-11-01

    To update our previously published systematic review and meta-analysis by subjecting the literature on shoulder physical examination (ShPE) to careful analysis in order to determine each tests clinical utility. This review is an update of previous work, therefore the terms in the Medline and CINAHL search strategies remained the same with the exception that the search was confined to the dates November, 2006 through to February, 2012. The previous study dates were 1966 - October, 2006. Further, the original search was expanded, without date restrictions, to include two new databases: EMBASE and the Cochrane Library. The Quality Assessment of Diagnostic Accuracy Studies, version 2 (QUADAS 2) tool was used to critique the quality of each new paper. Where appropriate, data from the prior review and this review were combined to perform meta-analysis using the updated hierarchical summary receiver operating characteristic and bivariate models. Since the publication of the 2008 review, 32 additional studies were identified and critiqued. For subacromial impingement, the meta-analysis revealed that the pooled sensitivity and specificity for the Neer test was 72% and 60%, respectively, for the Hawkins-Kennedy test was 79% and 59%, respectively, and for the painful arc was 53% and 76%, respectively. Also from the meta-analysis, regarding superior labral anterior to posterior (SLAP) tears, the test with the best sensitivity (52%) was the relocation test; the test with the best specificity (95%) was Yergason's test; and the test with the best positive likelihood ratio (2.81) was the compression-rotation test. Regarding new (to this series of reviews) ShPE tests, where meta-analysis was not possible because of lack of sufficient studies or heterogeneity between studies, there are some individual tests that warrant further investigation. A highly specific test (specificity >80%, LR+ ≥ 5.0) from a low bias study is the passive distraction test for a SLAP lesion. This test may

  16. Screening of the pelvic organ prolapse without a physical examination; (a community based study

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    Tehrani Fahimeh

    2011-11-01

    Full Text Available Abstract Background Pelvic organ prolapse (POP is a silent disorder with a huge impact on women's quality of life. There is limited data from community-based studies conducted to determine the prevalence of POP as its assessment needs a pelvic examination. We aimed to develop a simple screening inventory for identification of pelvic organ prolapse and then evaluate its sensitivity and specificity. Methods This study had two phases. In the first phase in order to develop a simple inventory for assessment of POP, the Pelvic Floor Disorder Inventory (PFDI was completed for a convenience sample of 200 women, aged 18-45 years, referred for annual gynecologic examination, and their pelvic organ prolapse was assessed using the standard protocol. The most sensitive and specific questions were selected as pelvic organ prolapse simple screening inventory (POPSSI. In the second phase, using a stratified multistage probability cluster sampling method, the sensitivity and specificity of the POPSSI was investigated in a non selected sample of 954 women recruited from among reproductive aged women living in four randomly selected provinces of Iran. Results The sensitivity and specificity of POPSSI for identification of pelvic organ prolapse in the general population were 45.5 and 87.4% respectively; these values were 96.7 and 20% among those women who were aware of their pelvic dysfunction. Conclusion Community based screening studies on pelvic organ prolapse could be facilitated by using the POPSSI, the sensitivity of which would be enhanced through conducting of public awareness programs.

  17. What's Your "Street Race"? Leveraging Multidimensional Measures of Race and Intersectionality for Examining Physical and Mental Health Status Among Latinxs.

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    López, Nancy; Vargas, Edward D; Juarez, Melina; Cacari-Stone, Lisa; Bettez, Sonia

    2018-01-01

    Using the 2015 Latino National Health and Immigration Survey (N= 1,197) we examine the relationship between physical and mental health status and three multidimensional measures of race: 1) "street race," or how you believe other "Americans" perceive your race at the level of the street; 2) socially assigned race or what we call "ascribed race," which refers to how you believe others usually classify your race in the U.S.; and 3) "self-perceived race," or how you usually self-classify your race on questionnaires. We engage in intersectional inquiry by combining street race and gender. We find that only self-perceived race correlates with physical health and that street race is associated with mental health. We also find that men reporting their street race as Latinx 1 or Arab were associated with higher odds of reporting worse mental health outcomes. One surprising finding was that, for physical health, men reporting their street race as Latinx were associated with higher odds of reporting optimal physical health. Among women, those reporting their street race as Mexican were associated with lower odds of reporting optimal physical health when compared to all other women; for mental health status, however, we found no differences among women. We argue that "street race" is a promising multidimensional measure of race for exploring inequality among Latinxs.

  18. A Pilot Examination of a Mosque-Based Physical Activity Intervention for South Asian Muslim Women in Ontario, Canada.

    Science.gov (United States)

    Banerjee, Ananya Tina; Landry, Mireille; Zawi, Maha; Childerhose, Debbie; Stephens, Neil; Shafique, Ammara; Price, Jennifer

    2017-04-01

    Low levels of physical activity have been reported in South Asian Muslim women. Mosques could be beneficial in providing physical activity opportunities for Muslim women. This study examined the feasibility, acceptability and effectiveness of a mosque-based physical activity program for South Asian Muslim women in Canada. Sixty-two South Asian Muslim women participated in a 24-week mosque-based exercise intervention. Feasibility, acceptability and effectiveness of the program was evaluated by pre-post survey questions from the Duke Activity Status Index (DASI) and International Physical Activity Questionnaire among 28 women who consented to the research data collection. Nineteen women were assessed pre-and post-intervention. The women demonstrated increase in median scores of self-efficacy (90 pre vs. 100 post; p = 0.004) and the importance of engaging in regular physical activity (90 pre vs. 100 post; p = 0.01). Fewer participants were classified as inactive at the end of the intervention (42 % pre vs. 10 % post; p = 0.006). There was a mean increase in DASI scores (39.2 pre vs. 44.6 post; p = 0.06) reflecting an improvement in peak aerobic capacity and functional quality of life. Culturally relevant structured networks such as mosques are important assets when designing healthy lifestyle interventions for South Asian Muslim women.

  19. Participation in Types of Physical Activities Among US Adults--National Health and Nutrition Examination Survey 1999-2006.

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    Dai, Shifan; Carroll, Dianna D; Watson, Kathleen B; Paul, Prabasaj; Carlson, Susan A; Fulton, Janet E

    2015-06-01

    Information on specific types of physical activities in which US adults participate is important for community and program development to promote physical activity. Prevalence of participation and average time spent for 33 leisure-time aerobic activities and 10 activity categories were calculated using self-reported data from 22,545 participants aged ≥ 18 years in the National Health and Nutrition Examination Survey 1999-2006. Overall, 38% of US adults reported no leisure-time physical activities, and 43% reported 1 or 2 activities in the past 30 days. Walking was the most frequently reported activity for both men (29%) and women (38%). Among walkers, the average time spent walking was 198 minutes/week for men and 152 minutes/week for women. The most reported activities for men after walking were bicycling and yard work, and for women were aerobics and dance. For most activity categories, participation was lower among adults aged ≥ 65 years than among younger adults, and among Mexican Americans and non-Hispanic blacks than among non-Hispanic whites. Participation in most categories increased with increasing educational attainment. Participation in physical activity differs by types of activities and demographic characteristics. Physical activity promotion programs should take these differences into account when developing intervention strategies.

  20. Examining Dark Triad traits in relation to mental toughness and physical activity in young adults.

    Science.gov (United States)

    Sabouri, Sarah; Gerber, Markus; Sadeghi Bahmani, Dena; Lemola, Sakari; Clough, Peter J; Kalak, Nadeem; Shamsi, Mahin; Holsboer-Trachsler, Edith; Brand, Serge

    2016-01-01

    The Dark Triad (DT) describes a set of three closely related personality traits: Machiavellianism, narcissism, and psychopathy. Mental toughness (MT) refers to a psychological construct combining confidence, commitment, control, and challenge. High MT is related to greater physical activity (PA) and, relative to men, women have lower MT scores. The aims of the present study were 1) to investigate the association between DT, MT, and PA, and 2) to compare the DT, MT, and PA scores of men and women. A total of 341 adults (M=29 years; 51.6% women; range: 18-37 years) took part in the study. Participants completed a series of questionnaires assessing DT, MT, and PA. Machiavellianism, narcissism, and psychopathy were all significantly associated with higher MT scores (rs =0.45, 0.50, and 0.20, respectively). DT traits and MT were associated with more vigorous PA. Compared to men, women participants had lower scores for DT traits (overall score and psychopathy), while no differences were found for MT or PA in both sexes. DT traits, high MT, and vigorous PA are interrelated. This pattern of results might explain why, for instance, successful professional athletes can at the same time be tough and ruthless.

  1. A comparison of physical examinations with musculoskeletal ultrasound in the diagnosis of biceps long head tendinitis.

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    Chen, Hung-Sheng; Lin, Shu-Hsien; Hsu, Yen-Hsia; Chen, Shih-Ching; Kang, Jiunn-Horng

    2011-09-01

    Provocative tests are useful in diagnosing biceps tendon tendinitis. This is the first study to establish the reliability of these tests by comparing the resuts with musculoskeletal ultrasound (US) findings. This study examined 125 patients (69 women and 56 men) and 143 shoulders with shoulder pain. Yergason's test, Speed's test and a bicipital groove tenderness test were performed and musculoskeletal US findings were used as standard reference. Biceps tendon tendinitis was diagnosed with US in 39.1% of the patients and, of those, 55.3% had coexisting rotator cuff injury. The sensitivity and specificity of Yergason's test were 32% and 78%, respectively. The sensitivity and specificity of Speed's test were 63% and 58%, respectively. In conclusion, all three tests are limited by poor sensitivity. US can be an image modality choice in diagnosing biceps pathology. Copyright © 2011 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  2. Physical activity after commitment lotteries: examining long-term results in a cluster randomized trial.

    Science.gov (United States)

    van der Swaluw, Koen; Lambooij, Mattijs S; Mathijssen, Jolanda J P; Schipper, Maarten; Zeelenberg, Marcel; Berkhout, Stef; Polder, Johan J; Prast, Henriëtte M

    2018-02-26

    To overcome self-control difficulties, people can commit to their health goals by voluntarily accepting deadlines with consequences. In a commitment lottery, the winners are drawn from all participants, but can only claim their prize if they also attained their gym-attendance goals. In a 52-week, three-arm trial across six company gyms, we tested if commitment lotteries with behavioral economic underpinnings would promote physical activity among overweight adults. In previous work, we presented an effective 26-week intervention. In the present paper we analyzed maintenance of goal attainment at 52-week follow-up and the development of weight over time. We compared weight and goal attainment (gym attendance ≥ 2 per week) between three arms that-in the intervention period- consisted of (I) weekly short-term lotteries for 13 weeks; (II) the same short-term lotteries in combination with an additional long-term lottery after 26 weeks; and (III) a control arm without lottery-deadlines. After a successful 26-week intervention, goal attainment declined between weeks 27 and 52 in the long-term lottery arm, but remained higher than in the control group. Goal attainment did not differ between the short-term lottery arm and control arm. Weight declined slightly in all arms in the first 13 weeks of the trial and remained stable from there on. Commitment lotteries can support regular gym attendance up to 52 weeks, but more research is needed to achieve higher levels of maintenance and weight loss.

  3. Diagnostic accuracy of physical examination for anterior knee instability: a systematic review.

    Science.gov (United States)

    Leblanc, Marie-Claude; Kowalczuk, Marcin; Andruszkiewicz, Nicole; Simunovic, Nicole; Farrokhyar, Forough; Turnbull, Travis Lee; Debski, Richard E; Ayeni, Olufemi R

    2015-10-01

    Determining diagnostic accuracy of Lachman, pivot shift and anterior drawer tests versus gold standard diagnosis (magnetic resonance imaging or arthroscopy) for anterior cruciate ligament (ACL) insufficiency cases. Secondarily, evaluating effects of: chronicity, partial rupture, awake versus anaesthetized evaluation. Searching MEDLINE, EMBASE and PubMed identified studies on diagnostic accuracy for ACL insufficiency. Studies identification and data extraction were performed in duplicate. Quality assessment used QUADAS tool, and statistical analyses were completed for pooled sensitivity and specificity. Eight studies were included. Given insufficient data, pooled analysis was only possible for sensitivity on Lachman and pivot shift test. During awake evaluation, sensitivity for the Lachman test was 89 % (95 % CI 0.76, 0.98) for all rupture types, 96 % (95 % CI 0.90, 1.00) for complete ruptures and 68 % (95 % CI 0.25, 0.98) for partial ruptures. For pivot shift in awake evaluation, results were 79 % (95 % CI 0.63, 0.91) for all rupture types, 86 % (95 % CI 0.68, 0.99) for complete ruptures and 67 % (95 % CI 0.47, 0.83) for partial ruptures. Decreased sensitivity of Lachman and pivot shift tests for partial rupture cases and for awake patients raised suspicions regarding the accuracy of these tests for diagnosis of ACL insufficiency. This may lead to further research aiming to improve the understanding of the true accuracy of these physical diagnostic tests and increase the reliability of clinical investigation for this pathology. IV.

  4. A systematic review of the diagnostic performance of orthopedic physical examination tests of the hip.

    Science.gov (United States)

    Rahman, Labib Ataur; Adie, Sam; Naylor, Justine Maree; Mittal, Rajat; So, Sarah; Harris, Ian Andrew

    2013-08-30

    Previous reviews of the diagnostic performances of physical tests of the hip in orthopedics have drawn limited conclusions because of the low to moderate quality of primary studies published in the literature. This systematic review aims to build on these reviews by assessing a broad range of hip pathologies, and employing a more selective approach to the inclusion of studies in order to accurately gauge diagnostic performance for the purposes of making recommendations for clinical practice and future research. It specifically identifies tests which demonstrate strong and moderate diagnostic performance. A systematic search of Medline, Embase, Embase Classic and CINAHL was conducted to identify studies of hip tests. Our selection criteria included an analysis of internal and external validity. We reported diagnostic performance in terms of sensitivity, specificity, predictive values and likelihood ratios. Likelihood ratios were used to identify tests with strong and moderate diagnostic utility. Only a small proportion of tests reported in the literature have been assessed in methodologically valid primary studies. 16 studies were included in our review, producing 56 independent test-pathology combinations. Two tests demonstrated strong clinical utility, the patellar-pubic percussion test for excluding radiologically occult hip fractures (negative LR 0.05, 95% Confidence Interval [CI] 0.03-0.08) and the hip abduction sign for diagnosing sarcoglycanopathies in patients with known muscular dystrophies (positive LR 34.29, 95% CI 10.97-122.30). Fifteen tests demonstrated moderate diagnostic utility for diagnosing and/or excluding hip fractures, symptomatic osteoarthritis and loosening of components post-total hip arthroplasty. We have identified a number of tests demonstrating strong and moderate diagnostic performance. These findings must be viewed with caution as there are concerns over the methodological quality of the primary studies from which we have extracted our

  5. An examination of compensation effects in accelerometer-measured occupational and non-occupational physical activity

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    Jennifer L. Gay

    2017-12-01

    Full Text Available Self-report data suggests a large proportion of total physical activity (PA occurs at work. However, adults with higher levels of occupational PA may compensate by engaging in less non-occupational PA. The study aims were to 1 estimate the intensity, volume, and duration of PA in American adults that occurs at work, and 2 determine if those more active at work are less active outside of work. A cross-sectional sample of full-time employed adults (N=510 was recruited from Georgia city and county governments in 2013–2015. Participants wore an Actigraph GT3X+ accelerometer for two weeks. In 2016, for 442 participants with complete data including work schedules and self-reported job titles, accelerometer wear minutes were classified as either occupational or non-occupational, and as sedentary, LPA (light-intensity PA, or MVPA (moderate-to-vigorous intensity PA. The proportion of daily PA that occurred during work was 41.2% for total PA, 41.0% for LPA, and 39.5% for MVPA. Higher levels of occupational LPA were associated with lower levels of non-occupational LPA (r=−0.38, P<0.0001. However, higher levels of occupational MVPA were associated with higher levels of non-occupational MVPA (r=0.17, P<0.0001. These associations remained significant in a MANOVA adjusting for labor sector and other covariates. On average, employed adults get more LPA and MVPA outside of work. Adults who do more occupational MVPA do not compensate by doing less non-occupational MVPA. In contrast, adults who do more occupational LPA do compensate by doing less non-occupational LPA. Evaluations of interventions to reduce sedentary behavior should be designed to detect compensation effects. Keywords: Intensity, Work, Accelerometer

  6. Evaluating the effect of physical examination training on the competency of medical students

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    Hasanzadeh Salmasi, S

    2004-10-01

    Full Text Available Background: The skill to perform physical exam (ph/ex is a vital aspect of clinical skills needed by physicians. In traditional curricula of medical schools little attention is paid to students' practical skills and more emphasis is put on the cognitive domain of learning. Purpose: To study the effect of training clinical skills as a part of reformed curricula on the medical students' practical competence. Methods: In this cross sectional study of 150 medical students who had started their externship after passing the clinical skill course, 50 were randomly selected. A self-assessment questionnaire with Likerts’ scale type items was distributed among the students .Data was analyzed by SPSS and measures of central value and dispersion were utilized for discussion. Results: The mean for standardized score for the effect of training in the clinical skill course (CSC on gaining the skill of ph/ex was 51.51(± 23.13 with a median of 50.69, and a range of 83.33-29.17. The value of 25th percentile for the score was 41.66 and the 75th percentile was 58.68. Conclusion: Integrating the training in CSC with the current curricula in medical schools, will provide the students the opportunity to perform the ph/ex completely and gain an acceptable and high quality professional function which will end in improving the patient satisfaction and reducing the costs of health and treatment services for the individuals, the families and the community. Keywords: CLINICAL SKILL, TEACHING PROCEDURE

  7. Examining physical activity service provision to culturally and linguistically diverse (CALD communities in Australia: a qualitative evaluation.

    Directory of Open Access Journals (Sweden)

    Cristina M Caperchione

    Full Text Available Strong evidence exists for the role of physical activity in preventing and managing a range of chronic health conditions. A particular challenge in promoting physical activity as a health strategy exists in culturally and linguistically diverse (CALD groups, as such groups demonstrate high risk for a range of non-communicable diseases. The aim of this research was to examine the perspective of multicultural health service providers for CALD groups with respect to the physical activity services/initiatives on offer, access barriers to these services, and ideas for future service delivery in this area. Semi-structured interviews were conducted with 15 multicultural health service providers across the capital cities of the three most populous states in Australia (New South Wales, Queensland, and Victoria, and thematic content analysis was used to examine the data. Findings indicated that the majority of physical activity initiatives were associated with organizations offering other social services for CALD communities but were greatly restrained by resources. As well, it was found that most services were not designed by taking into account specific cultural requirements for CALD communities or their cultural expectations. Common barriers identified to service uptake were classified as socio-cultural (e.g., gender, language, context of health and environmental (e.g., transportation in nature. These findings should be utilized when planning future physical activity and health promotion initiatives for increasing CALD participation. In particular, programs need to be culturally tailored to the specific expectations of CALD groups, addressing cultural safety and sensitivity, and should be in partnership with other organizations to extend the reach and capacity.

  8. Accuracy of physical examination in the diagnosis of hypothyroidism: a cross-sectional, double-blind study

    Directory of Open Access Journals (Sweden)

    Indra R

    2004-01-01

    Full Text Available Background: Hypothyroidism is a common, potentially treatable endocrine disorder. Since hypothyroidism is not always associated with the signs and symptoms typically attributed to it, the diagnosis is often missed. Conversely, patients with typical signs and symptoms may not have the disease when laboratory tests are performed. Aims: We aimed to determine the accuracy of physical examination in the diagnosis of hypothyroidism. Setting and design: Prospective, hospital-based, cross-sectional diagnostic study. Material and Methods: Consecutive outpatients from the medicine department were screened and an independent comparison of physical signs (coarse skin, puffy face, slow movements, bradycardia, pretibial oedema and ankle reflex against thyroid hormone assay (TSH and FT4 was performed. Statistical analysis: Diagnostic accuracy was measured as sensitivity, specificity, positive likelihood ratios, negative likelihood ratios and positive and negative predictive values. Results: Of the 1450 patients screened, 130 patients (102 women and 28 men underwent both clinical examination and thyroid function tests. Twenty-three patients (18% were diagnosed to have hypothyroidism by thyroid hormone assays. No single sign could easily discriminate a euthyroid from a hypothyroid patient (range of positive likelihood ratio (LR+ 1.0 to 3.88; range of negative likelihood ratio (LR-: 0.42 to 1.0. No physical sign generated a likelihood ratio large enough to increase the post-test probability significantly. The combination of signs that had the highest likelihood ratios (coarse skin, bradycardia and delayed ankle reflex was associated with modest accuracy (LR+ 3.75; LR- 0.48. Conclusion: Clinicians cannot rely exclusively on physical examination to confirm or rule out hypothyroidism. Patients with suspected hypothyroidism require a diagnostic workup that includes thyroid hormone assays.

  9. The relationship between physical activity level and completion rate of small bowel examination in patients undergoing capsule endoscopy.

    Science.gov (United States)

    Shibuya, Tomoyoshi; Mori, Hiroki; Takeda, Tsutomu; Konishi, Masae; Fukuo, Yuka; Matsumoto, Kenshi; Beppu, Kazuko; Sakamoto, Naoto; Osada, Taro; Nagahara, Akihito; Otaka, Michiro; Ogihara, Tatsuo; Watanabe, Sumio

    2012-01-01

    Capsule endoscopy (CE) allows direct examination of the small bowel in a safe, noninvasive and well-tolerated manner. Nonetheless, experience indicates failure to reach the cecum in 20-30% of patients within the 8 hour battery life. Attempts to improve the completion rate (CR) as defined by reaching the cecum have been unsuccessful. This study was to investigate the relationship between patients' physical activity and CR. Between January 2009 and January 2010, 76 patients (44 men, 32 women; median age 64.5 yr) underwent CE for the diagnosis of small intestinal disorders. Indications for CE were obscure gastrointestinal bleeding/anemia (62 cases), others (14 cases). Patients were divided into an outpatient group (n=23), mild bed rest group (n=35) and strict bed rest group (n=18). For all patients, the average gastric transit time was 65.5 minutes, small bowel transit time was 301.4 minutes and the CR was 86.8%. However, the CR was 100% (23/23) in the outpatient group, an 85.7% (30/35) in the mild bed rest group, and 72.2% (13/18) in the strict bed rest group. The CR increased with physical activity of patients by Cochran-Armitage Trend Test (p=0.009). In multivariate logistic regression analyses, low physical activity was a significant risk factor for failure to reach the cecum during CE examination; adjusted OR: 3.39, 95% CI: 1.01-11.42 (p=0.048). Our observations suggested that increasing physical activity would increase the likelihood of a complete bowel examination by CE. Further, for CE, inconvenient bowel preparations like the use of polyethylene glycol may be avoided.

  10. Self-detection and clinical breast examination: comparison of the two "classical" physical examination methods for the diagnosis of breast cancer.

    Science.gov (United States)

    Schwab, Fabienne Dominique; Huang, Dorothy Jane; Schmid, Seraina Margaretha; Schötzau, Andreas; Güth, Uwe

    2015-02-01

    This is the first comprehensive analysis comparing specific aspects of tumor detection between the two "traditional" breast cancer detection methods self-detection (SD) and clinical breast examination (CBE). a) Which method is better in detecting smaller tumors? Both methods showed similar mean tumor diameters (SD: 22.1 mm vs. CBE: 21.9 mm; p = 0.991). b) Different frequency distributions of tumor locations would indicate that certain locations in the breast are more difficult to palpate: comparison of both methods showed comparable results (p = 0.835). c) General differences in tumor sizes with regard to certain locations would be of importance because the patients and/or the physicians could be educated to pay particular attention to certain locations during physical examination, where larger tumors tend to be found: tumors located in the central region were with 25.0 mm significantly larger than those in the peripheral regions of the breast (superior: 21.6 mm, p = 0.001; inferior: 21.6 mm, p = 0.015; lateral: 21.9 mm, p = 0.002; medial (20.9 mm, p = 0.001). Tumor sizes within the four peripheral regions did not differ significantly. d) Patients whose tumors were found by CBE were older than those whose tumors were found by SD (67 years vs. 60 years, p < 0.001). annual CBE should be an integral part of general medical care in older women. Copyright © 2014 Elsevier Ltd. All rights reserved.

  11. Examining individual, interpersonal, and environmental influences on children's physical activity levels.

    Science.gov (United States)

    Wilk, Piotr; Clark, Andrew F; Maltby, Alana; Smith, Christine; Tucker, Patricia; Gilliland, Jason A

    2018-04-01

    The purpose of this study was to explore individual-level socio-demographic factors and interpersonal-level factors related to social support, as well as the potential role of neighborhood and school environments that may influence the physical activity (PA) levels of children (ages 9-11). Child and parent questionnaires included individual and interpersonal factors, and PA behaviour. Home postal codes were used to determine the neighbourhood the child resides within, as well as their geographic accessibility to recreation opportunities. The models were assessed using a series of cross-classified random-intercept multi-level regression models as children's PA may be affected by both the school they attend and the neighbourhood in which they live. In the unadjusted model, PA varied significantly across school environments (γ = 0.023; CI: 0.003-0.043), but not across neighbourhoods (γ = 0.007; CI: -0.008 to 0.021). Boys were found to be more active compared to girls (b = 0.183; CI: 0.092-0.275), while the level of PA was lower for children whose fathers achieved post-secondary education (b = - 0.197; CI: -0.376 to 0.018) than for those whose parents completed only high school. The addition of the individual-level correlates did not have a substantial effect on level 2 variances and the level 2 variance associated with school environment remained statistically significant. At the interpersonal level, children's perception of parental support (b = 0.117; CI: 0.091-0.143) and peer support (b = 0.111; CI: 0.079-0.142) were positively related to PA. The level 2 variance for the school environment became statistically non-significant when the interpersonal factors were added to the model. At the environmental level, geographic accessibility did not have a significant association with PA and they did not significantly affect level 1 or 2 variance. As many children do not accrue sufficient levels of PA, identifying modifiable determinants is necessary to develop effective

  12. A suggested model for physical examination and conservative treatment of athletic pubalgia.

    Science.gov (United States)

    Hegedus, Eric J; Stern, Ben; Reiman, Michael P; Tarara, Dan; Wright, Alexis A

    2013-02-01

    Athletic pubalgia (AP) is a chronic debilitating syndrome that affects many athletes. As a syndrome, AP is difficult to diagnose both with clinical examination and imaging. AP is also a challenge for conservative intervention with randomized controlled trials showing mixed success rates. In other syndromes where clinical diagnosis and conservative treatment have been less than clear, a paradigm has been suggested as a framework for clinical decision making. To propose a new clinical diagnostic and treatment paradigm for the conservative management of AP. Relevant studies were viewed with regard to diagnosis and intervention and where a gap in evidence existed, clinical expertise was used to fill that gap and duly noted. A new paradigm is proposed to assist with clinical diagnosis and non-surgical intervention in patients suffering with AP. The level of evidence supporting this paradigm, according to the SORT taxonomy, is primarily level 2B. Further testing is warranted but following the suggested paradigm should lead to a clearer diagnosis of AP and allow more meaningful research into homogeneous patient populations within the AP diagnostic cluster. Strength-of-Recommendation Taxonomy (SORT): 2B. Copyright © 2012 Elsevier Ltd. All rights reserved.

  13. Clinical diagnosis of partial or complete anterior cruciate ligament tears using patients' history elements and physical examination tests

    Science.gov (United States)

    Fallaha, Michel; Belzile, Sylvain; Martel-Pelletier, Johanne; Pelletier, Jean-Pierre; Feldman, Debbie; Sylvestre, Marie-Pierre; Vendittoli, Pascal-André; Desmeules, François

    2018-01-01

    Objective To assess the diagnostic validity of clusters combining history elements and physical examination tests to diagnose partial or complete anterior cruciate ligament (ACL) tears. Design Prospective diagnostic study. Settings Orthopaedic clinics (n = 2), family medicine clinics (n = 2) and community-dwelling. Participants Consecutive patients with a knee complaint (n = 279) and consulting one of the participating orthopaedic surgeons (n = 3) or sport medicine physicians (n = 2). Interventions Not applicable. Main outcome measures History elements and physical examination tests performed independently were compared to the reference standard: an expert physicians’ composite diagnosis including history elements, physical tests and confirmatory magnetic resonance imaging. Penalized logistic regression (LASSO) was used to identify history elements and physical examination tests associated with the diagnosis of ACL tear and recursive partitioning was used to develop diagnostic clusters. Diagnostic accuracy measures including sensitivity (Se), specificity (Sp), predictive values and positive and negative likelihood ratios (LR+/-) with associated 95% confidence intervals (CI) were calculated. Results Forty-three individuals received a diagnosis of partial or complete ACL tear (15.4% of total cohort). The Lachman test alone was able to diagnose partial or complete ACL tears (LR+: 38.4; 95%CI: 16.0–92.5). Combining a history of trauma during a pivot with a “popping” sensation also reached a high diagnostic validity for partial or complete tears (LR+: 9.8; 95%CI: 5.6–17.3). Combining a history of trauma during a pivot, immediate effusion after trauma and a positive Lachman test was able to identify individuals with a complete ACL tear (LR+: 17.5; 95%CI: 9.8–31.5). Finally, combining a negative history of pivot or a negative popping sensation during trauma with a negative Lachman or pivot shift test was able to exclude both partial or complete ACL tears (LR

  14. Physical strength is associated with Mini-Mental State Examination scores in Spanish institutionalized elderly.

    Science.gov (United States)

    Pedrero-Chamizo, Raquel; Albers, Ulrike; Tobaruela, José L; Meléndez, Agustín; Castillo, Manuel J; González-Gross, Marcela

    2013-10-01

    The present cross-sectional study aimed at assessing muscle strength of hands, the dominant arm and legs in Spanish institutionalized elderly people according to sex, age and cognitive status. A total of 153 elderly subjects (102 females, 51 males, mean age 83.6 ± 6.8 years) living in the region of Madrid were measured for handgrip strength (kg) with a Takei TKK 5101 digital dynamometer (range 5-100 kg, precision 0.1 kg), and arm and leg endurance strength (repetitions) according to the Rikli and Jones tests. Cognitive status was determined with the Mini-Mental State Examination (MMSE). The values for men and women were, respectively: 23.5 ± 7.3 kg and 11.6 ± 4.6 kg (right handgrip), 22.0 ± 7.8 kg and 10.7 ± 4.8 kg (left handgrip), 13 ± 5 and 10 ± 5 repetitions (arm strength), 8 ± 5 and 5 ± 4 repetitions (legs strength), and 21 ± 6 and 17 ± 7 (MMSE score). All parameters were significantly higher for men (P ≤ 0.01), but strength decline with age was less pronounced in women. In all MMSE groups, lower strength was associated with lower cognitive status. Strength values were lower in older subjects in both sexes; this difference was higher in men than in women. Higher strength values were associated with better cognitive status, which was the most influencing variable, even more than sex and age. © 2013 Japan Geriatrics Society.

  15. Physical activity patterns and socioeconomic position: the German National Health Interview and Examination Survey 1998 (GNHIES98).

    Science.gov (United States)

    Finger, Jonas D; Tylleskär, Thorkild; Lampert, Thomas; Mensink, Gert B M

    2012-12-15

    We investigated the associations between education and leisure-time, occupational, sedentary and total physical-activity levels based on data from the German National Health Interview and Examination Survey 1998 (GNHIES98). The roles of income level, occupational status and other mediating variables for these associations were also examined. The total study sample of the GNHIES98 comprised 7,124 participants between the ages of 18 and 79. Complete information was available for 6,800 persons on leisure-time, sedentary and total physical-activity outcomes and for 3,809 persons in regular employment on occupational activity outcomes. The associations between educational level and physical activity (occupational, sedentary, leisure-time and total physical activity) were analysed separately for men and women using multivariate logistic regression analysis. Odds ratios (OR) of educational level on physical-activity outcomes were calculated and adjusted for age, region, occupation, income and other mediating variables. After adjusting for age and region, a higher education level was associated with more leisure-time activity - with an OR of 1.6 (95% CI, 1.3-2.0) for men with secondary education and 2.1 (1.7-2.7) for men with tertiary education compared to men with primary education. The corresponding ORs for women were 1.3 (1.1-1.6) and 1.7 (1.2-2.4), respectively. Higher education was associated with a lower level of vigorous work activity: an OR of 6.9 (4.6-10.3) for men with secondary education and 18.6 (12.0-27.3) for men with primary education compared to men with tertiary education. The corresponding ORs for women were 2.8 (2.0-4.0) and 5.8 (4.0-8.5), respectively. Higher education was also associated with a lower level of total activity: an OR of 2.9 (2.2-3.8) for men with secondary education and 4.3 (3.3-5.6) for men with tertiary education compared to men with primary education. The corresponding ORs for women were 1.6 (1.2-2.0) and 1.6 (1.2-2.1), respectively

  16. Hip and Lumbar Spine Physical Examination Findings in People Presenting With Low Back Pain, With or Without Lower Extremity Pain.

    Science.gov (United States)

    Prather, Heidi; Cheng, Abby; Steger-May, Karen; Maheshwari, Vaibhav; Van Dillen, Linda

    2017-03-01

    Study Design Prospective cohort study, cross-sectional design. Background The hip-spine syndrome is described in patients with known arthritis of the hip. This study describes the hip examination findings of people presenting with low back pain (LBP). Objectives To (1) report examination findings of the hip in patients with LBP and (2) compare pain and function in patients with positive hip examination findings to those in patients without positive hip examination findings. Methods An examination and validated questionnaires of spine and hip pain and function were completed. Pain and function scores were compared between patients with and without positive hip findings. Results Consecutive patients (68 women, 33 men) with a mean age of 47.6 years (range, 18.4-79.8 years) participated. On physical examination, 81 (80%) had reduced hip flexion; 76 (75%) had reduced hip internal rotation; and 25 (25%) had 1, 32 (32%) had 2, and 23 (23%) had 3 positive provocative hip tests. Patients with reduced hip flexion had worse LBP-related (mean modified Oswestry Disability Index, 35.3 versus 25.6; P = .04) and hip-related function (mean modified Harris Hip Score, 66.0 versus 82.0; P = .03). Patients with reduced hip internal rotation had worse LBP-related function (mean Roland-Morris questionnaire, 12.4 versus 8.2; P = .003). A positive provocative hip test was coupled with more intense pain (median, 9 versus 7; P = .05) and worse LBP-related (mean Roland-Morris questionnaire, 12.1 versus 8.5; P = .02) and hip-related function (mean modified Harris Hip Score, 65.8 versus 89.7; P = .005). Conclusion Physical examination findings indicating hip dysfunction are common in patients presenting with LBP. Patients with LBP and positive hip examination findings have more pain and worse function compared to patients with LBP but without positive hip examination findings. Level of Evidence Symptom prevalence, level 1b. J Orthop Sports Phys Ther 2017;47(3):163-172. Epub 3 Feb 2017. doi:10

  17. An Examination of Exercise-Induced Feeling States and Their Association With Future Participation in Physical Activity Among Older Adults.

    Science.gov (United States)

    Brunet, Jennifer; Guérin, Eva; Speranzini, Nicolas

    2018-01-01

    Although exercise-induced feeling states may play a role in driving future behavior, their role in relation to older adults' participation in physical activity (PA) has seldom been considered. The objectives of this study were to describe changes in older adults' feeling states during exercise, and examine if levels of and changes in feeling states predicted their future participation in PA. Self-reported data on feeling states were collected from 82 older adults immediately before, during, and after a moderate-intensity exercise session, and on participation in PA 1 month later. Data were analyzed using latent growth modeling. Feelings of revitalization, positive engagement, and tranquility decreased during exercise, whereas feelings of physical exhaustion increased. Feelings of revitalization immediately before the exercise session predicted future participation in PA; changes in feeling states did not. This study does not provide empirical evidence that older adults' exercise-induced feeling states predict their future participation in PA.

  18. Family caregivers of individuals with frontotemporal dementia: examining the relationship between coping and caregiver physical and mental health.

    Science.gov (United States)

    Wong, Cindy C; Wallhagen, Margaret I

    2014-01-01

    To identify strategies to assist family caregivers of individuals with frontotemporal dementia (FTD) in dealing with their caregiving demands, nurses must understand these family members' unique needs and how they currently deal with their demands. The purpose of this study was to examine the relationship between coping and caregiver physical and mental health among FTD family caregivers. Participants were primary caregivers of individuals with FTD (with behavioral symptoms) living at home (N = 61). A small positive association was noted between problem-focused coping and caregiver physical health (r = 0.29, p caregiver mental health (r = 0.21, p = 0.10). However, multiple regression analysis showed that emotion-focused coping (β = 0.46, p caregiver mental health and explained approximately 14% of its variance. These findings support the potential value of emotion-focused coping strategies when dealing with behavioral symptoms manifested by individuals with FTD. Copyright 2014, SLACK Incorporated.

  19. An investigation of the prevalence rate of fatty liver disease among people undergoing physical examination in Tangshan, China

    Directory of Open Access Journals (Sweden)

    MENG Yulin

    2017-12-01

    Full Text Available ObjectiveTo investigate the prevalence rate of fatty liver disease among people undergoing physical examination in Tangshan, China, and to provide a reasonable basis for the prevention and treatment of fatty liver disease. MethodsThe clinical data of 12 808 individuals who underwent physical examination in Tangshan from March 2014 to February 2016 were collected, and among these individuals, 3540 had fatty liver disease. The data including age, sex, body mass index (BMI, fasting plasma glucose (FPG, total cholesterol (TC, triglyceride (TG, low-density lipoprotein cholesterol (LDL-C, and liver ultrasound findings were analyzed. The t-test was used for comparison of continuous data between groups and the chi-square test was used for comparison of categorical data between groups. Results Of all 7151 male individuals who underwent physical examination, 2750 (38.46% had fatty liver disease, and of all 5657 female individuals, 790 (13.96% had fatty liver disease; there was a significant difference in the prevalence rate of fatty liver disease between male and female individuals (χ2=947.25, P<0.01. There was a significant difference in the detection rate of fatty liver disease between male and female individuals in each age group of 18-29, 30-39, 40-49, and ≥50 years (χ2=337.58, 474.06, 449.38, and 12.86, all P<0.01. There was a significant difference in the detection rate of fatty liver disease between male or female individuals with different BMIs [obese (BMI ≥28, overweight (24≤BMI<28, and normal (BMI<24] (χ2=1104.01 and 500.23, both P<0.01. In the three groups of obese (BMI ≥28, overweight (24≤BMI<28, and normal (BMI<24 individuals who underwent physical examination, there was a significant difference in the detection rate of fatty liver disease between male and female individuals in each group (χ2=71.24, 87.97, and 323.84, all P<0.01. Male and female individuals with obesity (BMI ≥28 and overweight (24

  20. Inter-rater reliability of three musculoskeletal physical examination techniques used to assess motion in three planes while standing.

    Science.gov (United States)

    Prather, Heidi; Hunt, Devyani; Steger-May, Karen; Hayes, Marcie Harris; Knaus, Evan; Clohisy, John

    2009-07-01

    The objective of the study was to measure the reliability between examiners of 3 basic maneuvers of the Total Body Functional Profile physical examination test. The hypothesis was musculoskeletal health care providers of different disciplines could reliably use the 3 basic maneuvers as part of the musculoskeletal physical examination. A prospective observational study was conducted. Twenty-eight adult volunteers were measured on both the left and right side by 2 independent raters on a single occasion. The subjects were recruited through advertisements placed by the orthopedic department at a tertiary university. Twenty-eight volunteers were recruited and completed the study. The volunteers were between the ages of 18 and 51 years of age, had no symptoms in the lower extremity or spine, had no previous history of surgery or tumor involving the lower extremity, and no medical conditions that would preclude participation. On a single occasion, 2 examiners per 1 volunteer were blinded to their own and each others' measurements. Each examiner assessed the distance of frontal and sagittal plane lunge and angle of motion for transverse plane testing. Inter-rater agreement is expressed with intraclass correlation coefficients (ICCs) and corresponding 95% confidence intervals (CIs). The difference between raters is reported with 95% CIs. Baseline demographics, University of California Los Angeles (UCLA), and Harris hip questionnaires were completed by all participants. The UCLA and Harris hip scores showed no significant activity restrictions or pain limitations in all participants. The inter-rater reliability for sagittal, frontal, and transverse plane matrix testing was good with ICCs of 0.86 (95% CI 0.77-0.91), 0.90 (95% CI 0.84-0.94), and 0.85 (95% CI 0.75-0.91), respectively. The rater reliability between disciplines for transverse, sagittal, and frontal plane matrix testing was good with ICCs of 0.89 (95% CI 0.80-0.94), 0.88 (95% CI 0.79-0.94), and 0.90 (95% CI 0

  1. Necrotizing Soft Tissue Infection: Diagnostic Accuracy of Physical Examination, Imaging, and LRINEC Score: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Fernando, Shannon M; Tran, Alexandre; Cheng, Wei; Rochwerg, Bram; Kyeremanteng, Kwadwo; Seely, Andrew J E; Inaba, Kenji; Perry, Jeffrey J

    2018-04-18

    We sought to summarize accuracy of physical examination, imaging, and Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score in diagnosis of necrotizing soft tissue infection (NSTI) in adults with a soft tissue infection clinically concerning for NSTI. NSTI is a life-threatening diagnosis. Delay to diagnosis and surgical management is associated with increased mortality. We searched 6 databases from inception through November 2017. We included English-language studies reporting diagnostic accuracy of testing or LRINEC Score. Outcome was NSTI confirmed by surgery or histopathology. Two reviewers screened all citations and extracted data independently. Summary measures were obtained from the Hierarchical Summary Receiver Operating Characteristic model. From 2,290 citations, we included 23 studies (n = 5982). Of physical examination signs, pooled sensitivity and specificity for fever was 46.0% and 77.0% respectively, for hemorrhagic bullae 25.2% and 95.8%, and for hypotension 21.0% and 97.7%. Computed tomography (CT) had sensitivity of 88.5% and specificity of 93.3%, while plain radiography had sensitivity of 48.9% and specificity of 94.0%. Finally, LRINEC ≥ 6 had sensitivity of 68.2% and specificity of 84.8%, while LRINEC ≥ 8 had sensitivity of 40.8% and specificity of 94.9%. Absence of any 1 physical examination feature (eg, fever or hypotension) is not sufficient to rule-out NSTI. CT is superior to plain radiography. LRINEC had poor sensitivity, and should not be used to rule-out NSTI. Given the poor sensitivity of these tests, a high clinical suspicion warrants early surgical consultation for definitive diagnosis and management.

  2. Assessment of patient's pain-related behavior at physical examination may allow diagnosis of recent osteoporotic vertebral fracture.

    Science.gov (United States)

    Postacchini, Roberto; Paolino, Michela; Faraglia, Silvia; Cinotti, Gianluca; Postacchini, Franco

    2013-09-01

    Although innumerable studies have analyzed the multiple aspects of osteoporotic vertebral fractures, no study has focused on the clinical features related to spine pain in patients with recent osteoporotic vertebral compression fractures (VCFs). To determine whether the assessment of pain-related behavior (P-RB) of patients with osteoporotic VCFs of recent onset may allow the fracture to be strongly suspected, or even diagnosed, at physical examination. Pain-related behavior of elderly patients attending an outpatient spine clinic was evaluated on the basis of six consecutive movements made on the examining table. Fifty-six patients complaining only of lumbar or thoracic pain. The fractured patients (FPs), representing the fracture group (FG), were the 19 who had a recent VCF, whereas the control group (CG) consisted of the remaining 37 patients. Assessment of P-RB was based on six parameters: grimacing, sighing, clenching or blocking eyelids, gaping or strongly tightening the lips, need for help to take positions, and extreme difficulty to turn in the prone position. A score of 1 or a decimal was assigned to each parameter, the final score to each patient being 0 to 6. Three types of injury, acute (I), subacute (II), or chronic (III), were identified on the basis of the time elapsed from the probable occurrence of the fracture. The diagnosis of recent fracture was based on magnetic resonance images. Patients were videotaped during their movements. An examiner, unaware of the clinical history and diagnosis, gave a P-RB score to all patients and indicated whether they had to be placed in FG or CG, and also their presumable type of fracture. Subsequently, a DVD with the videotapes of all patients was given to three independent examiners, not specifically expert of spine conditions, who were asked to make the same evaluations as the first examiner. The mean scores for P-RB given by the first examiner were 4.6 to FG and 0.7 to CG (pPain-related behavior evaluation of

  3. Importance of physical examination in early detection of lump in breast in women of different age groups

    International Nuclear Information System (INIS)

    Abbas, H.; Imran, S.; Waris, Noorul-ain-Hafeez; Khanam, A.; Khurshid, R.

    2010-01-01

    Background: The spectrum of breast lesions in adolescents varies markedly from that for adults, with the former lesions being overwhelmingly benign. Fine needle biopsy can be used to distinguish benign and malignant tumour. Study Design: This study examined the characteristics and outcome of women with different age groups in whom physical examination was their sole method of lump in breast detection. Patients and Methods: A total of 200 patients were included in the study. These were divided into 3 groups. Group A was consisting of 75 girls with age of pubescent. Group B included 69 suspected breast cancer women with age range 26-38 years. Fifty-six suspected breast cancer women with age range 41-60 year were included as group C. Study was carried out in patients admitted in the Department/Out-door of Surgery, Sir Ganga Ram Hospital, Lahore, Pakistan. Study period was 6 months. All women received a physical examination by a breast surgeon. Proforma including demographic and clinical characteristics were filled. The diagnosis for patients in this study was achieved by core needle biopsy using a 14-gauge cutting needle. Results: It was observed that early age at menarche ( 25 may be a risk factor in peri/post menopausal women. Active life style is more important with increasing age as it decreases the risk of developing tumour state. Family history was more common in women with peri/post menopausal status as compared to other age groups. Clinical characteristics showed that lump size <2.5 cm was more common in both pubescent and reproductive age. While lump size with a range of 2.5-5.0 cm, was observed in all groups of patients. Fibroadenoma is observed in almost all women with pubescent age while both benign and malignant tumour observed in women with reproductive age. Malignant tumour was observed mostly in women with peri/post menopausal status. Conclusion: Study concluded that early detection or clinical examination with FNA cut out the patients from harassment

  4. The use of laser-induced shock wave plasma spectroscopy (LISPS) for examining physical characteristics of pharmaceutical products

    Energy Technology Data Exchange (ETDEWEB)

    Abdulmadjid, Syahrun Nur, E-mail: syahrun-madjid@yahoo.com; Lahna, Kurnia, E-mail: kurnialahna@gmail.com [Department of Physics, Faculty of Mathematics and Natural Sciences, Syiah Kuala University, Darussalam, Banda Aceh 23111, Aceh (Indonesia); Desiyana, Lydia Septa, E-mail: lydia-septa@yahoo.com [Department of Pharmacy, Faculty of Mathematics and Natural Sciences, Syiah Kuala University, Darussalam, Banda Aceh 23111, Aceh (Indonesia)

    2016-03-11

    An experimental study has been performed to examine the physical characteristics of pharmaceutical products, such as tablet, by employing an emission plasma induced by Nd-YAG laser at a low pressure of Helium gas. The hardness of tablet is one of the parameters that examined during the production process for standard quality of pharmaceutical products. In the Laser-Induced Shock Wave Plasma Spectroscopy (LISPS), the shock wave has a significant role in inducing atomic excitation. It was known that, the speed of the shock wavefront depends on the hardness of the sample, and it correlates with the ionization rate of the ablated atoms. The hardness of the tablet is examined using the intensity ratio between the ion of Mg (II) 275.2 nm and the neutral of Mg (I) 285.2 nm emission lines detected from the laser-induced plasma. It was observed that the ratio changes with respect to the change in the tablet hardness, namely the ratio is higher for the hard tablet. Besides the ratio measurements, we also measured the depth profile of a tablet by focusing 60 shots of irradiation of laser light at a fixed position on the surface of the tablet. It was found that the depth profile varies differently with the hardness of the tablet. These experiment results show that the technique of LISPS can be applied to examine the quality of pharmaceutical products.

  5. The use of laser-induced shock wave plasma spectroscopy (LISPS) for examining physical characteristics of pharmaceutical products

    International Nuclear Information System (INIS)

    Abdulmadjid, Syahrun Nur; Lahna, Kurnia; Desiyana, Lydia Septa

    2016-01-01

    An experimental study has been performed to examine the physical characteristics of pharmaceutical products, such as tablet, by employing an emission plasma induced by Nd-YAG laser at a low pressure of Helium gas. The hardness of tablet is one of the parameters that examined during the production process for standard quality of pharmaceutical products. In the Laser-Induced Shock Wave Plasma Spectroscopy (LISPS), the shock wave has a significant role in inducing atomic excitation. It was known that, the speed of the shock wavefront depends on the hardness of the sample, and it correlates with the ionization rate of the ablated atoms. The hardness of the tablet is examined using the intensity ratio between the ion of Mg (II) 275.2 nm and the neutral of Mg (I) 285.2 nm emission lines detected from the laser-induced plasma. It was observed that the ratio changes with respect to the change in the tablet hardness, namely the ratio is higher for the hard tablet. Besides the ratio measurements, we also measured the depth profile of a tablet by focusing 60 shots of irradiation of laser light at a fixed position on the surface of the tablet. It was found that the depth profile varies differently with the hardness of the tablet. These experiment results show that the technique of LISPS can be applied to examine the quality of pharmaceutical products.

  6. Sociodemographic, psychosocial and physical health correlates of common mental disorder symptoms among mothers in Trinidad and Tobago: Examining ethnic variations.

    Science.gov (United States)

    Krishnakumar, Ambika; Narine, Lutchmie; Roopnarine, Jaipaul L; Logie, Carol

    2016-08-22

    Historical and cultural experiences have shaped the life experiences of cultural communities in Trinidad and Tobago. Using a cultural focus, the goal of this investigation was to examine ethnic variations both in the prevalence of common mental disorder (CMD) symptoms as well as in the associations between sociodemographic, psychosocial, physical health correlates and CMDs among mothers in Trinidad and Tobago. Participants included 1002 mothers (359 African-, 353 Indo- and 290 Mixed-Ethnic Trinidadian). Mean comparisons indicated similarities in the levels of depression, somatisation and anxiety across ethnic groups. The associations between physical ill health, experiences of pain and depression and between physical ill health and somatisation were stronger for Mixed-Ethnic Trinidadian than Indo-Trinidadian mothers. The relationship between early experiences of domestic violence and depression was stronger for Indo-Trinidadian than Mixed-Ethnic Trinidadian mothers. The associations between early experiences of domestic violence and depression and between experiences of pain and somatisation were stronger for African Trinidadian than Mixed-Ethnic Trinidadian mothers. Thus beyond the direct effects, mothers belonging to specific ethnic groups indicated greater or lesser vulnerabilities to CMDs depending on their exposure to specific correlates. Results have applicability for the development of culturally sensitive interventions for mothers experiencing CMDs. © 2016 International Union of Psychological Science.

  7. A prospective examination of exercise and barrier self-efficacy to engage in leisure-time physical activity during pregnancy.

    Science.gov (United States)

    Cramp, Anita G; Bray, Steven R

    2009-06-01

    Pregnant women without medical contraindications should accumulate 30 min of moderate exercise on most days of the week, yet many pregnant women do not exercise at recommended levels. The purpose the study was to examine barriers to leisure-time physical activity (LTPA) and investigate barrier and exercise self-efficacy as predictors of self-reported LTPA during pregnancy. Pregnant women (n = 160) completed questionnaires eliciting barriers to LTPA, measures of exercise and barrier self-efficacy, and 6-week LTPA recall at gestational weeks 18, 24, 30, and 36. A total of 1,168 barriers were content-analyzed, yielding nine major themes including fatigue, time constraints, and physical limitations. Exercise self-efficacy predicted LTPA from gestational weeks 18 to 24 (beta = 0.32, R(2) = 0.26) and weeks 30 to 36 (beta = 0.41, R(2) = 0.37), while barrier self-efficacy predicted LTPA from weeks 24 to 30 (beta = 0.40, R(2) = 0.32). Pregnant women face numerous barriers to LTPA during pregnancy, the nature of which may change substantially over the course of pregnancy. Higher levels of self-efficacy to exercise and to overcome exercise barriers are associated with greater LTPA during pregnancy. Research and interventions to understand and promote LTPA during pregnancy should explore the dynamic nature of exercise barriers and foster women's confidence to overcome physical activity barriers.

  8. Unemployment among women: examining the relationship of physical and psychological intimate partner violence and posttraumatic stress disorder.

    Science.gov (United States)

    Kimerling, Rachel; Alvarez, Jennifer; Pavao, Joanne; Mack, Katelyn P; Smith, Mark W; Baumrind, Nikki

    2009-03-01

    Prior research has demonstrated that intimate partner violence (IPV) is associated with employment instability among poor women. The current study assesses the broader relationship between IPV and women's workforce participation in a population-based sample of 6,698 California women. We examined past-year IPV by analyzing specific effects of physical violence, psychological violence, and posttraumatic stress disorder (PTSD) symptoms as predictors of unemployment. Results indicated substantial rates of unemployment among women who reported IPV, with rates of 20% among women who experienced psychological violence, 18% among women who experienced physical violence, and 19% among women with PTSD symptoms. When the relationship was adjusted for demographic characteristics and educational attainment, PTSD (adjusted odds ratio [AOR] = 1.60; 95% confidence interval [CI] = 1.22, 2.09) and psychological violence (AOR = 1.78; 95% CI = 1.36, 2.32), but not physical violence, were associated with unemployment. Implications for supported employment programs and workplace responses to IPV are discussed.

  9. The association of physical examination abnormalities and carboxyhemoglobin concentrations in 21 dogs trapped in a kennel fire.

    Science.gov (United States)

    Ashbaugh, Elizabeth A; Mazzaferro, Elisa M; McKiernan, Brendan C; Drobatz, Kenneth J

    2012-06-01

    To evaluate physical examination findings and their association with carboxyhemoglobin (COHb) concentrations in 21 dogs that were exposed to smoke during a kennel fire. Twenty-one dogs were exposed to a kennel fire. Physical exam findings, presenting, and posttherapy COHb concentrations as well as therapeutic interventions were evaluated. COHb concentrations upon presentation were increased in all smoke inhalation exposed dogs. These dogs were compared to a small set of clinically normal staff-owned dogs who were not exposed to fire. Physical parameters significantly associated with higher COHb concentrations included lower body temperature, increased respiratory effort, abnormal respiratory auscultation, altered neurologic status, and length of hospital stay. Oxygen therapy resulted in a more rapid decline in COHb concentrations although 5 dogs still had mildly increased COHb concentrations 24-hour postadmission. This study describes the relationship of admitting clinical findings of dogs exposed to a kennel fire with their initial blood COHb concentrations. It also describes the resolution of increased COHb concentrations with use of oxygen therapy and hospitalization. Additionally, COHb concentrations for a control group of dogs was evaluated and compared to the dogs exposed to smoke inhalation. © Veterinary Emergency and Critical Care Society 2012.

  10. Can the Social Vulnerability Index Be Used for More Than Emergency Preparedness? An Examination Using Youth Physical Fitness Data.

    Science.gov (United States)

    Gay, Jennifer L; Robb, Sara W; Benson, Kelsey M; White, Alice

    2016-02-01

    The Social Vulnerability Index (SVI), a publicly available dataset, is used in emergency preparedness to identify communities in greatest need of resources. The SVI includes multiple socioeconomic, demographic, and geographic indicators that also are associated with physical fitness and physical activity. This study examined the utility of using the SVI to explain variation in youth fitness, including aerobic capacity and body mass index. FITNESSGRAM data from 2,126 Georgia schools were matched at the census tract level with SVI themes of socioeconomic, household composition, minority status and language, and housing and transportation. Multivariate multiple regression models were used to test whether SVI factors explained fitness outcomes, controlling for grade level (ie, elementary, middle, high school) and stratified by gender. SVI themes explained the most variation in aerobic fitness and body mass index for both boys and girls (R2 values 11.5% to 26.6%). Socioeconomic, Minority Status and Language, and Housing and Transportation themes were salient predictors of fitness outcomes. Youth fitness in Georgia was related to socioeconomic, demographic, and geographic themes. The SVI may be a useful needs assessment tool for health officials and researchers examining multilevel influences on health behaviors or identifying communities for prevention efforts.

  11. Contrast-enhanced MRI compared with the physical examination in the evaluation of disease activity in juvenile idiopathic arthritis

    International Nuclear Information System (INIS)

    Hemke, Robert; Maas, Mario; Veenendaal, Mira van; Kuijpers, Taco W.; Dolman, Koert M.; Rossum, Marion A.J. van; Berg, J.M. van den

    2014-01-01

    To assess the value of magnetic resonance imaging (MRI) in discriminating between active and inactive juvenile idiopathic arthritis (JIA) patients and to compare physical examination outcomes with MRI outcomes in the assessment of disease status in JIA patients. Consecutive JIA patients with knee involvement were prospectively studied using an open-bore MRI. Imaging findings from 146 JIA patients were analysed (59.6 % female; mean age, 12.9 years). Patients were classified as clinically active or inactive. MRI features were evaluated using the JAMRIS system, comprising validated scores for synovial hypertrophy, bone marrow oedema, cartilage lesions and bone erosions. Inter-reader reliability was good for all MRI features (intra-class correlation coefficient [ICC] = 0.87-0.94). No differences were found between the two groups regarding MRI scores of bone marrow oedema, cartilage lesions or bone erosions. Synovial hypertrophy scores differed significantly between groups (P = 0.016). Nonetheless, synovial hypertrophy was also present in 14 JIA patients (35.9 %) with clinically inactive disease. Of JIA patients considered clinically active, 48.6 % showed no signs of MRI-based synovitis. MRI can discriminate between clinically active and inactive JIA patients. However, physical examination is neither very sensitive nor specific in evaluating JIA disease activity compared with MRI. Subclinical synovitis was present in >35 % of presumed clinically inactive patients. (orig.)

  12. Utility of the History and Physical Examination in the Detection of Acute Coronary Syndromes in Emergency Department Patients

    Directory of Open Access Journals (Sweden)

    Zachary DW Dezman

    2017-05-01

    Full Text Available Chest pain accounts for approximately 6% of all emergency department (ED visits and is the most common reason for emergency hospital admission. One of the most serious diagnoses emergency physicians must consider is acute coronary syndrome (ACS. This is both common and serious, as ischemic heart disease remains the single biggest cause of death in the western world. The history and physical examination are cornerstones of our diagnostic approach in this patient group. Their importance is emphasized in guidelines, but there is little evidence to support their supposed association. The purpose of this article was to summarize the findings of recent investigations regarding the ability of various components of the history and physical examination to identify which patients presenting to the ED with chest pain require further investigation for possible ACS. Previous studies have consistently identified a number of factors that increase the probability of ACS. These include radiation of the pain, aggravation of the pain by exertion, vomiting, and diaphoresis. Traditional cardiac risk factors identified by the Framingham Heart Study are of limited diagnostic utility in the ED. Clinician gestalt has very low predictive ability, even in patients with a non-diagnostic electrocardiogram (ECG, and gestalt does not seem to be enhanced appreciably by clinical experience. The history and physical alone are unable to reduce a patient’s risk of ACS to a generally acceptable level (<1%. Ultimately, our review of the evidence clearly demonstrates that “atypical” symptoms cannot rule out ACS, while “typical” symptoms cannot rule it in. Therefore, if a patient has symptoms that are compatible with ACS and an alternative cause cannot be identified, clinicians must strongly consider the need for further investigation with ECG and troponin measurement.

  13. A practical, evidence-based, comprehensive (PEC) physical examination for diagnosing pathology of the long head of the biceps.

    Science.gov (United States)

    Rosas, Samuel; Krill, Michael K; Amoo-Achampong, Kelms; Kwon, KiHyun; Nwachukwu, Benedict U; McCormick, Frank

    2017-08-01

    Clinical examination of the shoulder joint has gained attention as clinicians aim to use an evidence-based examination of the biceps tendon, with the desire for a proper diagnosis while minimizing costly imaging procedures. The purpose of this study is to create a decision tree analysis that enables the development of a clinical algorithm for diagnosing long head of biceps (LHB) pathology. A literature review of Level I and II diagnostic studies was conducted to extract characteristics of clinical tests for LHB pathology through a systematic review of PubMed, Medline, Ovid, and Cochrane Review databases. Tests were combined in series and parallel to determine sensitivities and specificities, and positive and negative likelihood ratios were determined for each combination using a subjective pretest probability. The "gold standard" for diagnosis in all included studies was arthroscopy or arthrotomy. The optimal testing modality was use of the uppercut test combined with the tenderness to palpation of the biceps tendon test. This combination achieved a sensitivity of 88.4% when performed in parallel and a specificity of 93.8% when performed in series. These tests used in combination optimize post-test probability accuracy greater than any single individual test. Performing the uppercut test and biceps groove tenderness to palpation test together has the highest sensitivity and specificity of known physical examinations maneuvers to aid in the diagnosis of LHB pathology compared with diagnostic arthroscopy (practical, evidence-based, comprehensive examination). A decision tree analysis aides in the practical, evidence-based, comprehensive examination diagnostic accuracy post-testing based on the ordinal scale pretest probability. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  14. Examining Motivations to Play Pokémon GO and Their Influence on Perceived Outcomes and Physical Activity.

    Science.gov (United States)

    Marquet, Oriol; Alberico, Claudia; Adlakha, Deepti; Hipp, J Aaron

    2017-10-24

    Pokémon GO is the most played augmented reality game in history. With more than 44 million players at the peak of its popularity, the game has sparked interest on its effects on the young population's health. This pilot study examined motivations to start playing Pokémon GO among a sample of US college students, and how motivations were associated with perceived outcomes of the playing experience and physical activity derived while playing. In November 2016, we asked a sample of 47 US college students (all Pokémon GO players) to complete online surveys and install an ecological momentary assessment (EMA) tool and step counter on their smartphones. The EMA tool prompted a set of questions on playing behavior and physical activity, 3 times per day (12:00 PM, 7:00 PM, and 10:00 PM), for 7 days. We used a factorial analysis to identify 3 distinctive groups of players based on their motivations to start playing Pokémon GO. We tested differences across motivation groups related to 5 unique outcomes using 1-way analysis of variance. We extracted 3 interpretable factors from the clustering of motivations to start playing Pokémon GO: Pokémon and video game fans (n=26, 55% of the sample), physical activity seekers (n=8, 17%), and curious & social (n=13, 28%). The clusters differed significantly on the enjoyment of different aspects of the game, particularly battling, discovering new places, and meeting new people, as well as differences in agreement that playing improved mood and made them more social. Days when playing Pokémon GO were associated with higher number of steps reported at the end of the day, especially among physical activity seekers, but also for Pokémon and video game fans. All groups perceived traffic as a major threat to playing. Days during which Pokémon GO was played were positively associated with a set of beneficial health behaviors, including higher physical activity levels, more socialization, and better mood. Results, however, depended on

  15. Physical fitness examination in a selected group of the North-Moravian industrial population. I: Results in coke plant workers

    Energy Technology Data Exchange (ETDEWEB)

    Jirac, Z

    1974-01-01

    Basic spirographic and spiroergometric examinations, according to Hollman, were performed on 269 men, aged 20-60 years, who had been working at coke-oven batteries for 1, 16 and more years. There were no significant differences in the spirographic and spiroergometric indicators of cardiopulmonary efficiency in relation to the length of exposure within the age groups. Maximum oxygen uptake in younger men (20-29 years) was identical, in older age groups it was below average according to Hollmann. This phenomenon can be explained by a combined effect of a low physical load and the heat load on the cardiovascular system. Values were compared with those of Shepard. The working and sanitary conditions and investigation methods are described in detail.

  16. Examining the individual and perceived neighborhood associations of leisure-time physical activity in persons with spinal cord injury.

    Science.gov (United States)

    Arbour-Nicitopoulos, Kelly P; Martin Ginis, Kathleen A; Wilson, Philip M

    2010-05-01

    Theory of Planned Behavior (TPB) constructs have been shown to be useful for explaining leisure-time physical activity (LTPA) in persons with spinal cord injury (SCI). However, other factors not captured by the TPB may also be important predictors of LTPA for this population. The purpose of this study is to examine the role of neighborhood perceptions within the context of the TPB for understanding LTPA in persons living with SCI. This is a cross-sectional analysis (n = 574) using structural equation modeling involving measures of the TPB constructs, perceived neighborhood esthetics and sidewalks, and LTPA. TPB constructs explained 57% of the variance in intentions and 12% of the variance in behavior. Inclusion of the neighborhood variables to the model resulted in an additional 1% of the variance explained in intentions, with esthetics exhibiting significant positive relationships with the TPB variables. Integrating perceived neighborhood esthetics into the TPB framework provides additional understanding of LTPA intentions in persons living with SCI.

  17. Diagnosis of Groin Pain Associated With Sports Hernia Using Dynamic Ultrasound and Physical Examination: A Case Report.

    Science.gov (United States)

    Yang, Dong Chan; Nam, Ki Yeun; Kwon, Bum Sun; Park, Jin Woo; Ryu, Ki Hyung; Lee, Ho Jun; Sim, Gyu Jeong

    2015-12-01

    Groin pain in athletes is a complex diagnostic and therapeutic challenge. Sports hernia is one of the common causes of groin pain. We report a case of sports hernia, initially presented as groin pain and aggravated by sports activity. A 19-year-old soccer player visited the outpatient department of general surgery and was referred to the rehabilitation center due to no abnormalities detected in the abdomen and pelvis by computed tomography. An incipient direct bulge of the posterior inguinal wall was detected with dynamic ultrasound when abdominal tension was induced by raising both legs during a full inhalation. Surgery was performed and preoperatively both groins showed the presence of inguinal hernia. Diagnosing sports hernia is very challenging. Through careful history documentation and physical examination followed by dynamic ultrasonography, we identified his posterior inguinal wall deficiency for early management.

  18. Medical students' attitudes towards peer physical examination: findings from an international cross-sectional and longitudinal study.

    Science.gov (United States)

    Rees, Charlotte E; Wearn, Andy M; Vnuk, Anna K; Sato, Toshio J

    2009-03-01

    Although studies have begun to shed light on medical students' attitudes towards peer physical examination (PPE), they have been conducted at single sites, and have generally not examined changes in medical students' attitudes over time. Employing both cross-sectional and longitudinal designs, the current study examines medical students' attitudes towards PPE at schools from different geographical and cultural regions and assess changes in their attitudes over their first year of medical study. Students at six schools (Peninsula, UK; Durham, UK; Auckland, New Zealand; Flinders, Australia; Sapporo, Japan and Li Ka Shing, Hong Kong) completed the Examining Fellow Students (EFS) questionnaire near the start of their academic year (T1), and students at four schools (Peninsula, Durham, Auckland and Flinders) completed the EFS for a second time, around the end of their academic year (T2). Univariate and multivariate analyses revealed a high level of acceptance for PPE of non-intimate body regions amongst medical students from all schools (greater than 83%, hips, at T1 and 94.5%, hips and upper body, at T2). At T1 and T2, students' willingness to engage in PPE was associated with their gender, ethnicity, religiosity and school. Typically, students least comfortable with PPE at T1 and T2 were female, non-white, religious and studying at Auckland. Although students' attitudes towards PPE were reasonably stable over their first year of study, and after exposure to PPE, we did find some statistically significant differences in attitudes between T1 and T2. Interestingly, attitude changes were consistently predicted by gender, even when controlling for school. While male students' attitudes towards PPE were relatively stable over time, females' attitudes were changeable. In this paper, we discuss our findings in light of existing research and theory, and discuss their implications for educational practice and further research.

  19. The impact of parenthood on Canadians' objectively measured physical activity: an examination of cross-sectional population-based data.

    Science.gov (United States)

    Gaston, Anca; Edwards, Sarah A; Doelman, Amy; Tober, Jo Ann

    2014-11-03

    Parenthood has been associated with declines in leisure-time exercise and moderate-to-vigorous physical activity (MVPA), but less is known about its impact on sedentary time and light-intensity activity. Although the health benefits of MVPA are well established, a growing body of research has been showing that even after controlling for MVPA levels, a detrimental dose-response association exists between sedentary time and adverse health outcomes and a beneficial dose-response association exists for light-intensity activity. This study examined the impact of parenthood, the number of children in the home, and the age of the youngest child on objectively measured physical activity (i.e., accelerometer derived daily minutes of sedentary, light, and MVPA) among a nationally representative cross-sectional sample of 2234 men and women who participated in the 2009-2011 Canadian Health Measures Survey. After controlling for sociodemographic variables, ANCOVAs indicated that parents engaged in more light activity but less MVPA than non-parents and women whose youngest child was aged 12-15 years were more sedentary than women without children. Among both men and women, having a child activity and lowest MVPA. Modest differences emerged between the physical activity level of parents and non-parents for both genders and across intensity levels. In general, parenthood was associated with less MVPA and more light-intensity activity, and more differences emerged among women compared to men. More research is needed before conclusions can be drawn regarding the health consequences of these differences.

  20. Improving doctor-patient communication: content validity examination of a novel urinary system-simulating physical model.

    Science.gov (United States)

    Hu, WenGang; Song, YaJun; Zhong, Xiao; Feng, JiaYu; Wang, PingXian; Huang, ChiBing

    2016-01-01

    Effective doctor-patient communication is essential for establishing a successful doctor-patient relationship and implementing high-quality health care. In this study, a novel urinary system-simulating physical model was designed and fabricated, and its content validity for improving doctor-patient communication was examined by conducting a randomized controlled trial in which this system was compared with photographs. A total of 240 inpatients were randomly selected and assigned to six doctors for treatment. After primary diagnosis and treatment had been determined, these patients were randomly divided into the experimental group and the control group. Patients in the experimental group participated in model-based doctor-patient communication, whereas control group patients received picture-based communication. Within 30 min after this communication, a Demographic Information Survey Scale and a Medical Interview Satisfaction Scale (MISS) were distributed to investigate patients' demographic characteristics and their assessments of total satisfaction, distress relief, communication comfort, rapport, and compliance intent. The study results demonstrated that the individual groups were comparable with respect to demographic variables but that relative to patients in the picture-based communication group, patients in the model-based communication group had significantly higher total satisfaction scores and higher ratings for distress relief, communication comfort, rapport, and compliance intent. These results indicate that the physical model is more effective than the pictures at improving doctor-patient communication and patient outcomes. The application of the physical model in doctor-patient communication is helpful and valuable and therefore merits widespread clinical popularization.

  1. A longitudinal examination of the influence of maturation on physical self-perceptions and the relationship with physical activity in early adolescent girls.

    Science.gov (United States)

    Knowles, Ann-Marie; Niven, Ailsa G; Fawkner, Samantha G; Henretty, Joan M

    2009-06-01

    This longitudinal study investigated the influence of maturation on physical self-perceptions and the relationship with physical activity in early adolescent girls (N=150; mean age=12.79+/-0.31). Physical characteristics were measured and participants completed the Physical Activity Questionnaire for Children, the Children and Youth Physical Self-Perception Profile and the Pubertal Development Scale on two occasions 12 months apart. The results demonstrated a decrease in overall physical activity levels over 12 months which was not influenced by maturational status or physical characteristics. Additional analysis indicated that physical self-perceptions partially accounted for the explained variance in physical activity change, with physical condition being an important individual predictor of physical activity. Further analysis indicated that body mass was an important individual predictor of changes in perceptions of body attractiveness and physical self-worth. At this age maturation has a limited influence on the physical activity behaviours of early adolescent girls and although the variance in physical activity was partly accounted for by physical self-perceptions, this was a relatively small contribution and other factors related to this drop in physical activity need to be considered longitudinally.

  2. Examining the use of evidence-based and social media supported tools in freely accessible physical activity intervention websites.

    Science.gov (United States)

    Vandelanotte, Corneel; Kirwan, Morwenna; Rebar, Amanda; Alley, Stephanie; Short, Camille; Fallon, Luke; Buzza, Gavin; Schoeppe, Stephanie; Maher, Carol; Duncan, Mitch J

    2014-08-17

    It has been shown that physical activity is more likely to increase if web-based interventions apply evidence-based components (e.g. self-monitoring) and incorporate interactive social media applications (e.g. social networking), but it is unclear to what extent these are being utilized in the publicly available web-based physical activity interventions. The purpose of this study was to evaluate whether freely accessible websites delivering physical activity interventions use evidence-based behavior change techniques and provide social media applications. In 2013, a systematic search strategy examined 750 websites. Data was extracted on a wide range of variables (e.g. self-monitoring, goal setting, and social media applications). To evaluate website quality a new tool, comprising three sub-scores (Behavioral Components, Interactivity and User Generated Content), was developed to assess implementation of behavior change techniques and social media applications. An overall website quality scored was obtained by summing the three sub-scores. Forty-six publicly available websites were included in the study. The use of self-monitoring (54.3%), goal setting (41.3%) and provision of feedback (46%) was relatively low given the amount of evidence supporting these features. Whereas the presence of features allowing users to generate content (73.9%), and social media components (Facebook (65.2%), Twitter (47.8%), YouTube (48.7%), smartphone applications (34.8%)) was relatively high considering their innovative and untested nature. Nearly all websites applied some behavioral and social media applications. The average Behavioral Components score was 3.45 (±2.53) out of 10. The average Interactivity score was 3.57 (±2.16) out of 10. The average User Generated Content Score was 4.02 (±2.77) out of 10. The average overall website quality score was 11.04 (±6.92) out of 30. Four websites (8.7%) were classified as high quality, 12 websites (26.1%) were classified as moderate

  3. [A young boy with elevated aminotransferases in physical examination--Two novel missense mutations associated with Wilson's disease were found].

    Science.gov (United States)

    Zhu, Yu; Deng, Si-Yan; Wan, Chao-Min

    2015-07-01

    A 3-year-old boy had abnormal liver function, which was found in physical examination, for 5 months before admission. He had no symptoms such as anorexia, poor appetite, and jaundice, had normal growth and development, and showed no hepatosplenomegaly. Laboratory examination revealed significantly reduced ceruloplasmin (35 mg/L), as well as negative hepatotropic virus, cytomegalovirus, and Epstein-Barr virus. There were normal muscle enzymes, blood glucose, and blood ammonia and negative liver-specific autoantibodies. The boy had negative K-F ring and normal 24-hour urine copper (0.56 μmol/L). The ATP7B gene testing for the boy, his sister, and their parents detected two novel missense mutations in the boy and his sister, i.e., compound heterozygous mutations in exon 7 (c.2075T>C, p.L692P) and exon 13 (c.3044T>C, p.L1015P), which were inherited from their father and mother, respectively. Wilson's disease was confirmed by genetic diagnosis in the boy and his sister. The boy and his sister were given a low-copper diet. The boy was administered with penicillamine for decoppering and zinc supplement against copper uptake. His sister received zinc supplement alone because no clinical symptoms were observed. The boy showed normal liver function in the reexamination after 3 months of treatment.

  4. A quasi-experimental examination of how school-based physical activity changes impact secondary school student moderate- to vigorous- intensity physical activity over time in the COMPASS study

    OpenAIRE

    Hunter, Stephen; Leatherdale, Scott T.; Storey, Kate; Carson, Valerie

    2016-01-01

    Background Adolescence is characterized by low moderate- to vigorous- intensity physical activity (MVPA) levels. Targeting the school setting can increase MVPA among a large proportion of adolescents. However, school-based physical activity interventions for adolescents remain largely ineffective. Therefore, the purpose of this study was to examine how naturally-occurring changes to school physical activity policy, recreational programming, public health resources, and the physical environmen...

  5. Determinants of physical activity in America: a first characterization of physical activity profile using the National Health and Nutrition Examination Survey (NHANES).

    Science.gov (United States)

    Kao, Ming-Chih Jeffrey; Jarosz, Renata; Goldin, Michael; Patel, Amy; Smuck, Matthew

    2014-10-01

    To develop and implement methodologies for characterizing accelerometry-derived patterns of physical activity (PA) in the United States in relation to demographics, anthropometrics, behaviors, and comorbidities using the National Health and Nutrition Examination Survey (NHANES) dataset. Retrospective analysis of nationally representative database. Computer-generated modeling in silico. A total of 6329 adults in the United States from the NHANES 2003-2004 database. To discover subtle multivariate signal in the dynamic and noisy accelerometry data, we developed a novel approach, termed discretized multiple adaptive regression and implemented the algorithm in SAS 9.2 (SAS Institute, Cary, NC). Demographic, anthropometric, comorbidity, and behavioral variables. The intensity of PA decreased with both increased age and increased body mass index. Both greater education and greater income correlate with increased activity over short durations and reduced activity intensity over long durations. Numerous predictors demonstrated effects within activity ranges that may be masked by use of the standard activity intensity intervals. These include age, one of the most robust variables, where we discovered decreasing activities inside the moderate activity range. It also includes gender, where women compared with men have increased proportions of active times up to the center of light activity range, and income greater than $45,000, where a complex effect is seen with little correspondence to existing cut-points. The results presented in this study suggest that the method of multiple regression and heat map visualization can generate insights otherwise hidden in large datasets such as NHANES. A review of the provided heat maps reveals the trends discussed previously involving demographic, anthropometric, comorbidity, and behavioral variables. It also demonstrates the power of accelerometry to expose alterations in PA. Ultimately, this study provides a US population-based norm to

  6. Correlation between physical examination and three-dimensional gait analysis in the assessment of rotational abnormalities in children with cerebral palsy.

    Science.gov (United States)

    Teixeira, Fernando Borge; Ramalho Júnior, Amancio; Morais Filho, Mauro César de; Speciali, Danielli Souza; Kawamura, Catia Miyuki; Lopes, José Augusto Fernandes; Blumetti, Francesco Camara

    2018-01-01

    Objective To evaluate the correlation between physical examination data concerning hip rotation and tibial torsion with transverse plane kinematics in children with cerebral palsy; and to determine which time points and events of the gait cycle present higher correlation with physical examination findings. Methods A total of 195 children with cerebral palsy seen at two gait laboratories from 2008 and 2016 were included in this study. Physical examination measurements included internal hip rotation, external hip rotation, mid-point hip rotation and the transmalleolar axis angle. Six kinematic parameters were selected for each segment to assess hip rotation and shank-based foot rotation. Correlations between physical examination and kinematic measures were analyzed by Spearman correlation coefficients, and a significance level of 5% was considered. Results Comparing physical examination measurements of hip rotation and hip kinematics, we found moderate to strong correlations for all variables (pphysical examination and hip rotation kinematics (rho range: 0.48-0.61). Moderate correlations were also found between the transmalleolar axis angle measurement on physical examination and foot rotation kinematics (rho range 0.44-0.56; p<0.001). Conclusion These findings may have clinical implications in the assessment and management of transverse plane gait deviations in children with cerebral palsy.

  7. A narrative review of evidence-based recommendations for the physical examination of the lumbar spine, sacroiliac and hip joint complex.

    Science.gov (United States)

    Wong, C K; Johnson, E K

    2012-09-01

    Non-specific low back pain is a frequent complaint in primary care, but the differential diagnosis for low back pain can be complex. Despite advances in diagnostic imaging, a specific pathoanatomical source of low back pain can remain elusive in up to 85% of individuals. Best practice guidelines recommend that clinicians conduct a focused physical examination to help to identify patients with non-specific low back pain and an evidence-based course of clinical management. The use of sensitive and specific clinical methods to assess the lumbar spine, sacroiliac and hip joints is critical for effective physical examination. Psychosocial factors also play an important role in the evaluation of individuals with low back pain, but are not included in this narrative review of physical examination methods. Physical examination of the lumbar spine, sacroiliac and hip joints is presented, organized around patient position for efficient and effective clinical assessment. Copyright © 2012 John Wiley & Sons, Ltd.

  8. Examining Explanations for the Link Between Bullying Perpetration and Physical Dating Violence Perpetration: Do They Vary by Bullying Victimization?

    Science.gov (United States)

    Foshee, Vangie A.; Benefield, Thad S.; Reyes, Heath Luz McNaughton; Eastman, Meridith; Vivolo-Kantor, Alana M.; Basile, Kathleen C.; Ennett, Susan T.; Faris, Robert

    2015-01-01

    This short-term longitudinal study examined whether the association between bullying perpetration and later physical dating violence perpetration and mediators of that association (via anger, depression, anxiety, and social status), varied depending on level of bullying victimization. Differences have been noted between those who bully but are not victims of bullying, and those who are both bullies and victims. These differences may influence dating violence risk and the explanations for why bullying leads to dating violence. Data were from dating adolescents in three rural counties who completed self-administered questionnaires in the fall semester of grades 8–10 and again in the spring semester. The sample (N =2,414) was 44.08% male and 61.31% white. Bullying perpetration in the fall semester predicted physical dating violence perpetration in the spring semester when there was no bullying victimization, but not when there was any bullying victimization. Bullying perpetration was positively associated with anger at all levels of bullying victimization and with social status when there was no or low amounts of victimization; it was negatively associated with social status at high levels of victimization. Bullying victimization was positively associated with anger, depression, and anxiety at all levels of bullying perpetration. Anger mediated the association between bullying perpetration and dating violence, regardless of level of victimization; depression, anxiety, and social status did not mediate the association at any level of bullying victimization. The findings have implications for dating violence prevention efforts and for future research on the link between bullying and dating violence. PMID:26299840

  9. Examining explanations for the link between bullying perpetration and physical dating violence perpetration: Do they vary by bullying victimization?

    Science.gov (United States)

    Foshee, Vangie A; Benefield, Thad S; McNaughton Reyes, Heath Luz; Eastman, Meridith; Vivolo-Kantor, Alana M; Basile, Kathleen C; Ennett, Susan T; Faris, Robert

    2016-01-01

    This short-term longitudinal study examined whether the association between bullying perpetration and later physical dating violence perpetration and mediators of that association (via anger, depression, anxiety, and social status), varied depending on level of bullying victimization. Differences have been noted between those who bully but are not victims of bullying, and those who are both bullies and victims. These differences may influence dating violence risk and the explanations for why bullying leads to dating violence. Data were from dating adolescents in three rural counties who completed self-administered questionnaires in the fall semester of grades 8-10 and again in the spring semester. The sample (N = 2,414) was 44.08% male and 61.31% white. Bullying perpetration in the fall semester predicted physical dating violence perpetration in the spring semester when there was no bullying victimization, but not when there was any bullying victimization. Bullying perpetration was positively associated with anger at all levels of bullying victimization and with social status when there was no or low amounts of victimization; it was negatively associated with social status at high levels of victimization. Bullying victimization was positively associated with anger, depression, and anxiety at all levels of bullying perpetration. Anger mediated the association between bullying perpetration and dating violence, regardless of level of victimization; depression, anxiety, and social status did not mediate the association at any level of bullying victimization. The findings have implications for dating violence prevention efforts and for future research on the link between bullying and dating violence. © 2015 Wiley Periodicals, Inc.

  10. An examination of eating behaviors, physical activity, and obesity in african american adolescents: gender, socioeconomic status, and residential status differences.

    Science.gov (United States)

    Tate, Nutrena H; Dillaway, Heather E; Yarandi, Hossein N; Jones, Lenette M; Wilson, Feleta L

    2015-01-01

    African American adolescents experience higher rates of obesity and have an increased risk of obesity-related diseases than do White American adolescents. Despite culturally sensitive obesity preventive interventions, obesity rates are increasing within the African American adolescent population. Current obesity interventions do not usually address the heterogeneity (e.g., socioeconomic status [SES], gender, and residential status differences) within the African American adolescent community that can affect the efficacy of these interventions. To examine the gender, SES, and residential status differences related to obesity and weight behaviors in African American adolescents. A descriptive correlational study was conducted with 15- to 17-year-old African American adolescents (n = 145) from community clinics, youth organizations, churches, and social networks in metropolitan and inner-city Detroit. Data were collected through use of survey methods and analyzed with use of descriptive statistics, independent sample t tests, and multiple regression equations. Female adolescents consumed foods higher in fat and calories (t = -2.36, p = .019) and had more body fat (t = -9.37, p = .000) than did males. Adolescents of lower SES consumed food higher in fat and calories (t = -2.23, p = .027) and had higher body mass (t = -2.57, p = .011) than did adolescents of higher SES. Inner-city African American adolescents had higher levels of physical activity (t = -2.39, p = .018) and higher body mass (t = 2.24, p = .027) than did suburban African American adolescent counterparts. Gender, SES, and residential status were statistically significant predictors of eating behaviors, physical activity, body mass index, and body fat. The initial findings from the study will assist in better understanding the obesity epidemic that affects African American adolescents in disparate proportions. Further examination of the study variables is essential to serve as a basis for

  11. The effect of mere measurement from a cardiovascular examination program on physical activity and sedentary time in an adult population.

    Science.gov (United States)

    Voigt, Lisa; Baumann, Sophie; Ullrich, Antje; Weymar, Franziska; John, Ulrich; Ulbricht, Sabina

    2018-01-01

    Measuring physical activity (PA) and sedentary time (ST) by self-report or device as well as assessing related health factors may alter those behaviors. Thus, in intervention trials assessments may bias intervention effects. The aim of our study was to examine whether leisure-time PA, transport-related PA, and overall ST measured via self-report vary after assessments and whether a brief tailored letter intervention has an additional effect. Among a sample of subjects with no history of myocardial infarction, stroke, or vascular intervention, a number of 175 individuals participated in a study comprising multiple repeated assessments. Of those, 153 were analyzed (mean age 54.5 years, standard deviation = 6.2; 64% women). At baseline, participants attended a cardiovascular examination (standardized measurement of blood pressure and waist circumference, blood sample taking) and wore an accelerometer for seven days. At baseline and after 1, 6, and 12 months, participants completed the International Physical Activity Questionnaire. A random subsample received a tailored counseling letter intervention at month 1, 3, and 4. Changes in PA and ST from baseline to 12-month follow-up were analyzed using random-effects modelling. From baseline to 1-month assessment, leisure-time PA did not change (Incidence rate ratio = 1.13, p  = .432), transport-related PA increased (Incidence rate ratio = 1.45, p  = .023), and overall ST tended to decrease (b = - 1.96, p  = .060). Further, overall ST decreased from month 6 to month 12 (b = - 0.52, p  = .037). Time trends of the intervention group did not differ significantly from those of the assessment-only group. Results suggest an effect of measurements on PA and ST. Data of random-effects modelling results revealed an increase of transport-related PA after baseline to 1-month assessment. Decreases in overall ST may result from repeated assessments. A brief tailored letter intervention seemed to

  12. Patient education for colon cancer screening: a randomized trial of a video mailed before a physical examination.

    Science.gov (United States)

    Zapka, Jane G; Lemon, Stephenie C; Puleo, Elaine; Estabrook, Barbara; Luckmann, Roger; Erban, Stephen

    2004-11-02

    Colorectal cancer screening is underused, and primary care clinicians are challenged to provide patient education within the constraints of busy practices. To test the effect of an educational video, mailed to patients' homes before a physical examination, on performance of colorectal cancer screening, particularly sigmoidoscopy. Randomized, controlled trial. 5 primary care practices in central Massachusetts. 938 patients age 50 to 74 years who were scheduled for an upcoming physical examination, had no personal history of colorectal cancer, and were eligible for lower-endoscopy screening according to current guidelines. Participants were randomly assigned to receive usual care (n = 488) or a video about colorectal cancer, the importance of early detection, and screening options (n = 450). Baseline and 6-month follow-up telephone assessments were conducted. A dependent variable classified screening since baseline as 1) sigmoidoscopy with or without other tests, 2) another test or test combination, or 3) no tests. Overall screening rates were the same in the intervention and control groups (55%). In regression modeling, intervention participants were nonsignificantly more likely to complete sigmoidoscopy alone or in combination with another test (odds ratio, 1.22 [95% CI, 0.88 to 1.70]). Intervention dose (viewing at least half of the video) was significantly related to receiving sigmoidoscopy with or without another test (odds ratio, 2.81 [CI, 1.85 to 4.26]). Recruitment records showed that at least 23% of people coming for periodic health assessments were currently screened by a lower-endoscopy procedure and therefore were not eligible. The primary care sample studied consisted primarily of middle-class white persons who had high screening rates at baseline. The results may not be generalizable to other populations. The trial was conducted during a period of increased health insurance coverage for lower-endoscopy procedures and public media attention to colon

  13. Evaluation of the acceptability of Peer Physical Examination (PPE) in medical and osteopathic students: a cross sectional survey.

    Science.gov (United States)

    Consorti, Fabrizio; Mancuso, Rosaria; Piccolo, Annalisa; Consorti, Giacomo; Zurlo, Joseph

    2013-08-22

    Peer physical examination (PPE) is a method of training in medical and osteopathic curricula. The aim of this study was to compare the acceptability of PPE in two classes of medical and osteopathic students after their first experience, to obtain comparative information useful for an understanding of the different professional approaches. The leading hypothesis was that osteopathic students enter the curriculum with a more positive attitude to bodily contact.As a secondary aim, this study validated the new version of a questionnaire to assess the acceptability of PPE. A new version of a previously validated questionnaire and an instrument from the literature (the Examining Fellow Student [EFS] questionnaire) were used for a cross-sectional survey in a class of 129 3rd year medical students and in two parallel classes of 1st year osteopathic students (total of 112 students). The mean score of the new questionnaire was significantly higher for the osteopathic students than for the medical students (53.4 ± 6.3 vs. 43.4 ± 8.9; p student. The EFS mean score also showed a significant difference between the osteopathic and medical students (30.76 ± 2.9 vs. 27.85 ± 4.3; p accounting for 62.8% of the variance. Criterion validity was assessed by correlation with the EFS (Pearson's r coefficient = 0.61). Reliability was expressed in terms of Cronbach's alpha coefficient, which equals 0.86. These quantitative results are consistent with previous qualitative research on the process of embodiment both in medicine and osteopathy. The new questionnaire proved to be valid and reliable. The objective assessment of the acceptability of PPE is a way to determine differences in students' attitudes towards contact with the body and can be used for counselling students regarding career choice. This study can also highlight differences between students from different professions and serve as a basis for reflection for improved mutual interprofessional understanding and future

  14. [Lumbar disc herniation: Natural history, role of physical examination, timing of surgery, treatment options and conflicts of interests].

    Science.gov (United States)

    Delgado-López, Pedro David; Rodríguez-Salazar, Antonio; Martín-Alonso, Javier; Martín-Velasco, Vicente

    Indication for surgery in lumbar disc herniation (LDH) varies widely depending on the geographical area. A literature review is presented on the natural history, role of physical examination, timing of surgery, evidence-based treatment, and conflicts of interests in LDH. Surgery is shown to provide significant faster relief of pain compared to conservative therapy, although the effect fades after a year. There is no treatment modality better than the rest in terms of pain control and neurological recovery, nor is there a surgical technique clearly superior to simple discectomy. The lack of sound scientific evidence on the surgical indication may contribute to its great geographical variability. Since LDH has a favourable natural history, neuroimaging and surgery should not be considered until after a 6-week period. It is necessary to specify and respect the surgical indications for LDH, avoiding conflicts of interests. Copyright © 2016 Sociedad Española de Neurocirugía. Publicado por Elsevier España, S.L.U. All rights reserved.

  15. Physical Examination Tools Used to Identify Swollen and Tender Lower Limb Joints in Juvenile Idiopathic Arthritis: A Scoping Review.

    Science.gov (United States)

    Fellas, Antoni; Singh-Grewal, Davinder; Santos, Derek; Coda, Andrea

    2018-01-01

    Juvenile idiopathic arthritis (JIA) is the most common form of rheumatic disease in childhood and adolescents, affecting between 16 and 150 per 100,000 young persons below the age of 16. The lower limb is commonly affected in JIA, with joint swelling and tenderness often observed as a result of active synovitis. The objective of this scoping review is to identify the existence of physical examination (PE) tools to identify and record swollen and tender lower limb joints in children with JIA. Two reviewers individually screened the eligibility of titles and abstracts retrieved from the following online databases: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and CINAHL. Studies that proposed and validated a comprehensive lower limb PE tool were included in this scoping review. After removal of duplicates, 1232 citations were retrieved, in which twelve were identified as potentially eligible. No studies met the set criteria for inclusion. Further research is needed in developing and validating specific PE tools for clinicians such as podiatrists and other allied health professionals involved in the management of pathological lower limb joints in children diagnosed with JIA. These lower limb PE tools may be useful in conjunction with existing disease activity scores to optimise screening of the lower extremity and monitoring the efficacy of targeted interventions.

  16. Cardiovascular health metrics and accelerometer-measured physical activity levels: National Health and Nutrition Examination Survey, 2003-2006.

    Science.gov (United States)

    Barreira, Tiago V; Harrington, Deirdre M; Katzmarzyk, Peter T

    2014-01-01

    To determine whether relationships exist between accelerometer-measured moderate-to-vigorous physical activity (MVPA) and other cardiovascular (CV) health metrics in a large sample. Data from the 2003-2006 National Health and Nutrition Examination Survey (NHANES) collected from January 1, 2003, through December 31, 2006, were used. Overall, 3454 nonpregnant adults 20 years or older who fasted for 6 hours or longer, with valid accelerometer data and with CV health metrics, were included in the study. Blood pressure (BP), body mass index (BMI), smoking status, diet, fasting plasma glucose level, and total cholesterol level were defined as ideal, intermediate, and poor on the basis of American Heart Association criteria. Results were weighted to account for sampling design, oversampling, and nonresponse. Significant increasing linear trends in mean daily MVPA were observed across CV health levels for BMI, BP, and fasting plasma glucose (Pphysical activity in the overall definition of ideal CV health. Copyright © 2014 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  17. Examination of the Attitudes of School of Physical Education and Sports Students towards Teaching Profession in Terms of Various Variables

    Science.gov (United States)

    Cetinkaya, Turan; Kirtepe, Abdurrahman; Ugurlu, Fatih Mehmet

    2018-01-01

    The aim of this research is to determine the attitudes of the students who are studying in the physical education and sports departments towards the teaching profession. 244 students attending Ahi Evran University School of Physical Education and Sports and Firat University Sports Sciences Faculty Physical Education and Sport Teacher Training,…

  18. Barriers to undergraduate peer-physical examination of the lower limb in the health sciences and strategies to improve inclusion: a review.

    Science.gov (United States)

    Hendry, Gordon James

    2013-10-01

    Peer-physical examination is a widely adopted and an integral component of the undergraduate curriculum for many health science programs. Unwillingness or perceived inability to participate in peer-physical examination classes may have a negative impact upon students' abilities to competently conduct physical examinations of patients in future as registered health professionals. A literature review on the perceptions and attitudes of peer-physical examination of the lower limb amongst medical and health science students was conducted to identify potential barriers to participation, and to review strategies to improve participation in classes designed to develop clinical examination skills. A pragmatic search strategy of the literature from PubMed and Google Scholar published prior to June 2012 yielded 23 relevant articles. All articles were concerned with the views of medical students' education and there were no articles explicitly addressing the role of peer-physical examination in health science disciplines. Several ethical issues were identified including feelings of coercion, embarrassment, and perceptions of a lack of consideration for cultural and religious beliefs. The available evidence suggests that barriers to participation may be overcome by implementing standard protocols concerned with obtaining informed written consent, adequate choice of peer-examiner, changing facilities and garment advice, and possible alternative learning methods.

  19. An Examination of the Reliability and Factor Structure of the Physical Activity Scale for Individuals With Physical Disabilities (PASIPD) Among Individuals Living With Parkinson's Disease.

    Science.gov (United States)

    Jimenez-Pardo, J; Holmes, J D; Jenkins, M E; Johnson, A M

    2015-07-01

    Physical activity is generally thought to be beneficial to individuals with Parkinson's disease (PD). There is, however, limited information regarding current rates of physical activity among individuals with PD, possibly due to a lack of well-validated measurement tools. In the current study we sampled 63 individuals (31 women) living with PD between the ages of 52 and 87 (M = 70.97 years, SD = 7.53), and evaluated the amount of physical activity in which they engaged over a 7-day period using a modified form of the Physical Activity Scale for Individuals with Physical Disabilities (PASIPD). The PASIPD was demonstrated to be a reliable measure within this population, with three theoretically defensible factors: (1) housework and home-based outdoor activities; (2) recreational and fitness activities; and (3) occupational activities. These results suggest that the PASIPD may be useful for monitoring physical activity involvement among individuals with PD, particularly within large-scale questionnaire-based studies.

  20. Reliability and Validity of the SE-HEPA: Examining Physical Activity- and Healthy Eating-Specific Self-Efficacy among a Sample of Preadolescents

    Science.gov (United States)

    Steele, Michael M.; Burns, Leonard G.; Whitaker, Brandi N.

    2013-01-01

    Objective. The purpose of this study was to examine the psychometric properties of the self-efficacy for healthy eating and physical activity measure (SE-HEPA) for preadolescents. Method. The reliability of the measure was examined to determine if the internal consistency of the measure was adequate (i.e., [alpha]s greater than 0.70). Next, in an…

  1. Physical examination instead of laboratory tests for most infants born to mothers colonized with group B Streptococcus: support for the Centers for Disease Control and Prevention's 2010 recommendations.

    Science.gov (United States)

    Cantoni, Luigi; Ronfani, Luca; Da Riol, Rosalia; Demarini, Sergio

    2013-08-01

    To compare 2 approaches in the management of neonates at risk for group B Streptococcus early-onset sepsis: laboratory tests plus standardized physical examination and standardized physical examination alone. Prospective, sequential study over 2 consecutive 12-month periods, carried out in the maternity hospitals of the region Friuli-Venezia Giulia (north-eastern Italy). All term infants were included (7628 in the first period, 7611 in the second). In the first period, complete blood count and blood culture were required for all infants at risk, followed by a 48-hour period of observation with a standardized physical examination. In the second period, only standardized physical examination was performed. Study outcomes were: (1) number of neonates treated with antibiotics; and (2) time between onset of signs of possible sepsis and beginning of treatment. There was no difference between the 2 periods in the rate of maternal colonization (19.7% vs 19.8%, P = .8), or in other risk factors. The interval between onset of signs of sepsis and starting of antibiotics was not different in the 2 periods. Significantly fewer infants were treated with antibiotics in the second period (0.5% vs 1.2%, P examination seem to offer no advantage over standardized physical examination alone; the latter was associated with fewer antibiotic treatments. Our results are in agreement with the Center for Disease Control and Prevention's 2010 recommendations. Copyright © 2013 Mosby, Inc. All rights reserved.

  2. Diagnostic accuracy of history, physical examination, and bedside ultrasound for diagnosis of extremity fractures in the emergency department: a systematic review.

    Science.gov (United States)

    Joshi, Nikita; Lira, Alena; Mehta, Ninfa; Paladino, Lorenzo; Sinert, Richard

    2013-01-01

    Understanding history, physical examination, and ultrasonography (US) to diagnose extremity fractures compared with radiography has potential benefits of decreasing radiation exposure, costs, and pain and improving emergency department (ED) resource management and triage time. The authors performed two electronic searches using PubMed and EMBASE databases for studies published between 1965 to 2012 using a strategy based on the inclusion of any patient presenting with extremity injuries suspicious for fracture who had history and physical examination and a separate search for US performed by an emergency physician (EP) with subsequent radiography. The primary outcome was operating characteristics of ED history, physical examination, and US in diagnosing radiologically proven extremity fractures. The methodologic quality of the studies was assessed using the quality assessment of studies of diagnostic accuracy tool (QUADAS-2). Nine studies met the inclusion criteria for history and physical examination, while eight studies met the inclusion criteria for US. There was significant heterogeneity in the studies that prevented data pooling. Data were organized into subgroups based on anatomic fracture locations, but heterogeneity within the subgroups also prevented data pooling. The prevalence of fracture varied among the studies from 22% to 70%. Upper extremity physical examination tests have positive likelihood ratios (LRs) ranging from 1.2 to infinity and negative LRs ranging from 0 to 0.8. US sensitivities varied between 85% and 100%, specificities varied between 73% and 100%, positive LRs varied between 3.2 and 56.1, and negative LRs varied between 0 and 0.2. Compared with radiography, EP US is an accurate diagnostic test to rule in or rule out extremity fractures. The diagnostic accuracy for history and physical examination are inconclusive. Future research is needed to understand the accuracy of ED US when combined with history and physical examination for upper

  3. Evaluating Photographs as a Replacement for the In-Person Physical Examination of the Scored Patient-Generated Subjective Global Assessment in Elderly Hospital Patients.

    Science.gov (United States)

    Miller, Michelle; Thomas, Jolene; Suen, Jenni; Ong, De Sheng; Sharma, Yogesh

    2018-05-01

    Undernourished patients discharged from the hospital require follow-up; however, attendance at return visits is low. Teleconsultations may allow remote follow-up of undernourished patients; however, no valid method to remotely perform physical examination, a critical component of assessing nutritional status, exists. This study aims to compare agreement between photographs taken by trained dietitians and in-person physical examinations conducted by trained dietitians to rate the overall physical examination section of the scored Patient Generated Subjective Global Assessment (PG-SGA). Nested cross-sectional study. Adults aged ≥60 years, admitted to the general medicine unit at Flinders Medical Centre between March 2015 and March 2016, were eligible. All components of the PG-SGA and photographs of muscle and fat sites were collected from 192 participants either in the hospital or at their place of residence after discharge. Validity of photograph-based physical examination was determined by collecting photographic and PG-SGA data from each participant at one encounter by trained dietitians. A dietitian blinded to data collection later assessed de-identified photographs on a computer. Percentage agreement, weighted kappa agreement, sensitivity, and specificity between the photographs and in-person physical examinations were calculated. All data collected were included in the analysis. Overall, the photograph-based physical examination rating achieved a percentage agreement of 75.8% against the in-person assessment, with a weighted kappa agreement of 0.526 (95% CI: 0.416, 0.637; Pexamination by trained dietitians achieved a nearly acceptable percentage agreement, moderate weighted kappa, and fair sensitivity-specificity pair. Methodological refinement before field testing with other personnel may improve the agreement and accuracy of photograph-based physical examination. Copyright © 2018 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights

  4. Examining acute bi-directional relationships between affect, physical feeling states, and physical activity in free-living situations using electronic ecological momentary assessment.

    Science.gov (United States)

    Liao, Yue; Chou, Chih-Ping; Huh, Jimi; Leventhal, Adam; Dunton, Genevieve

    2017-06-01

    Current knowledge about the relationship of physical activity with acute affective and physical feeling states is informed largely by lab-based studies, which have limited generalizability to the natural ecology. This study used ecological momentary assessment to assess subjective affective and physical feeling states in free-living settings across 4 days from 110 non-physically active adults (Age M = 40.4, SD = 9.7). Light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA) were measured objectively by an accelerometer. Multilevel modeling was used to test the bi-directional associations between affective and physical feeling states and LPA/MVPA minutes. Higher positive affect, lower negative affect and fatigue were associated with more MVPA over the subsequent 15 min, while higher negative affect and energy were associated with more LPA over the subsequent 15 and 30 min. Additionally, more LPA and MVPA were associated with feeling more energetic over the subsequent 15 and 30 min, and more LPA was additionally associated with feeling more negative and less tired over the subsequent 15 and 30 min. Positive and negative affective states might serve as antecedents to but not consequences of MVPA in adults' daily lives. Changes in LPA may be predicted and followed by negative affective states. Physical feeling states appear to lead up to and follow changes in both LPA and MVPA.

  5. Physical examination tests of the shoulder: a systematic review and meta-analysis of diagnostic test performance.

    Science.gov (United States)

    Gismervik, Sigmund Ø; Drogset, Jon O; Granviken, Fredrik; Rø, Magne; Leivseth, Gunnar

    2017-01-25

    Physical examination tests of the shoulder (PETS) are clinical examination maneuvers designed to aid the assessment of shoulder complaints. Despite more than 180 PETS described in the literature, evidence of their validity and usefulness in diagnosing the shoulder is questioned. This meta-analysis aims to use diagnostic odds ratio (DOR) to evaluate how much PETS shift overall probability and to rank the test performance of single PETS in order to aid the clinician's choice of which tests to use. This study adheres to the principles outlined in the Cochrane guidelines and the PRISMA statement. A fixed effect model was used to assess the overall diagnostic validity of PETS by pooling DOR for different PETS with similar biomechanical rationale when possible. Single PETS were assessed and ranked by DOR. Clinical performance was assessed by sensitivity, specificity, accuracy and likelihood ratio. Six thousand nine-hundred abstracts and 202 full-text articles were assessed for eligibility; 20 articles were eligible and data from 11 articles could be included in the meta-analysis. All PETS for SLAP (superior labral anterior posterior) lesions pooled gave a DOR of 1.38 [1.13, 1.69]. The Supraspinatus test for any full thickness rotator cuff tear obtained the highest DOR of 9.24 (sensitivity was 0.74, specificity 0.77). Compression-Rotation test obtained the highest DOR (6.36) among single PETS for SLAP lesions (sensitivity 0.43, specificity 0.89) and Hawkins test obtained the highest DOR (2.86) for impingement syndrome (sensitivity 0.58, specificity 0.67). No single PETS showed superior clinical test performance. The clinical performance of single PETS is limited. However, when the different PETS for SLAP lesions were pooled, we found a statistical significant change in post-test probability indicating an overall statistical validity. We suggest that clinicians choose their PETS among those with the highest pooled DOR and to assess validity to their own specific clinical

  6. Keeping women active: an examination of the impacts of self-efficacy, intrinsic motivation, and leadership on women's persistence in physical activity.

    Science.gov (United States)

    Lloyd, Kathleen M; Little, Donna E

    2010-10-01

    Physical inactivity in women is a worldwide problem that has not only been well-documented but has provoked much government concern and policy activity. However, an even more important issue is encouraging women's persistence in physical activity. The purpose of this study was to examine the links between women's experiences of participation in a government-funded physical activity festival, their intentions to continue participation, and their participation behavior six months after the festival. Results from semi-structured, in-depth interviews with 20 women revealed that enhanced self-efficacy, intrinsic motivation, and supportive leadership had motivated the women's future intentions to participate. Follow-up surveys showed their levels of interest and participation in physical activity had been maintained. These results enhance our understanding of the relationship between key outcomes of women's physical activity participation and their persistence in physical activity.

  7. Physical examination tests and imaging studies based on arthroscopic assessment of the long head of biceps tendon are invalid.

    Science.gov (United States)

    Jordan, Robert W; Saithna, Adnan

    2017-10-01

    The aim of this study was to evaluate whether glenohumeral arthroscopy is an appropriate gold standard for the diagnosis of long head of biceps (LHB) tendon pathology. The objectives were to evaluate whether the length of tendon that can be seen at arthroscopy allows visualisation of areas of predilection of pathology and also to determine the rates of missed diagnoses at arthroscopy when compared to an open approach. A systematic review of cadaveric and clinical studies was performed. The search strategy was applied to MEDLINE, PubMed and Google Scholar databases. All relevant articles were included. Critical appraisal of clinical studies was performed using a validated quality assessment scale. Five articles were identified for inclusion in the review. This included both clinical and cadaveric studies. The overall population comprised 18 cadaveric specimens and 575 patients. Out of the five included studies, three reported the length of LHB tendon visualised during arthroscopy and four reported the rate of missed LHB diagnosis. Cadaveric studies showed that the use of a hook probe allowed arthroscopic visualisation of between 34 and 48 % of the overall length of the LHB. In the clinical series, the rate of missed diagnoses at arthroscopy when compared to open exploration ranged between 33 and 49 %. Arthroscopy allows visualisation of only a small part of the extra-articular LHB tendon. This leads to a high rate of missed pathology in the distal part of the tendon. Published figures for sensitivities and specificities of common physical examination and imaging tests for LHB pathology that are based on arthroscopy as the gold standard are therefore invalid. In clinical practice, it is important to note that a "negative" arthroscopic assessment does not exclude a lesion of the LHB tendon as this technique does not allow visualisation of common sites of distal pathology. IV.

  8. Incremental Value of Pocket-Sized Echocardiography in Addition to Physical Examination during Inpatient Cardiology Evaluation: A Multicenter Italian Study (SIEC).

    Science.gov (United States)

    Di Bello, Vitantonio; La Carrubba, Salvatore; Conte, Lorenzo; Fabiani, Iacopo; Posteraro, Alfredo; Antonini-Canterin, Francesco; Barletta, Valentina; Nicastro, Irene; Mariotti, Egidio; Severino, Sergio; Caso, Pio; Benedetto, Frank; Savino, Ketty; Carerj, Scipione

    2015-10-01

    We prospectively assessed the incremental value of a pocket-sized echocardiography (PSE) device during cardiology consultations, in addition to physical examination, ECG reading, and chest x-ray. A total of 443 consecutive patients (53% men), referred for bedside consultations, underwent physical examination, ECG, and CXR, followed by PSE examination. The physician completed a detailed questionnaire (clinical and echocardiographic data, scanning time, abnormal results). Receiver operating characteristic (ROC) curve analysis was generated to test the predictive discrimination value of the different methods. The incremental value of PSE examination compared to clinical visit alone or combined with ECG results was expressed as a global chi-square value. The PSE examination did not influence the definitive diagnosis in only 23.5% of cases, while 25.3% of the diagnoses were confirmed and verified by PSE. The clinical diagnosis was enriched by PSE in 21.9% of cases, and the diagnosis was changed in 26.2%. The area under curve (AUC) of physical examination + ECG results (sensitivity: 80%; specificity: 67%) was significantly higher than physical examination alone (sensitivity: 75%; specificity: 62%) (P echocardiography. © 2015, Wiley Periodicals, Inc.

  9. Gender differences in physical activity and health-related behaviors among stroke survivors: data from the 5th Korea National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Lee, Yookyung; Kim, Won-Seok; Paik, Nam-Jong

    2017-07-01

    Physical activity and health-related behaviors are important in primary prevention of stroke and are also recommended for secondary prevention. Gender differences in physical activity and health-related behaviors have been reported in various populations and diseased states but data is lacking on stroke survivors. To assess gender disparities in physical activity in stroke patients and to investigate possible reasons for such disparities. This is a cross-sectional study using nationwide data from the 5th Korean National Health and Nutrition Examination Survey (2010-2012). A total of 9539 participants (stroke (n = 170), non-stroke (n = 9369)) between the ages of 40-80, with no problems walking were included. Physical activity, smoking, and alcohol drinking of stroke survivors were assessed by gender and compared with non-stroke groups. Multiple logistic regression was used to estimate the odds ratios (ORs) for insufficient physical activity and possible explanatory variables for gender differences. Women showed higher prevalence of insufficient physical activity after adjusting for age (OR = 7.32, 95% CI: 1.89-28.32) compared to men. Medical conditions such as depression and comorbidities failed to explain the low physical activity in women with stroke but adding socioeconomic factors to the model nullified the gender difference in physical activity. In order to reduce noted gender disparities in physical activity following stroke, more focused effort to increase physical activity in women, especially with lower socioeconomic status, has to be considered.

  10. Effects of physical examination and diet consultation on serum cholesterol and health-behavior in the Korean pilots employed in commercial airline.

    Science.gov (United States)

    Choi, Yun Young; Kim, Ki Youn

    2013-01-01

    An objective of this study is to search how physical examination and diet consultation can influence those risk factors of cardiovascular disease. The subjects were 326 pilots of the "B" airline company in Korea whose total cholesterol values were over 220 mg/dl on their regular physical examinations from April 2006 to December 2008. They were divided into two groups, one who had diet consultation (an intervention group) and a control group. The physical examination components used to each group were body mass index (BMI), total cholesterol (TC), high density lipoprotein (HDL), low density lipoprotein (LDL) and triglyceride (TG). The behavioral, anthropometric and biomedical measurements were collected at each visit. This study compares and investigates the changes of serum cholesterol and also the health-behavior at each physical examination. Within the intervention group significant improvements were observed for total cholesterol, BMI (body mass index) and HDL (high density lipoprotein). The normalizing rates for cholesterol level to decrease down to lower than 200 mg/dl were 17.7% in intervention group and 8.7% in control group, which is statistically significantly higher among the intervention group. The odds ratio of diet consultation was 2.80 (95% CI=1.35-5.79), which indicates that it is a significantly contributing factor to normalize the serum cholesterol value down to lower than 200 mg/dl. Based on result, it is recommended to have regular physical examination and intensive management with diet and exercise consultation.

  11. Sexual victimization of youth with a physical disability: an examination of prevalence rates, and risk and protective factors.

    Science.gov (United States)

    Mueller-Johnson, Katrin; Eisner, Manuel P; Obsuth, Ingrid

    2014-11-01

    Children with disabilities have been shown to be at greater risk of victimization than those without. Although much of the research combines disability of any type into a single disability category, recent evidence suggests that not all types of disabilities are equally associated with victimization. To date, little knowledge exists about the victimization of youth with physical disabilities. This study used data from a national school-based survey of adolescents (n = 6,749, mean age = 15.41, SD = .66) in Switzerland to investigate sexual victimization (SV) among physically disabled youth. Two subtypes of SV were differentiated: contact SV, including penetration or touching/kissing, and non-contact SV, such as exhibitionism, verbal harassment, exposure to sexual acts, or cyber SV. A total of 360 (5.1%) youth self-identified as having a physical disability. Lifetime prevalence rates for contact SV were 25.95% for girls with a physical disability (odds ratio [OR] = 1.29 compared with able-bodied girls), 18.50% for boys with physical disability (OR = 2.78 compared with able-bodied boys), and 22.35% for the total sample with physical disability (OR = 1.74 compared with able-bodied youth). For non-contact SV, the lifetime prevalence was 48.11% for girls with a physical disability (OR = 1.44 compared with able-bodied girls), 31.76% for boys with physical disability (OR = 1.95 compared with able-bodied boys), and 40.28% for the total sample with physical disability (OR = 1.67 compared with able-bodied youth). After controlling for other risk factors, physical disability was a significant predictor of contact and non-contact SV for boys, but not for girls. © The Author(s) 2014.

  12. Affect and subsequent physical activity: An ambulatory assessment study examining the affect-activity association in a real-life context

    OpenAIRE

    Christina eNiermann; Christian eHerrmann; Birte evon Haaren; Dave evan Kann; Alexander eWoll

    2016-01-01

    Traditionally, cognitive, motivational, and volitional determinants have been used to explain and predict health behaviors such as physical activity. Recently, the role of affect in influencing and regulating health behaviors received more attention. Affects as internal cues may automatically activate unconscious processes of behavior regulation. The aim of our study was to examine the association between affect and physical activity in daily life. In addition, we studied the influence of the...

  13. Rationale and design of a randomized controlled trial examining the effect of classroom-based physical activity on math achievement

    Directory of Open Access Journals (Sweden)

    Mona Have

    2016-04-01

    Full Text Available Abstract Background Integration of physical activity (PA into the classroom may be an effective way of promoting the learning and academic achievement of children at elementary school. This paper describes the research design and methodology of an intervention study examining the effect of classroom-based PA on mathematical achievement, creativity, executive function, body mass index and aerobic fitness. Methods The study was designed as a school-based cluster-randomized controlled trial targeting schoolchildren in 1st grade, and was carried out between August 2012 and June 2013. Eligible schools in two municipalities in the Region of Southern Denmark were invited to participate in the study. After stratification by municipality, twelve schools were randomized to either an intervention group or a control group, comprising a total of 505 children with mean age 7.2 ± 0.3 years. The intervention was a 9-month classroom-based PA program that involved integration of PA into the math lessons delivered by the schools’ math teachers. The primary study outcome was change in math achievement, measured by a 45-minute standardized math test. Secondary outcomes were change in executive function (using a modified Eriksen flanker task and the Behavior Rating Inventory of Executive Function (BRIEF questionnaire filled out by the parents, creativity (using the Torrance Tests of Creative Thinking, TTCT, aerobic fitness (by the Andersen intermittent shuttle-run test and body mass index. PA during math lessons and total PA (including time spent outside school were assessed using accelerometry. Math teachers used Short Message Service (SMS-tracking to report on compliance with the PA intervention and on their motivation for implementing PA in math lessons. Parents used SMS-tracking to register their children’s PA behavior in leisure time. Discussion The results of this randomized controlled trial are expected to provide schools and policy-makers with

  14. Rationale and design of a randomized controlled trial examining the effect of classroom-based physical activity on math achievement.

    Science.gov (United States)

    Have, Mona; Nielsen, Jacob Have; Gejl, Anne Kær; Thomsen Ernst, Martin; Fredens, Kjeld; Støckel, Jan Toftegaard; Wedderkopp, Niels; Domazet, Sidsel Louise; Gudex, Claire; Grøntved, Anders; Kristensen, Peter Lund

    2016-04-11

    Integration of physical activity (PA) into the classroom may be an effective way of promoting the learning and academic achievement of children at elementary school. This paper describes the research design and methodology of an intervention study examining the effect of classroom-based PA on mathematical achievement, creativity, executive function, body mass index and aerobic fitness. The study was designed as a school-based cluster-randomized controlled trial targeting schoolchildren in 1st grade, and was carried out between August 2012 and June 2013. Eligible schools in two municipalities in the Region of Southern Denmark were invited to participate in the study. After stratification by municipality, twelve schools were randomized to either an intervention group or a control group, comprising a total of 505 children with mean age 7.2 ± 0.3 years. The intervention was a 9-month classroom-based PA program that involved integration of PA into the math lessons delivered by the schools' math teachers. The primary study outcome was change in math achievement, measured by a 45-minute standardized math test. Secondary outcomes were change in executive function (using a modified Eriksen flanker task and the Behavior Rating Inventory of Executive Function (BRIEF) questionnaire filled out by the parents), creativity (using the Torrance Tests of Creative Thinking, TTCT), aerobic fitness (by the Andersen intermittent shuttle-run test) and body mass index. PA during math lessons and total PA (including time spent outside school) were assessed using accelerometry. Math teachers used Short Message Service (SMS)-tracking to report on compliance with the PA intervention and on their motivation for implementing PA in math lessons. Parents used SMS-tracking to register their children's PA behavior in leisure time. The results of this randomized controlled trial are expected to provide schools and policy-makers with significant new insights into the potential of classroom

  15. Correlation of liver stiffness measured by FibroScan with sex and age in healthy adults undergoing physical examination

    Directory of Open Access Journals (Sweden)

    ZHAO Chongshan

    2016-04-01

    Full Text Available ObjectiveTo determine the reference range of liver stiffness in healthy population, and to investigate the influence of age and sex on liver stiffness. MethodsA total of 1794 healthy subjects who underwent physical examination in China National Petroleum Corporation Central Hospital from October 1, 2012 to October 31, 2014 were enrolled, and FibroScan was used to perform liver stiffness measurement (LSM. Since LSM value was not normally distributed, the Wilcoxon rank sum test was used to compare LSM value between male and female patients, the Kruskal-Wallis test was used to compare LSM value between different age groups, and the Spearman's rank correlation analysis was used to analyze the correlation between LSM value and age. The one-sided percentile method was used to determine the range of normal reference values in male and female subjects or in different age groups. ResultsLSM was successfully performed in 1590 patients, and the rate of successful measurement was 88.63%. A total of 107 patients were excluded due to abnormal liver enzymes. The analysis showed that LSM value showed a significant difference between male and female subjects (Z=-4.980, P<0.001, as well as between different age groups (χ2=16.983, P=0.001. Age was positively correlated with LSM value (r=0.087, P=0.001. The reference range was estimated to be ≤7.1 kPa in adults, ≤7.0 kPa in females, and ≤7.2 kPa in males. From the perspective of age, the reference range was estimated to be ≤6.8 kPa in persons aged 20-29 years, ≤6.7 kPa in persons aged 30-44 years, ≤7.8 kPa in persons aged 45-59 years, and ≤8.8 kPa in persons aged 60-74 years. ConclusionLiver stiffness value is influenced by sex and age. Sex and age should be taken into account while performing liver stiffness measurement in healthy subjects.

  16. Consumption of energy drinks by children and young people: a rapid review examining evidence of physical effects and consumer attitudes.

    Science.gov (United States)

    Visram, Shelina; Cheetham, Mandy; Riby, Deborah M; Crossley, Stephen J; Lake, Amelia A

    2016-10-08

    To examine patterns of energy drink consumption by children and young people, attitudes towards these drinks, and any associations with health or other outcomes. Rapid evidence assessment and narrative synthesis. 9 electronic bibliographic databases, reference lists of relevant studies and searches of the internet. A total of 410 studies were located, with 46 meeting the inclusion criteria. The majority employed a cross-sectional design, involved participants aged 11-18 years, and were conducted in North America or Europe. Consumption of energy drinks by children and young people was found to be patterned by gender, with boys consuming more than girls, and also by activity levels, with the highest consumption observed in the most and least sedentary individuals. Several studies identified a strong, positive association between the use of energy drinks and higher odds of health-damaging behaviours, as well as physical health symptoms such as headaches, stomach aches, hyperactivity and insomnia. There was some evidence of a dose-response effect. 2 experimental studies involving small numbers of junior athletes demonstrated a positive impact on limited aspects of sports performance. 3 themes emerged from the qualitative studies: reasons for use; influences on use; and perceived efficacy and impact. Taste and energy-seeking were identified as key drivers, and branding and marketing were highlighted as major influences on young people's consumption choices. Awareness of possible negative effects was low. There is growing evidence that consumption of energy drinks is associated with a range of adverse outcomes and risk behaviours in terms of children's health and well-being. However, taste, brand loyalty and perceived positive effects combine to ensure their popularity with young consumers. More research is needed to explore the short-term and long-term impacts in all spheres, including health, behaviour and education. CRD42014010192. Published by the BMJ Publishing

  17. Physical Examination for Men and Women With Urologic Chronic Pelvic Pain Syndrome: A MAPP (Multidisciplinary Approach to the Study of Chronic Pelvic Pain) Network Study.

    Science.gov (United States)

    Yang, Claire C; Miller, Jane L; Omidpanah, Adam; Krieger, John N

    2018-06-01

    To examine the feasibility of implementing a standardized, clinically relevant genitourinary examination for both men and women, and to identify physical examination findings characteristic of urologic chronic pelvic pain syndrome (UCPPS). This study analyzed 2 samples: men and women with UCPPS who participated in the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network Epidemiology and Phenotyping (EP) Study, and age-matched controls who were either positive for chronic fatigue syndrome or healthy (pain-free). We compared physical examination findings in both positive and healthy controls with UCPPS cases: findings from both the EP examinations and from an extended genitourinary examination. EP and extended examinations were performed on 143 participants: 62 UCPPS cases (30 women, 32 men), 42 positive controls (15 women, 27 men), and 39 healthy controls (22 women, 17 men). EP examinations showed that pelvic floor tenderness was more prevalent in cases (55.0%) than in positive (14.6%) or healthy controls (10.5%). Extended examinations revealed specific areas of tenderness in the pelvic floor musculature. Cases were also more likely than healthy controls to report tenderness in multiple areas, including suprapubic, symphysis pubis, and posterior superior iliac spine, and on bimanual examination. No comparative findings were specific to biological sex, and no evidence of pudendal neuropathy was observed on extended examination of cases or controls. The extended genitourinary examination is an easily administered addition to the assessment of men and women during evaluation for UCPPS. Physical findings may help to better categorize patients with UCPPS into clinically relevant subgroups for optimal treatment. Published by Elsevier Inc.

  18. Answer first: Applying the heuristic-analytic theory of reasoning to examine student intuitive thinking in the context of physics

    OpenAIRE

    Mila Kryjevskaia; MacKenzie R. Stetzer; Nathaniel Grosz

    2014-01-01

    We have applied the heuristic-analytic theory of reasoning to interpret inconsistencies in student reasoning approaches to physics problems. This study was motivated by an emerging body of evidence that suggests that student conceptual and reasoning competence demonstrated on one task often fails to be exhibited on another. Indeed, even after instruction specifically designed to address student conceptual and reasoning difficulties identified by rigorous research, many undergraduate physics s...

  19. Prognostic value of the physical examination in patients with heart failure and atrial fibrillation: insights from the AF-CHF trial (atrial fibrillation and chronic heart failure).

    Science.gov (United States)

    Caldentey, Guillem; Khairy, Paul; Roy, Denis; Leduc, Hugues; Talajic, Mario; Racine, Normand; White, Michel; O'Meara, Eileen; Guertin, Marie-Claude; Rouleau, Jean L; Ducharme, Anique

    2014-02-01

    This study sought to assess the prognostic value of physical examination in a modern treated heart failure population. The physical examination is the cornerstone of the evaluation and monitoring of patients with heart failure. Yet, the prognostic value of congestive signs (i.e., peripheral edema, jugular venous distension, a third heart sound, and pulmonary rales) has not been assessed in the current era. A post-hoc analysis was conducted on all 1,376 patients, 81% male, mean age 67 ± 11 years, with symptomatic left ventricular systolic dysfunction enrolled in the AF-CHF (Atrial Fibrillation and Congestive Heart Failure) trial. The prognostic value of baseline physical examination findings was assessed in univariate and multivariate Cox regression analyses. Peripheral edema was observed in 425 (30.9%), jugular venous distension in 297 (21.6%), a third heart sound in 207 (15.0%), and pulmonary rales in 178 (12.9%) patients. Death from cardiovascular causes occurred in 357 (25.9%) patients over a mean follow-up of 37 ± 19 months. All 4 physical examination findings were associated with cardiovascular mortality in univariate analyses (all p values examination (i.e., peripheral edema, jugular venous distension, a third heart sound, and pulmonary rales) continue to provide important prognostic information in patients with congestive heart failure. Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  20. Greek pre-service physical education teachers’ beliefs about curricular orientations: Instrument validation and examination of four important goals

    Directory of Open Access Journals (Sweden)

    Manolis Adamakis

    2013-12-01

    Full Text Available BACKGROUND: The way people interpret reality is influenced by their mental constructions, their cognitive abilities and their beliefs. Physical Education (PE students have a wide range of formed beliefs concerning the purposes of PE, which cannot be easily modified, even during undergraduate studies. OBJECTIVE: This study validated the scores from a previously constructed questionnaire and investigated the Physical Education students’ belief systems toward the Greek curricular outcome goals. METHODS: Students (N = 483; males = 259, females = 224 from a Greek Faculty of Physical Education and Sport Science shared their beliefs about curricular outcomes. They completed the Greek version of the four factor instrument “Attitudes/beliefs toward curriculum in physical education”. A confirmatory factor analysis was conducted for the validation of the instrument and MANOVAs followed in order to control for group differences. Finally, a profile analysis was run in order to determine if PE students considered each goal to be equally important. RESULTS: The validation of the instrument confirmed the proposed four factors dependant model. Both internal consistency and the confirmatory factor analysis fit indices produced valid and reliable scores. The profile analysis was significant, indicating that students did not view the outcome goals as equally important. The leading goal was physical activity and fitness, followed by self-actualization, social development and motor skill development. MANOVA results for comparisons between sub-groups revealed significant differences only between genders. CONCLUSIONS: Between groups similarities and differences are discussed, focusing on the classification of the four important outcome goals. Currently, Greek Physical Education students consider physical activity and fitness outcome goal as the most important, while motor skill development is considered the least important one.

  1. PHYSICS

    CERN Multimedia

    P. Sphicas

    There have been three physics meetings since the last CMS week: “physics days” on March 27-29, the Physics/ Trigger week on April 23-27 and the most recent physics days on May 22-24. The main purpose of the March physics days was to finalize the list of “2007 analyses”, i.e. the few topics that the physics groups will concentrate on for the rest of this calendar year. The idea is to carry out a full physics exercise, with CMSSW, for select physics channels which test key features of the physics objects, or represent potential “day 1” physics topics that need to be addressed in advance. The list of these analyses was indeed completed and presented in the plenary meetings. As always, a significant amount of time was also spent in reviewing the status of the physics objects (reconstruction) as well as their usage in the High-Level Trigger (HLT). The major event of the past three months was the first “Physics/Trigger week” in Apri...

  2. Keeping the Physical Educator "Connected" an Examination of Comfort Level, Usage and Professional Development Available for Technology Integration in the Curricular Area of Physical Education

    Science.gov (United States)

    Adkins, Megan; Bice, Matthew R.; Worrell, Vicki; Unruh, Nita

    2017-01-01

    Schools continue to integrate the use of technology, and gymnasiums are not an exception. The purpose of the study was to determine the comfort level of Physical Education teachers integrating technology in the gymnasium, determine types of professional development provided for technology use, and potential barriers associated with technology…

  3. A Daily Process Examination of the Temporal Association Between Alcohol Use and Verbal and Physical Aggression in Community Couples

    Science.gov (United States)

    Testa, Maria; Derrick, Jaye L.

    2014-01-01

    Alcohol use has been associated with intimate partner aggression perpetration and victimization; however, much of the evidence is based on survey research. Few studies have addressed the proximal effects of drinking episodes on the subsequent occurrence of partner aggression. The current study used daily diary methodology to consider the daily and temporal association between drinking episodes and episodes of partner verbal and physical aggression among a community sample of married and cohabiting couples (N = 118). Male and female partners each provided 56 days of independent daily reports of drinking and partner conflict episodes, including verbal and physical aggression, using interactive voice response technology. Dyadic data analyses, guided by the actor-partner interdependence model, were conducted using hierarchical generalized linear modeling with multivariate outcomes. Daily analyses revealed that alcohol consumption was associated with perpetration of verbal and physical aggression the same day, but not with victimization. Temporal analyses revealed that the likelihood of perpetrating verbal and physical aggression, and the likelihood of being verbally and physically victimized, increased significantly when alcohol was consumed in the previous four hours. Findings did not differ according to gender of perpetrator or victim, and the interaction between perpetrator and victim's alcohol use was not significant in any analysis. The study provides clear evidence that, within a sample of community couples without substance-use disorders or other psychopathology, alcohol consumption by men and women contributes to the occurrence of partner aggression episodes. PMID:24341618

  4. Perceptions and the role of group exercise among New York City adults, 2010-2011: an examination of interpersonal factors and leisure-time physical activity.

    Science.gov (United States)

    Firestone, Melanie J; Yi, Stella S; Bartley, Katherine F; Eisenhower, Donna L

    2015-03-01

    To examine associations of descriptive norms (i.e., behaviors of social group members) and exercising 'with a partner' or 'as a part of a group' on weekly leisure-time physical activity. T-tests and adjusted multivariable linear models were used to test the associations between descriptive norms and exercising with a partner or as a part of a group with self-reported leisure-time physical activity using the cross-sectional, population-based New York City Physical Activity and Transit (PAT) Survey 2010-2011 (n=3806). Overall, 70.6% of adult New Yorkers reported having physically active friends. Having active friends was associated with increased leisure-time physical activity; however, the effect varied by sex. Compared to those who did not have active friends, males with active friends reported two times more activity (56 min/week) and women reported two and a half times more activity (35 min/week) (both p-valuesPhysically active males and females who usually engaged in leisure-time activities as a part of a group reported 1.4 times more activity than those who exercised alone (both p-valuesexercise were associated with leisure-time physical activity among adults. Based on these associations, encouraging group exercise may be an effective strategy for increasing leisure-time physical activity among certain subgroups. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Preoperative estimation of the pathological breast tumour size by physical examination, mammography and ultrasound: a prospective study on 105 invasive tumours

    International Nuclear Information System (INIS)

    Bosch, Anne M.; Kessels, Alfons G.H.; Beets, Geerard L.; Rupa, Jan D.; Koster, Dick; Engelshoven, Jos M.A. van; Meyenfeldt, Maarten F. von

    2003-01-01

    Objective: The clinical breast tumour size can be assessed preoperatively by physical examination, mammography and ultrasound. At present it is not clear which modality correlates best with the histological invasive breast tumour size. This prospective study aims to determine the most accurate clinical method (physical examination, mammography or ultrasound) to predict the histological invasive tumour size preoperatively. Methods and patients: Between October 1999 and August 2000, 96 women with 105 invasive malignant breast tumours were included in this study. All patients underwent excision and the tumour size was measured on histology. Tumour size was measured by all three modalities in 73 cases. Results were evaluated by calculating correlation coefficients. The examination modalities presenting the best estimation of the pathological tumour size were used in a stepwise linear regression analysis to construct a formula predicting the pathological tumour size from the result of the various diagnostic modalities. Results: The correlation coefficient between ultrasound and pathological size (r=0.68) was significantly better than the correlations between physical examination and pathological size (r=0.42) and mammographic and pathological size (r=0.44). Physical examination overestimates and ultrasound underestimates breast tumour classification. The most accurate prediction formula was: Pathological tumour size (mm) equals sonographic tumour size (mm)+3 mm. Conclusion: When comparing physical examination, mammography and ultrasound for the prediction of the pathological size of a malignant breast tumour, ultrasound is the best predictor. The ensuing regression formula determines pathological size as tumour size by ultrasound+3 mm. However, with the wide 95% confidence interval of ±11 mm, it remains difficult to predict the exact pathological size for an individual invasive breast tumour. A small deviation in millimetres of the tumour size could lead to a change in

  6. Why Rural Community Day Secondary Schools Students' Performance in Physical Science Examinations Is Poor in Lilongwe Rural West Education District in Malawi

    Science.gov (United States)

    Mlangeni, Angstone Noel J. Thembachako; Chiotha, Sosten Staphael

    2015-01-01

    A study was conducted to investigate factors that affect students' poor performance in physical science examinations at Malawi School Certificate of Education and Junior Certificate of Education levels in Community day secondary schools (CDSS) in Lilongwe Rural West Education District in Malawi. Students' performance was collected from schools'…

  7. Examining the Use of Adaptive Technologies to Increase the Hands-On Participation of Students with Blindness or Low Vision in Secondary-School Chemistry and Physics

    Science.gov (United States)

    Supalo, Cary A.; Humphrey, Jennifer R.; Mallouk, Thomas E.; Wohlers, H. David; Carlsen, William S.

    2016-01-01

    To determine whether a suite of audible adaptive technologies would increase the hands-on participation of high school students with blindness or low vision in chemistry and physics courses, data were examined from a multi-year field study conducted with students in mainstream classrooms at secondary schools across the United States. The students…

  8. High diagnostic yield and accuracy of history, physical examination, and ECG in patients with transient loss of consciousness in FAST: The fainting assessment study

    NARCIS (Netherlands)

    van Dijk, Nynke; Boer, Kimberly R.; Colman, Nancy; Bakker, Annemieke; Stam, Jan; van Grieken, Johannes J. M.; Wilde, Arthur A. M.; Linzer, Mark; Reitsma, Johannes B.; Wieling, Wouter

    2008-01-01

    Yield and Accuracy of Diagnosing TLOC. Background: Transient loss of consciousness (TLOC) is a common clinical problem. Objective: The aim of this study was to assess the yield and accuracy of the initial evaluation, consisting of standardized history, physical examination, and ECG performed by

  9. Using Student Centred Evaluation for Curriculum Enhancement: An Examination of Undergraduate Physiotherapy Education in Relation to Physical Activity and Exercise Prescription

    Science.gov (United States)

    O'Donoghue, Grainne; Doody, Catherine; Cusack, Tara

    2011-01-01

    The purpose of this study was to examine physiotherapy students' perceptions of current education content of entry-level physiotherapy programmes in terms of physical activity (PA) and exercise promotion and prescription (EPP). Sixty-two physiotherapy students from three Irish Universities participated. Three Structured Group Feedback Sessions…

  10. Examining the content of weight, nutrition and physical activity advices provided by Dutch practice nurses in primary care: analysis of videotaped consultations.

    NARCIS (Netherlands)

    Dillen, S.M.E. van; Noordman, J.; Dulmen, S. van; Hiddink, G.J.

    2014-01-01

    Background/Objective: To examine the content of Dutch practice nurses’ (PNs’) advices about weight, nutrition and physical activity to overweight and obese patients. Subjects/Methods: A 100 videotaped real-life PN consultations (The Netherlands, 2010/2011) with overweight or obese patients were

  11. Cognitive Load Imposed by Knobology May Adversely Affect Learners' Perception of Utility in Using Ultrasonography to Learn Physical Examination Skills, but Not Anatomy

    Science.gov (United States)

    Jamniczky, Heather A.; McLaughlin, Kevin; Kaminska, Malgorzata E.; Raman, Maitreyi; Somayaji, Ranjani; Wright, Bruce; Ma, Irene W. Y.

    2015-01-01

    Ultrasonography is increasingly used for teaching anatomy and physical examination skills but its effect on cognitive load is unknown. This study aimed to determine ultrasound's perceived utility for learning, and to investigate the effect of cognitive load on its perceived utility. Consenting first-year medical students (n?=?137) completed…

  12. Diagnostic Value of History Taking and Physical Examination to Assess Effusion of the Knee in Traumatic Knee Patients in General Practice

    NARCIS (Netherlands)

    Kastelein, Marlous; Luijsterburg, Pim A.; Wagemakers, Harry A.; Bansraj, Santusha C.; Berger, Marjolein Y.; Koes, Bart W.; Bierma-Zeinstra, Sita M.

    Objective: To assess the diagnostic value of history taking and physical examination for knee joint effusion in patients with a knee injury who consult their general practitioner (GP). In addition, to determine the association between effusion seen on magnetic resonance imaging (MRI) and internal

  13. Answer First: Applying the Heuristic-Analytic Theory of Reasoning to Examine Student Intuitive Thinking in the Context of Physics

    Science.gov (United States)

    Kryjevskaia, Mila; Stetzer, MacKenzie R.; Grosz, Nathaniel

    2014-01-01

    We have applied the heuristic-analytic theory of reasoning to interpret inconsistencies in student reasoning approaches to physics problems. This study was motivated by an emerging body of evidence that suggests that student conceptual and reasoning competence demonstrated on one task often fails to be exhibited on another. Indeed, even after…

  14. Examining Secondary School Physics Teachers' Beliefs about Teaching and Classroom Practices in Lesotho as a Foundation for Professional Development

    Science.gov (United States)

    Qhobela, Makomosela; Kolitsoe Moru, Eunice

    2014-01-01

    The classroom practices of science teachers are indicative of their beliefs and pedagogical content knowledge (PCK). PCK is an amalgam of knowledge about subject matter, pedagogy, and contextual issues. This article identifies areas where physics teachers in Lesotho may need professional development support by addressing the research question: How…

  15. Examining Associations among Motivation, Physical Activity and Health in Chinese College Students: A Self-Determination Theory Perspective

    Science.gov (United States)

    Liu, Wenxi; Li, Xianxiong; Zeng, Nan; Ayyub, Mohammad; Xiong, Shanying; Tao, Kun; Peng, Qingwen

    2017-01-01

    This study was designed to investigate the associations among motives and physical activity behaviors and health in urban college students in China. Eight hundred and eighty-seven college students (521 females; M[subscript age] = 20.51, SD = ± 1.67) were recruited from four universities in South and South-central China. Participants' motives…

  16. Physics 30 Program Machine-Scorable Open-Ended Questions: Unit 2: Electric and Magnetic Forces. Diploma Examinations Program.

    Science.gov (United States)

    Alberta Dept. of Education, Edmonton.

    This document outlines the use of machine-scorable open-ended questions for the evaluation of Physics 30 in Alberta. Contents include: (1) an introduction to the questions; (2) sample instruction sheet; (3) fifteen sample items; (4) item information including the key, difficulty, and source of each item; (5) solutions to items having multiple…

  17. Teasing apart the effect of visibility and physical co-presence to examine the effect of CMC on interpersonal attraction

    NARCIS (Netherlands)

    Croes, Emmelyn; Antheunis, Marjolijn; Schouten, Alexander; Krahmer, Emiel

    2016-01-01

    This study analyzed the possible difference in interpersonal attraction between communicators in cue-rich computer-mediated communication (CMC) and face-to-face (FtF) communication. The first aim was to determine whether physical co-presence and visibility may account for differences in

  18. An Examination of Physical Education Teachers' Perceptions of Utilizing Contemporary Music in the Classroom Environment: A Qualitative Approach

    Science.gov (United States)

    Barney, David C.; Pleban, Francis T.

    2018-01-01

    Objectives: To provide further information regarding physical education (PE) teachers' perceptions of incorporating music in PE lessons and to evaluate the influence of music on the classroom environment using a qualitative approach. Method: Electronic survey interviews were conducted with 26 veteran PE instructors (10 male, 16 female), from 7…

  19. Examining the cost effectiveness of interventions to promote the physical health of people with mental health problems: a systematic review

    Science.gov (United States)

    2013-01-01

    Background Recently attention has begun to focus not only on assessing the effectiveness of interventions to tackle mental health problems, but also on measures to prevent physical co-morbidity. Individuals with mental health problems are at significantly increased risk of chronic physical health problems, such as cardiovascular disease or diabetes, as well as reduced life expectancy. The excess costs of co-morbid physical and mental health problems are substantial. Potentially, measures to reduce the risk of co-morbid physical health problems may represent excellent value for money. Methods To conduct a systematic review to determine what is known about economic evaluations of actions to promote better physical health in individuals identified as having a clinically diagnosed mental disorder, but no physical co-morbidity. Systematic searches of databases were supplemented by hand searches of relevant journals and websites. Results Of 1970 studies originally assessed, 11 met our inclusion criteria. In addition, five protocols for other studies were also identified. Studies looked at exercise programmes, nutritional advice, smoking, alcohol and drug cessation, and reducing the risk of blood borne infectious diseases such as HIV/AIDS and hepatitis. All of the lifestyle and smoking cessation studies focused on people with depression and anxiety disorders. Substance abuse and infectious disease prevention studies focused on people with psychoses and bipolar disorder. Conclusions There is a very small, albeit growing, literature on the cost effectiveness of interventions to promote the physical health of people with mental health problems. Most studies suggest that value for money actions in specific contexts and settings are available. Given that the success or failure of health promoting interventions can be very context specific, more studies are needed in more settings, focused on different population groups with different mental health problems and reporting

  20. [The module "Motorik" in the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Motor fitness and physical activity of children and young people].

    Science.gov (United States)

    Opper, E; Worth, A; Wagner, M; Bös, K

    2007-01-01

    Motor fitness and physical activity are important aspects of a healthy development in childhood and adolescence. However, the assessment of motor fitness and physical activity is not subject to standardized criteria; furthermore, the samples investigated do not provide a representative image of the whole population. Therefore, the existing data only allow very limited statements on the state and development of motor fitness and physical activity. The "Motorik" module, as part of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS), offers nationwide representative data on the motor fitness and physical activity of children and adolescents for the first time. Besides the baseline-analysis, another aim is to analyse the complex relationship between motor fitness, physical activity and health. Motor fitness, based on the systematisation of motor abilities, was assessed using a test profile. The test profile consists of 11 items measuring cardiorespiratory fitness, strength, coordination and mobility. Physical activity was assessed using a questionnaire containing 51 items on the duration, intensity and frequency of physical activity in everyday life, during leisure time, at school and in sports clubs. The above-mentioned questionnaire subtopics were supplemented by questions on the weekly prevalence of at least 60 minutes of daily physical activity, on material and local conditions, as well as on cognition and motivation for physical activity. In the years 2004 to 2006, the motor fitness and physical activity of 4,529 children and young people between the ages of 4 and 17 years was investigated on 168 sample points in the context of the "Motorik" module. Half of the children and adolescents investigated belong to the middle class, approximately 15% have a background of migration. The majority of the subjects come from small towns, about a quarter live in the city, less than 20% are settled in rural areas.

  1. Effects of Physical Examination and Diet Consultation on Serum Cholesterol and Health-behavior in the Korean Pilots Employed in Commercial Airline

    Science.gov (United States)

    CHOI, Yun Young; KIM, Ki Youn

    2013-01-01

    An objective of this study is to search how physical examination and diet consultation can influence those risk factors of cardiovascular disease. The subjects were 326 pilots of the “B” airline company in Korea whose total cholesterol values were over 220 mg/dl on their regular physical examinations from April 2006 to December 2008. They were divided into two groups, one who had diet consultation (an intervention group) and a control group. The physical examination components used to each group were body mass index (BMI), total cholesterol (TC), high density lipoprotein (HDL), low density lipoprotein (LDL) and triglyceride (TG). The behavioral, anthropometric and biomedical measurements were collected at each visit. This study compares and investigates the changes of serum cholesterol and also the health-behavior at each physical examination. Within the intervention group significant improvements were observed for total cholesterol, BMI (body mass index) and HDL (high density lipoprotein). The normalizing rates for cholesterol level to decrease down to lower than 200 mg/dl were 17.7% in intervention group and 8.7% in control group, which is statistically significantly higher among the intervention group. The odds ratio of diet consultation was 2.80 (95% CI=1.35–5.79), which indicates that it is a significantly contributing factor to normalize the serum cholesterol value down to lower than 200 mg/dl. Based on result, it is recommended to have regular physical examination and intensive management with diet and exercise consultation. PMID:24131872

  2. Total sitting time, leisure time physical activity and risk of hospitalization due to low back pain: The Danish Health Examination Survey cohort 2007-2008.

    Science.gov (United States)

    Balling, Mie; Holmberg, Teresa; Petersen, Christina B; Aadahl, Mette; Meyrowitsch, Dan W; Tolstrup, Janne S

    2018-02-01

    This study aimed to test the hypotheses that a high total sitting time and vigorous physical activity in leisure time increase the risk of low back pain and herniated lumbar disc disease. A total of 76,438 adults answered questions regarding their total sitting time and physical activity during leisure time in the Danish Health Examination Survey 2007-2008. Information on low back pain diagnoses up to 10 September 2015 was obtained from The National Patient Register. The mean follow-up time was 7.4 years. Data were analysed using Cox regression analysis with adjustment for potential confounders. Multiple imputations were performed for missing values. During the follow-up period, 1796 individuals were diagnosed with low back pain, of whom 479 were diagnosed with herniated lumbar disc disease. Total sitting time was not associated with low back pain or herniated lumbar disc disease. However, moderate or vigorous physical activity, as compared to light physical activity, was associated with increased risk of low back pain (HR = 1.16, 95% CI: 1.03-1.30 and HR = 1.45, 95% CI: 1.15-1.83). Moderate, but not vigorous physical activity was associated with increased risk of herniated lumbar disc disease. The results suggest that total sitting time is not associated with low back pain, but moderate and vigorous physical activity is associated with increased risk of low back pain compared with light physical activity.

  3. PHYSICS

    CERN Multimedia

    D. Acosta

    2010-01-01

    A remarkable amount of progress has been made in Physics since the last CMS Week in June given the exponential growth in the delivered LHC luminosity. The first major milestone was the delivery of a variety of results to the ICHEP international conference held in Paris this July. For this conference, CMS prepared 15 Physics Analysis Summaries on physics objects and 22 Summaries on new and interesting physics measurements that exploited the luminosity recorded by the CMS detector. The challenge was incorporating the largest batch of luminosity that was delivered only days before the conference (300 nb-1 total). The physics covered from this initial running period spanned hadron production measurements, jet production and properties, electroweak vector boson production, and even glimpses of the top quark. Since then, the accumulated integrated luminosity has increased by a factor of more than 100, and all groups have been working tremendously hard on analysing this dataset. The September Physics Week was held ...

  4. PHYSICS

    CERN Multimedia

    J. Incandela

    There have been numerous developments in the physics area since the September CMS week. The biggest single event was the Physics/Trigger week in the end of Octo¬ber, whereas in terms of ongoing activities the “2007 analyses” went into high gear. This was in parallel with participation in CSA07 by the physics groups. On the or¬ganizational side, the new conveners of the physics groups have been selected, and a new database for man¬aging physics analyses has been deployed. Physics/Trigger week The second Physics-Trigger week of 2007 took place during the week of October 22-26. The first half of the week was dedicated to working group meetings. The ple¬nary Joint Physics-Trigger meeting took place on Wednesday afternoon and focused on the activities of the new Trigger Studies Group (TSG) and trigger monitoring. Both the Physics and Trigger organizations are now focused on readiness for early data-taking. Thus, early trigger tables and preparations for calibr...

  5. PHYSICS

    CERN Multimedia

    P. Sphicas

    The CPT project came to an end in December 2006 and its original scope is now shared among three new areas, namely Computing, Offline and Physics. In the physics area the basic change with respect to the previous system (where the PRS groups were charged with detector and physics object reconstruction and physics analysis) was the split of the detector PRS groups (the old ECAL-egamma, HCAL-jetMET, Tracker-btau and Muons) into two groups each: a Detector Performance Group (DPG) and a Physics Object Group. The DPGs are now led by the Commissioning and Run Coordinator deputy (Darin Acosta) and will appear in the correspond¬ing column in CMS bulletins. On the physics side, the physics object groups are charged with the reconstruction of physics objects, the tuning of the simulation (in collaboration with the DPGs) to reproduce the data, the provision of code for the High-Level Trigger, the optimization of the algorithms involved for the different physics analyses (in collaboration with the analysis gr...

  6. Occupational medical prophylaxis for the musculoskeletal system: A function-oriented system for physical examination of the locomotor system in occupational medicine (fokus(C

    Directory of Open Access Journals (Sweden)

    Schwarze Sieglinde

    2007-10-01

    Full Text Available Abstract Occupational physicians are very often confronted with questions as to the fitness of the postural and locomotor systems, especially the spinal column. Occupational medical assessment and advice can be required by patients with acute symptoms, at routine check-ups, by persons who have problems doing certain jobs, and for expert medical reports as to the fitness of persons with chronic disorders or after operations. Therefore, for occupational medical purposes a physical examination must aim primarily to investigate functions and not structures or radiologic evidence. The physical examination should be structured systematically and according to regions of the body and, together with a specific (pain anamnesis should provide a basis for the medical assessment. This paper presents a function-oriented system for physical examination of the locomotor system, named fokus(C (Funktionsorientierte Koerperliche Untersuchungssystematik, also available on DVD. fokus(C has been developed with a view to its relevance for occupational medical practice and does not aim primarily to provide a precise diagnosis. Decisive for an occupational medical assessment of disorders of the musculoskeletal system is rather information about functional disorders and any impairment of performance or mobility which they can cause. The division of the physical examination into a rapid screening phase and a subsequent more intensive functional diagnostic phase has proved its practicability in many years of day-to-day use. Here, in contrast to the very extensive measures recommended for orthopaedic and manual diagnosis, for reasons of efficiency and usability of the system in routine occupational medical examinations the examination is structured according to the findings. So it is reduced to that which is most necessary and feasible.

  7. Stable isotope ratio mass spectrometry and physical comparison for the forensic examination of grip-seal plastic bags.

    Science.gov (United States)

    Taylor, Erica; Carter, James F; Hill, Jenny C; Morton, Carolyn; Daeid, Niamh Nic; Sleeman, Richard

    2008-05-20

    Plastic bags are frequently used to package drugs, explosives and other contraband. There exists, therefore, a requirement in forensic casework to compare bags found at different locations. This is currently achieved almost exclusively by the use of physical comparisons such as birefringence patterns. This paper discusses some of the advantages and shortcomings of this approach, and presents stable isotope ratio mass spectrometry (IRMS) as a supplementary tool for effecting comparisons of this nature. Carbon and hydrogen isotopic data are presented for sixteen grip-seal plastic bags from a wide range of sources, in order to demonstrate the range of values which is likely to be encountered. Both isotopic and physical comparison (specifically birefringence) techniques are then applied to the analysis of rolls of bags from different manufacturing lots from a leading manufacturer. Both approaches are able to associate bags from a common production batch. IRMS can be applied to small fragments which are not amenable to physical comparisons, and is able to discriminate bags which could be confused using birefringence patterns alone. Similarly, in certain cases birefringence patterns discriminate bags with similar isotopic compositions. The two approaches are therefore complementary. When more than one isotopically distinct region exists within a bag (e.g. the grip-seal is distinct from the body) the ability to discriminate and associate bags is greatly increased.

  8. Physical examination of the female cancer patient with sexual concerns: What oncologists and patients should expect from consultation with a specialist.

    Science.gov (United States)

    Lindau, Stacy Tessler; Abramsohn, Emily M; Baron, Shirley R; Florendo, Judith; Haefner, Hope K; Jhingran, Anuja; Kennedy, Vanessa; Krane, Mukta K; Kushner, David M; McComb, Jennifer; Merritt, Diane F; Park, Julie E; Siston, Amy; Straub, Margaret; Streicher, Lauren

    2016-05-01

    Answer questions and earn CME/CNE Sexual concerns are prevalent in women with cancer or cancer history and are a factor in patient decision making about cancer treatment and risk-reduction options. Physical examination of the female cancer patient with sexual concerns, regardless of the type or site of her cancer, is an essential and early component of a comprehensive evaluation and effective treatment plan. Specialized practices are emerging that focus specifically on evaluation and treatment of women with cancer and sexual function problems. As part of a specialized evaluation, oncologists and their patients should expect a thorough physical examination to identify or rule out physical causes of sexual problems or dysfunction. This review provides oncology professionals with a description of the physical examination of the female cancer patient with sexual function concerns. This description aims to inform anticipatory guidance for the patient and to assist in interpreting specialists' findings and recommendations. In centers or regions where specialized care is not yet available, this review can also be used by oncology practices to educate and support health care providers interested in expanding their practices to treat women with cancer and sexual function concerns. CA Cancer J Clin 2016;66:241-263. © 2016 American Cancer Society. © 2016 American Cancer Society, Inc.

  9. Physical examination of the female internal and external genitalia with and without pelvic organ prolapse: A review.

    Science.gov (United States)

    Pahwa, Avita K; Siegelman, Evan S; Arya, Lily A

    2015-04-01

    Pelvic organ prolapse, a herniation of pelvic organs through the vagina, is a common condition in older women. Pelvic organ prolapse distorts vaginal anatomy making pelvic examination difficult. A clinician must accurately identify anatomic landmarks both in women presenting with symptoms of prolapse and in women noted to have coincidental prolapse during routine gynecologic examination. We present a systematic approach to the female pelvic examination including anatomic landmarks of the external genitalia, vagina, and uterus in women with normal support as well as changes that occur with pelvic organ prolapse. Knowledge and awareness of normal anatomic landmarks will improve a clinician's ability to identify defects in pelvic support and allow for better diagnosis and treatment of pelvic organ prolapse. © 2014 Wiley Periodicals, Inc.

  10. PHYSICS

    CERN Multimedia

    Submitted by

    Physics Week: plenary meeting on physics groups plans for startup (14–15 May 2008) The Physics Objects (POG) and Physics Analysis (PAG) Groups presented their latest developments at the plenary meeting during the Physics Week. In the presentations particular attention was given to startup plans and readiness for data-taking. Many results based on the recent cosmic run were shown. A special Workshop on SUSY, described in a separate section, took place the day before the plenary. At the meeting, we had also two special DPG presentations on “Tracker and Muon alignment with CRAFT” (Ernesto Migliore) and “Calorimeter studies with CRAFT” (Chiara Rovelli). We had also a report from Offline (Andrea Rizzi) and Computing (Markus Klute) on the San Diego Workshop, described elsewhere in this bulletin. Tracking group (Boris Mangano). The level of sophistication of the tracking software increased significantly over the last few months: V0 (K0 and Λ) reconstr...

  11. Association of physical activity with sarcopenia and sarcopenic obesity in community-dwelling older adults: the Fourth Korea National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Ryu, Mikyung; Jo, Jaeseong; Lee, Yunhwan; Chung, Yoon-Sok; Kim, Kwang-Min; Baek, Weon-Chil

    2013-11-01

    this study examined the association of physical activity with sarcopenia and sarcopenic obesity among the community-dwelling Korean elderly. subjects consisted of 2,264 aged 65 years or older in the 2008-09 Korea National Health and Nutrition Examination Survey. Sarcopenia was defined as 2 SD below the mean of the appendicular skeletal muscle/weight for healthy young adults. Obesity was defined as waist circumference ≥ 90 cm for men and ≥ 85 cm for women. Levels of physical activity were classified using the metabolic equivalent task method. the prevalence of sarcopenia was 12.1% in men and 11.9% in women. Among those with sarcopenia, obesity was prevalent in 68.3% of men and 65.0% of women. Adjusting for all covariates, compared with those with low physical activity, men who engaged in moderate and high activity were 38% and 74%, respectively, less likely to have sarcopenia (Ptrend women, the relationship between physical activity and sarcopenia was not significant. For sarcopenic obesity, men participating in moderate [odds ratio (OR) = 0.47; 95% confidence interval (CI) 0.26-0.87] and high (OR = 0.27; 95% CI: 0.12-0.60) physical activity, compared with low activity, had significantly lower risk (Ptrend = 0.001). In women, high physical activity was associated with a lower risk of sarcopenic obesity (OR = 0.43; 95% CI: 0.22-0.86). physical activity is associated with a reduced risk of sarcopenia and sarcopenic obesity in older Korean adults. There were gender differences in the relationship, with stronger associations observed in men than in women.

  12. Beyond performance metrics: Examining a decrease in students’ physics self-efficacy through a social networks lens

    Directory of Open Access Journals (Sweden)

    Remy Dou

    2016-08-01

    Full Text Available The Modeling Instruction (MI approach to introductory physics manifests significant increases in student conceptual understanding and attitudes toward physics. In light of these findings, we investigated changes in student self-efficacy while considering the construct’s contribution to the career-decision making process. Students in the Fall 2014 and 2015 MI courses at Florida International University exhibited a decrease on each of the sources of self-efficacy and overall self-efficacy (N=147 as measured by the Sources of Self-Efficacy in Science Courses-Physics (SOSESC-P survey. This held true regardless of student gender or ethnic group. Given the highly interactive nature of the MI course and the drops observed on the SOSESC-P, we chose to further explore students’ changes in self-efficacy as a function of three centrality measures (i.e., relational positions in the classroom social network: inDegree, outDegree, and PageRank. We collected social network data by periodically asking students to list the names of peers with whom they had meaningful interactions. While controlling for PRE scores on the SOSESC-P, bootstrapped linear regressions revealed post-self-efficacy scores to be predicted by PageRank centrality. When disaggregated by the sources of self-efficacy, PageRank centrality was shown to be directly related to students’ sense of mastery experiences. InDegree was associated with verbal persuasion experiences, and outDegree with both verbal persuasion and vicarious learning experiences. We posit that analysis of social networks in active learning classrooms helps to reveal nuances in self-efficacy development.

  13. Coffee, alcohol, smoking, physical activity and QT interval duration: results from the Third National Health and Nutrition Examination Survey.

    Directory of Open Access Journals (Sweden)

    Yiyi Zhang

    2011-02-01

    Full Text Available Abnormalities in the electrocardiographic QT interval duration have been associated with an increased risk of ventricular arrhythmias and sudden cardiac death. However, there is substantial uncertainty about the effect of modifiable factors such as coffee intake, cigarette smoking, alcohol consumption, and physical activity on QT interval duration.We studied 7795 men and women from the Third National Health and Nutrition Survey (NHANES III, 1988-1994. Baseline QT interval was measured from the standard 12-lead electrocardiogram. Coffee and tea intake, alcohol consumption, leisure-time physical activities over the past month, and lifetime smoking habits were determined using validated questionnaires during the home interview.In the fully adjusted model, the average differences in QT interval comparing participants drinking ≥6 cups/day to those who did not drink any were -1.2 ms (95% CI -4.4 to 2.0 for coffee, and -2.0 ms (-11.2 to 7.3 for tea, respectively. The average differences in QT interval duration comparing current to never smokers was 1.2 ms (-0.6 to 2.9 while the average difference in QT interval duration comparing participants drinking ≥7 drinks/week to non-drinkers was 1.8 ms (-0.5 to 4.0. The age, race/ethnicity, and RR-interval adjusted differences in average QT interval duration comparing men with binge drinking episodes to non-drinkers or drinkers without binge drinking were 2.8 ms (0.4 to 5.3 and 4.0 ms (1.6 to 6.4, respectively. The corresponding differences in women were 1.1 (-2.9 to 5.2 and 1.7 ms (-2.3 to 5.7. Finally, the average differences in QT interval comparing the highest vs. the lowest categories of total physical activity was -0.8 ms (-3.0 to 1.4.Binge drinking was associated with longer QT interval in men but not in women. QT interval duration was not associated with other modifiable factors including coffee and tea intake, smoking, and physical activity.

  14. Coffee, alcohol, smoking, physical activity and QT interval duration: results from the Third National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Zhang, Yiyi; Post, Wendy S; Dalal, Darshan; Blasco-Colmenares, Elena; Tomaselli, Gordon F; Guallar, Eliseo

    2011-02-28

    Abnormalities in the electrocardiographic QT interval duration have been associated with an increased risk of ventricular arrhythmias and sudden cardiac death. However, there is substantial uncertainty about the effect of modifiable factors such as coffee intake, cigarette smoking, alcohol consumption, and physical activity on QT interval duration. We studied 7795 men and women from the Third National Health and Nutrition Survey (NHANES III, 1988-1994). Baseline QT interval was measured from the standard 12-lead electrocardiogram. Coffee and tea intake, alcohol consumption, leisure-time physical activities over the past month, and lifetime smoking habits were determined using validated questionnaires during the home interview. In the fully adjusted model, the average differences in QT interval comparing participants drinking ≥6 cups/day to those who did not drink any were -1.2 ms (95% CI -4.4 to 2.0) for coffee, and -2.0 ms (-11.2 to 7.3) for tea, respectively. The average differences in QT interval duration comparing current to never smokers was 1.2 ms (-0.6 to 2.9) while the average difference in QT interval duration comparing participants drinking ≥7 drinks/week to non-drinkers was 1.8 ms (-0.5 to 4.0). The age, race/ethnicity, and RR-interval adjusted differences in average QT interval duration comparing men with binge drinking episodes to non-drinkers or drinkers without binge drinking were 2.8 ms (0.4 to 5.3) and 4.0 ms (1.6 to 6.4), respectively. The corresponding differences in women were 1.1 (-2.9 to 5.2) and 1.7 ms (-2.3 to 5.7). Finally, the average differences in QT interval comparing the highest vs. the lowest categories of total physical activity was -0.8 ms (-3.0 to 1.4). Binge drinking was associated with longer QT interval in men but not in women. QT interval duration was not associated with other modifiable factors including coffee and tea intake, smoking, and physical activity.

  15. Unemployment among Women: Examining the Relationship of Physical and Psychological Intimate Partner Violence and Posttraumatic Stress Disorder

    Science.gov (United States)

    Kimerling, Rachel; Alvarez, Jennifer; Pavao, Joanne; Mack, Katelyn P.; Smith, Mark W.; Baumrind, Nikki

    2009-01-01

    Prior research has demonstrated that intimate partner violence (IPV) is associated with employment instability among poor women. The current study assesses the broader relationship between IPV and women's workforce participation in a population-based sample of 6,698 California women. We examined past-year IPV by analyzing specific effects of…

  16. Using ecological momentary assessment to examine antecedents and correlates of physical activity bouts in adults age 50+ years: a pilot study.

    Science.gov (United States)

    Dunton, Genevieve Fridlund; Atienza, Audie A; Castro, Cynthia M; King, Abby C

    2009-12-01

    National recommendations supporting the promotion of multiple short (10+ minute) physical activity bouts each day to increase overall physical activity levels in middle-aged and older adults underscore the need to identify antecedents and correlates of such daily physical activity episodes. This pilot study used Ecological Momentary Assessment to examine the time-lagged and concurrent effects of empirically supported social, cognitive, affective, and physiological factors on physical activity among adults age 50+ years. Participants (N = 23) responded to diary prompts on a handheld computer four times per day across a 2-week period. Moderate-to-vigorous physical activity (MVPA), self-efficacy, positive and negative affect, control, demand, fatigue, energy, social interactions, and stressful events were assessed during each sequence. Multivariate results showed that greater self-efficacy and control predicted greater MVPA at each subsequent assessment throughout the day (p positive social interaction was concurrently related to higher levels of MVPA (p = 0.052). Time-varying multidimensional individual processes predict within daily physical activity levels.

  17. A preliminary examination of child well-being of physically abused and neglected children compared to a normative pediatric population.

    Science.gov (United States)

    Lanier, Paul; Kohl, Patricia L; Raghavan, Ramesh; Auslander, Wendy

    2015-02-01

    Federal mandates require state child welfare systems to monitor and improve outcomes for children in three areas: safety, permanency, and well-being. Research across separate domains of child well-being indicates maltreated children may experience lower pediatric health-related quality of life (HRQL). This study assessed well-being in maltreated children using the Pediatric Quality of Life Inventory (PedsQL 4.0), a widely used measure of pediatric HRQL. The PedsQL 4.0 was used to assess well-being in a sample of children (N = 129) receiving child welfare services following reports of alleged physical abuse or neglect. We compared total scores and domain scores for this maltreated sample to those of a published normative sample. Within the maltreated sample, we also compared well-being by child and family demographic characteristics. As compared with a normative pediatric population, maltreated children reported significantly lower total, physical, and psychosocial health. We found no significant differences in total and domain scores based on child and parent demographics within the maltreated sample. This preliminary exploration indicates children receiving child welfare services have significantly lower well-being status than the general child population and have considerable deficits in social and emotional functioning. These findings support continued investment in maltreatment prevention and services to improve the well-being of victims of maltreatment. © The Author(s) 2014.

  18. Using Project-Based Data in Physics to Examine Television Viewing in Relation to Student Performance in Science

    Science.gov (United States)

    Espinoza, Fernando

    2009-10-01

    Mass media, particularly television, influence public conceptions and attitudes toward learning science. The discovery of an original method that does not rely on self-reported viewing habits to measure the impact of television on students' performance in science arose from a study of a unit on electricity in a Physics course. In determining the number of television sets at home and the number of hours of operation, data emerged that allowed an investigation of associations between each of these variables and student performance in physics. A negative impact on performance was found in its consistent decrease as both the number of sets and the time the sets are on increase. These results provide dramatic independent confirmation of the negative impact of television viewing on achievement determined through meta-analysis of many studies, and are also consistent with those in the literature at large, particularly from the Third International Mathematics and Science Study, and the National Assessment of Educational Progress. Furthermore, the totally `blind' participation of the subjects lends a degree of authenticity rarely found in a classically designed study. The findings impact scientific literacy, since performance in science and conceptions of science and scientists, are all inextricably linked.