Patient follow-up in pediatric orthopaedic retrospective call-back studies

2012 ◽  
Vol 23 (6) ◽  
pp. 590-594
Author(s):  
Benjamin J. Grear ◽  
Julie Neumann ◽  
William C. Warner ◽  
Jeffrey R. Sawyer ◽  
Derek M. Kelly
Keyword(s):  
Pediatric Orthopaedic

Increasing Timely Follow-up with Pediatric Orthopaedic Fracture Care

2022 ◽  
Vol 10 (1) ◽  
Author(s):  
Courtney Bishop ◽  
Kevin Dolan ◽  
Julie Balch Samora
Keyword(s):  
Fracture Care ◽  
Pediatric Orthopaedic

scholarly journals VARIABILITY IN EVALUATION AND TREATMENT OF PEDIATRIC TIBIAL TUBERCLE FRACTURES AMONGST PEDIATRIC ORTHOPAEDIC SURGEONS

2021 ◽  
Vol 9 (7_suppl3) ◽  
pp. 2325967121S0005
Author(s):  
Michael W. Fields ◽  
Neil K. Kaushal ◽  
Neeraj M. Patel ◽  
Sekinat K. McCormick ◽  
Craig P. Eberson ◽  
...  
Keyword(s):  
Operative Treatment ◽  
Practice Guidelines ◽  
Nonoperative Treatment ◽  
Post Treatment ◽  
Tibial Tubercle ◽  
Orthopaedic Surgeons ◽  
Moderate Agreement ◽  
Pediatric Orthopaedic ◽  
Work Up

Introduction: Tibial tubercle fractures are uncommon injuries typically seen in adolescents approaching skeletal maturity. No evidence based clinical practice guidelines currently exist regarding clinical management of both operative and nonoperative fractures. Purpose: To determine the variability in clinical management of tibial tubercle fractures among a group of pediatric orthopaedic surgeons. Methods: Nine fellowship trained academic pediatric orthopaedic surgeons reviewed 51 anteroposterior and lateral knee radiographs with associated case age (mean: 13.6yrs, range: 9-16yrs) and gender (86%male). Respondents were asked to describe each fracture using the Ogden classification (Type 1-5 with A/B modifiers), desired radiographic workup, operative vs. nonoperative treatment strategy, and plans for post treatment follow-up. Interrater reliability was determined among the surgeons using Fleiss Kappa analysis. Results: Fair agreement was reached when classifying the fracture type using the Ogden classification (k=0.39,p<0.001). There was slight agreement when determining if CT (k=0.10,p<0.001) should be ordered and when rating concern for compartment syndrome (k=0.17,p<0.001). Overall, surgeons had moderate agreement on whether to treat the fractures operatively vs. nonoperatively (k=0.51,p<0.001). Nonoperative management was selected for 80.4%(45/56) of Type 1A fractures. Respondents selected operative treatment for 75% (30/40) of Type 1B, 58.3% (14/24) of Type 2A, 97.4%(74/76) of Type 2B, 90.7%(39/43) of Type 3A, 96.3%(79/82) of Type 3B, 71.9%(87/121) of Type 4, and 94.1%(16/17) of Type 5 fractures. Regarding operative treatment, moderate agreement was reached when evaluating the emergent nature of the fracture (k=0.44,p<0.001) and surgical technique (k=0.44, p<0.001). However, only fair/slight agreement was reached when selecting the specifics of operative treatment including surgical fixation technique (k=0.25,p<0.001), screw type (k=0.26, p<0.001), screw size (k=0.08,p<0.001), use of washers (k=0.21,p<0.001), and performing a prophylactic anterior compartment fasciotomy (k=0.20,p<0.001). There was moderate agreement on radiographic work up at first (k=0.5,p<0.0011) and final (k=0.49,p<0.001) follow up visits. Surgeons had moderate agreement on plans to remove hardware (k=0.39,p<0.001). Non-operative treatment of fractures was observed to have only fair agreement (k=0.29,p<0.001). Furthermore, surgeons had fair/moderate agreement regarding the specifics of nonoperative treatment including degree of knee extension during immobilization (k=0.46,p<0.001), length of immobilization (k=0.34,p<0.001), post treatment weight bearing status (k=0.30,p<0.001), and post treatment rehabilitation (k=0.34,p<0.001). Finally, there was moderate agreement on radiographic work up at first (k=0.51,p<0.001) and final follow up (k=0.46,p<0.001). Conclusion: Significant variability exists between surgeons when evaluating and treating pediatric tibial tubercle fractures. Future studies should aim to create best practice guidelines for pediatric orthopaedic surgeons to reference when treating these fractures. [Table: see text]

Therapy and prevention for mental health: What if mental diseases are mostly not brain disorders?

2019 ◽  
Vol 42 ◽  
Author(s):  
John P. A. Ioannidis
Keyword(s):  
Mental Health ◽  
Mental Disease ◽  
Brain Disorders ◽  
Social Stressors ◽  
Labor Education ◽  
Mental Diseases ◽  
Long Term Follow Up ◽  
Political Decisions

AbstractNeurobiology-based interventions for mental diseases and searches for useful biomarkers of treatment response have largely failed. Clinical trials should assess interventions related to environmental and social stressors, with long-term follow-up; social rather than biological endpoints; personalized outcomes; and suitable cluster, adaptive, and n-of-1 designs. Labor, education, financial, and other social/political decisions should be evaluated for their impacts on mental disease.

Brief summary of Kleť photographic search programme for minor planets

1999 ◽  
Vol 173 ◽  
pp. 189-192
Author(s):  
J. Tichá ◽  
M. Tichý ◽  
Z. Moravec
Keyword(s):  
Ccd Camera ◽  
Minor Planet ◽  
Minor Planets ◽  
Main Belt

AbstractA long-term photographic search programme for minor planets was begun at the Kleť Observatory at the end of seventies using a 0.63-m Maksutov telescope, but with insufficient respect for long-arc follow-up astrometry. More than two thousand provisional designations were given to new Kleť discoveries. Since 1993 targeted follow-up astrometry of Kleť candidates has been performed with a 0.57-m reflector equipped with a CCD camera, and reliable orbits for many previous Kleť discoveries have been determined. The photographic programme results in more than 350 numbered minor planets credited to Kleť, one of the world's most prolific discovery sites. Nearly 50 per cent of them were numbered as a consequence of CCD follow-up observations since 1994.This brief summary describes the results of this Kleť photographic minor planet survey between 1977 and 1996. The majority of the Kleť photographic discoveries are main belt asteroids, but two Amor type asteroids and one Trojan have been found.

Intranuclear Crystals in Regenerating Canine Kidneys

1973 ◽  
Vol 31 ◽  
pp. 412-413
Author(s):  
D.G. Osborne ◽  
L.J. McCormack ◽  
M.O. Magnusson ◽  
W.S. Kiser
Keyword(s):  
Epithelial Cell ◽  
Epithelial Cells ◽  
Tubular Epithelial Cell ◽  
Tubular Epithelial Cells ◽  
Cell Nuclei ◽  
Crystalline Structures ◽  
Small Crystals ◽  
Membrane Bound

During a project in which regenerative changes were studied in autotransplanted canine kidneys, intranuclear crystals were seen in a small number of tubular epithelial cells. These crystalline structures were seen in the control specimens and also in regenerating specimens; the main differences being in size and number of them. The control specimens showed a few tubular epithelial cell nuclei almost completely occupied by large crystals that were not membrane bound. Subsequent follow-up biopsies of the same kidneys contained similar intranuclear crystals but of a much smaller size. Some of these nuclei contained several small crystals. The small crystals occurred at one week following transplantation and were seen even four weeks following transplantation. As time passed, the small crystals appeared to fuse to form larger crystals.

Electron Microscopy of Human Gallstones

1971 ◽  
Vol 29 ◽  
pp. 296-297
Author(s):  
C. Wolpers ◽  
R. Blaschke
Keyword(s):  
Electron Microscopy ◽  
Room Temperature ◽  
Bile Pigment ◽  
X Ray Diffraction ◽  
Triclinic Crystal System ◽  
X Ray ◽  
Follow Up Study ◽  
Infra Red ◽  
Main Components

Scanning microscopy was used to study the surface of human gallstones and the surface of fractures. The specimens were obtained by operation, washed with water, dried at room temperature and shadowcasted with carbon and aluminum. Most of the specimens belong to patients from a series of X-ray follow-up study, examined during the last twenty years. So it was possible to evaluate approximately the age of these gallstones and to get information on the intensity of growing and solving.Cholesterol, a group of bile pigment substances and different salts of calcium, are the main components of human gallstones. By X-ray diffraction technique, infra-red spectroscopy and by chemical analysis it was demonstrated that all three components can be found in any gallstone. In the presence of water cholesterol crystallizes in pane-like plates of the triclinic crystal system.

Articulatory Intervention for the Visually Impaired

1979 ◽  
Vol 10 (3) ◽  
pp. 139-144
Author(s):  
Cheri L. Florance ◽  
Judith O’Keefe
Keyword(s):  
High School ◽  
High School Students ◽  
Behavior Change ◽  
Visually Impaired ◽  
School Students ◽  
Handicapped Children ◽  
Paired Stimuli ◽  
Visually Handicapped ◽  
Parent Program

A modification of the Paired-Stimuli Parent Program (Florance, 1977) was adapted for the treatment of articulatory errors of visually handicapped children. Blind high school students served as clinical aides. A discussion of treatment methodology, and the results of administrating the program to 32 children, including a two-year follow-up evaluation to measure permanence of behavior change, is presented.

What Does Evidence-Based Practice Mean to You? A Follow-Up Study Examining School-Based Speech-Language Pathologists' Perspectives on Evidence-Based Practice

2020 ◽  
Vol 29 (2) ◽  
pp. 688-704
Author(s):  
Katrina Fulcher-Rood ◽  
Anny Castilla-Earls ◽  
Jeff Higginbotham
Keyword(s):  
Clinical Practice ◽  
Research Evidence ◽  
Evidence Based Practice ◽  
Evidence Based ◽  
Clinical Expertise ◽  
Speech Language Pathologists ◽  
School Based ◽  
Research Findings ◽  
Ebp Implementation

Purpose The current investigation is a follow-up from a previous study examining child language diagnostic decision making in school-based speech-language pathologists (SLPs). The purpose of this study was to examine the SLPs' perspectives regarding the use of evidence-based practice (EBP) in their clinical work. Method Semistructured phone interviews were conducted with 25 school-based SLPs who previously participated in an earlier study by Fulcher-Rood et al. 2018). SLPs were asked questions regarding their definition of EBP, the value of research evidence, contexts in which they implement scientific literature in clinical practice, and the barriers to implementing EBP. Results SLPs' definitions of EBP differed from current definitions, in that SLPs only included the use of research findings. SLPs seem to discuss EBP as it relates to treatment and not assessment. Reported barriers to EBP implementation were insufficient time, limited funding, and restrictions from their employment setting. SLPs found it difficult to translate research findings to clinical practice. SLPs implemented external research evidence when they did not have enough clinical expertise regarding a specific client or when they needed scientific evidence to support a strategy they used. Conclusions SLPs appear to use EBP for specific reasons and not for every clinical decision they make. In addition, SLPs rely on EBP for treatment decisions and not for assessment decisions. Educational systems potentially present other challenges that need to be considered for EBP implementation. Considerations for implementation science and the research-to-practice gap are discussed.

The Link Between Verbal Short-Term Memory and Anomia Treatment Gains

2019 ◽  
Vol 28 (3) ◽  
pp. 1039-1052
Author(s):  
Reva M. Zimmerman ◽  
JoAnn P. Silkes ◽  
Diane L. Kendall ◽  
Irene Minkina
Keyword(s):  
Short Term Memory ◽  
Controlled Trial ◽  
Treatment Success ◽  
Linear Regression Models ◽  
Language Performance ◽  
Short Term ◽  
Term Memory ◽  
Treatment Gains ◽  
Post Hoc

Purpose A significant relationship between verbal short-term memory (STM) and language performance in people with aphasia has been found across studies. However, very few studies have examined the predictive value of verbal STM in treatment outcomes. This study aims to determine if verbal STM can be used as a predictor of treatment success. Method Retrospective data from 25 people with aphasia in a larger randomized controlled trial of phonomotor treatment were analyzed. Digit and word spans from immediately pretreatment were run in multiple linear regression models to determine whether they predict magnitude of change from pre- to posttreatment and follow-up naming accuracy. Pretreatment, immediately posttreatment, and 3 months posttreatment digit and word span scores were compared to determine if they changed following a novel treatment approach. Results Verbal STM, as measured by digit and word spans, did not predict magnitude of change in naming accuracy from pre- to posttreatment nor from pretreatment to 3 months posttreatment. Furthermore, digit and word spans did not change from pre- to posttreatment or from pretreatment to 3 months posttreatment in the overall analysis. A post hoc analysis revealed that only the less impaired group showed significant changes in word span scores from pretreatment to 3 months posttreatment. Discussion The results suggest that digit and word spans do not predict treatment gains. In a less severe subsample of participants, digit and word span scores can change following phonomotor treatment; however, the overall results suggest that span scores may not change significantly. The implications of these findings are discussed within the broader purview of theoretical and empirical associations between aphasic language and verbal STM processing.

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