ORCID Profile
0000-0002-4924-5741
Current Organisation
University of Tasmania
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Publisher: BMJ
Date: 28-03-2018
Publisher: Elsevier BV
Date: 2005
DOI: 10.1016/S0004-9514(05)70052-0
Abstract: Physiotherapists often use within-session changes to provide a guide for refining treatment application. This study tested the validity of within-session changes as predictors of between-session changes for patients with neck pain receiving manual therapy treatment. A total of 70 pairs of treatments from 29 patients with sub-acute non-specific neck pain receiving manual therapy were assessed to determine the relationship between within-session and between-session changes in range of motion (ROM), pain intensity, and centralisation. Measurements were taken of ROM of the more limited direction on each axis of flexion, extension, lateral-flexion and rotation, and pain (intensity and location) before and after treatment. The same measurements were repeated before the following treatment. Regression analysis demonstrated that within-session change accounted for 26% to 48% of the variability in between-session change for ROM and six per cent for pain intensity. The proportion of the within-session change for ROM maintained between sessions ranged from 42% to 63% (95% CI 25% to 88%). The odds ratios for within-session improved/not improved categorisation to predict between-session category for ROM ranged from 2.5 (95% CI 0.6 to 4.3) to 21.3 (95% CI 10.1 to 96.1), for pain intensity 4.5 (95% CI 1.2 to 14.4) and for pain centralisation 9.2 (95% CI 2.2 to 38.7) indicating greater likelihood of between-session improvement after within-session improvement. The between-session results for most patients (71% to 83%) could be classified correctly by their within-session category. The results support the use of within-session changes in ROM, centralisation, and possibly pain intensity as predictors of between-session changes for musculoskeletal disorders of the cervical spine.
Publisher: Elsevier BV
Date: 1987
Publisher: Royal Society of Chemistry (RSC)
Date: 1981
DOI: 10.1039/P19810000842
Publisher: Elsevier BV
Date: 1990
Publisher: Springer International Publishing
Date: 2019
Publisher: American Chemical Society (ACS)
Date: 12-1998
DOI: 10.1021/JO980863Z
Publisher: Royal Society of Chemistry (RSC)
Date: 1973
DOI: 10.1039/P19730001647
Publisher: Elsevier BV
Date: 1989
Publisher: American Chemical Society (ACS)
Date: 04-1993
DOI: 10.1021/JO00060A030
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-2017
Publisher: Georg Thieme Verlag KG
Date: 13-12-2019
DOI: 10.1055/A-0732-5621
Abstract: We examined the accuracy of Smart Socks – a device that measures foot pressure during gait for detecting step-count across various walking speeds. Thirty-six participants (17 men 19 women) wore Smart Socks (Sock), a pedometer (Pedometer), and a smartphone with a commercially available Phone Application (Phone) pedometer to measure step-count during 3-min of treadmill or over-ground walking at 1.3, 2.2, 3.0, 3.8, and 4.7 km/h. Steps were compared to a gold-standard tally-counter (Count), collected by independent assessors. All devices (Sock, Pedometer, and Phone) underestimated step-count when compared to Count at 1.3 km/h (p .05) however, Sock (27±18%) demonstrated a lower percent error compared to Phone (40±28%) and Pedometer (98±5%) (both p .01). At 2.2 km/h, Sock was not different compared to Count (Sock: 213±39 Count: 229±24 steps, p=0.25) however, both Phone (271±55 steps) and Pedometer (169±166 steps) were different compared to Count (p .05). At 3.0 km/h, both Sock (258±30 steps) and Pedometer (254±45 steps) were similar to Count (267±22 steps) (p .05) however, Phone (291±28 steps) overestimated step-count (p .01). All devices (Sock, Pedometer, and Phone) were similar to Count at 3.8, and 4.7 km/h (p .05). These findings demonstrate that Smart Socks are more accurate than pedometers used in the present study for detecting step-count during treadmill or over-ground ambulation at slower walking speeds.
Publisher: Royal Society of Chemistry (RSC)
Date: 1996
DOI: 10.1039/P29960001367
Publisher: Springer Science and Business Media LLC
Date: 10-01-2013
Publisher: Springer Science and Business Media LLC
Date: 12-2019
DOI: 10.1186/S41077-019-0095-8
Abstract: Simulation-based learning (SBL) activities are increasingly used to replace or supplement clinical placements for physiotherapy students. There is limited literature evaluating SBL activities that replace on-c us teaching, and to our knowledge, no studies evaluate the role of SBL in counteracting the negative impact of delay between content teaching and clinical placements. The aims of this study were to (i) determine the effect on clinical placement performance of replacing 1 week of content teaching with a SBL activity and (ii) determine if a delay between content teaching and clinical placement impacted clinical placement performance. This study is a retrospective cohort study. Participants included students in the first two clinical placements of a graduate-entry, masters-level program. Six hundred twenty-nine student placements were analysed—285 clinical placements where students undertook a 20-h SBL activity immediately prior to clinical placement were compared with 344 placements where students received traditional content. Of the placements where students received the SBL, 147 occurred immediately following content teaching and 138 had a delay of at least 5 weeks. Performance on clinical placement was assessed using the Assessment of Physiotherapy Practice (APP). There was a significant main effect of SBL with higher APP marks for the experimental group (3.12/4, SD = 0.25 vs 3.01/4, SD = 0.22), and post hoc analysis indicated marks were significantly higher for all seven areas of assessment. Students whose placements immediately followed content teaching performed better on mid-placement APP marks in two areas of assessment (analysis and planning, and intervention) compared to students for whom there was a delay. There were no statistically significant differences in relation to delay for end of placement APP marks. Replacing 1 week of classroom teaching with a targeted, SBL activity immediately before placement significantly improved student performance on that clinical placement. A negative impact of delay was found on mid-placement, but not the end of placement APPs. Findings of improved performance when replacing a week of content teaching with a targeted SBL activity, and poorer performance on mid-placement marks with a delay between content teaching and clinical placement, may have implications for curriculum design.
Publisher: Elsevier BV
Date: 2006
DOI: 10.1016/S0004-9514(06)70008-3
Abstract: Does change in impairments within and between the first two manual therapy treatments predict change in activity limitations by the end of treatment in patients with subacute neck symptoms? Longitudinal, observational study. 29 people with neck pain for more than two weeks who subsequently received >or= three treatments. Impairments measured were active neck ROM in six directions (total ROM), most limited direction of ROM (limited ROM), pain intensity, and pain location. Activity limitations were measured using the Neck Disability Index and the Patient Specific Functional Scale. Patients' perceptions of change were measured using the Global Perceived Effect Scale. Impairments and patients' perceptions were measured before and after the first two treatments and before the final treatment whereas activity limitations were measured only before the first and last treatments. All measures improved by the end of treatment.Between-treatment change in limited ROM predicted change in limited ROM (rs2 = 0.53 and 0.57) and total ROM (rs2 = 0.26) by the end of treatment. Within- and between-treatment change in pain location predicted change in pain location (rs2 = 0.24, 0.27,0.28, and 0.57) by the end of treatment. No significant relationships were found between change in any impairments in the first two treatments and change in activity limitations by the end of treatment. Change in impairments predicts change in the same impairment by the end of treatment, but not in other impairments or activity limitations. It is recommended that there assessments used to guide and refine treatment be in idualised and related to the specific goals for that patient.
Publisher: MDPI AG
Date: 22-04-2021
DOI: 10.3390/SYM13050739
Abstract: Tropism, or asymmetry, of facet joints in the cervical spine has been found to be related to degenerative changes of the joints and discs. Clinicians often assume that differences in segmental mobility are related to tropism. The aims of this study were to determine the relationship between asymmetry of facet joints in the sub-axial cervical spine and (1) segmental mobility and (2) spinal levels perceived by therapists to have limited mobility. Eighteen participants with idiopathic neck pain had MRIs of their cervical spine in neutral and at the end of active rotation. Angular movement and translational movement of each motion segment was calculated from 3D segmentations of the vertebrae. A plane was fitted to the facet on each side. Tropism was considered to be the difference in the orientation of the facet planes and ranged from 1 to 30° with a median of 7.7°. No relationships were found between the extent of tropism and either segmental movement or locations deemed to be symptomatic. Tropism in the sub-axial cervical spine does not appear to be related to segmental mobility in rotation or to levels deemed to be symptomatic.
Publisher: Elsevier BV
Date: 1989
Publisher: American Chemical Society (ACS)
Date: 1996
DOI: 10.1021/JO9521817
Publisher: Elsevier BV
Date: 1987
Publisher: Mark Allen Group
Date: 02-08-2015
Publisher: Elsevier BV
Date: 1980
Publisher: Focal Press
Date: 27-09-2021
Publisher: Elsevier BV
Date: 05-2015
DOI: 10.1016/J.JMPT.2015.03.001
Abstract: The purposes of this study were to determine whether there were differences in mean values or reliability for 2 frequently used protocols for pressure pain threshold (PPT) and to calculate how large a difference in PPT is necessary to be 95% confident that a real change has occurred. Thirteen participants (8 females) aged 22.3 (±2.3) years from a university community were included. Two testers evaluated participants using 2 protocols, in which PPT was measured 3 times at 8 different body locations. The "cluster protocol" consisted of 3 successive measurements at each location with a 30-second rest between each measurement. The "circuit protocol" consisted of 1 measurement taken at each anatomical location until "the circuit" was complete and then repeated a total of 3 times. A 2-way analysis of variance did not reveal significant differences between protocols at any body location (P = .46-.98). Intertester reliability was good to excellent for all locations (intraclass correlation coefficient, 0.84-0.96), and limits of agreement ranged from 108 to 223 kPa. Either the cluster or circuit protocol can be used to measure PPT in clinical or research setting. A difference of 160 kPa is considered sufficient to indicate a real difference between repeated measures of PPT regardless of protocol used for testing.
Publisher: Informa UK Limited
Date: 06-08-2021
Publisher: Royal Society of Chemistry (RSC)
Date: 1977
DOI: 10.1039/C39770000266
Publisher: Informa UK Limited
Date: 10-2007
DOI: 10.1080/00140130701587293
Abstract: Both posture and comfort of a chair are influenced by the contour and characteristics of the seat. Knowledge of seat contours of a student population could thus be useful in the design of school chairs. This study investigated seated buttock contours of senior high-school students in order to determine: (a) their general characteristics, (b) the effect of gender and sitting posture and (c) the relationship between the contours and selected anthropometric variables (stature and mass). A contour measurement device was developed and used to measure buttock contours in five sitting postures (typing, sitting up, sitting back, slumping and writing). Buttock contours were quantified by constructing anterior-posterior (AP) and lateral profiles from which six discrete profile dimension measurements were made. AP and lateral profiles were found to have a consistent shape across all participants. Five out of six profile dimensions were significantly different between genders, with just one significantly different between sitting postures (typing and sitting back). Correlations between anthropometric measures and profile dimensions were relatively low (r < 0.34) with no clear patterns evident. Overall results of this study suggest that buttock contours are influenced by gender to a greater extent than sitting posture.
Publisher: Elsevier BV
Date: 08-2008
DOI: 10.1016/J.MATH.2007.03.005
Abstract: The repeatability of instrumented assessments of postero-anterior (PA) movements has been reported previously for lumbar and thoracic spines, but only in relation to limited parameters of the movement. This study describes a device for measuring PA movements of the cervical spine and reports on repeatability of the entire force/displacement (FD) curves. Repeatability was assessed using coefficients of multiple determination (CMDs) and adjusted CMDs (where the mean offset between the two curves are removed and the shape of the curve can be more directly assessed) for inter-rater intra-day (inter-rater), intra-rater inter-day (inter-day) and intra-rater intra-day (intra-rater) repeated measurements. The mean CMD and mean adjusted CMD for intra-rater measurements (0.90 and 0.99, respectively) were significantly higher than for the other measurement intervals. Inter-rater and inter-day mean CMDs were 0.76 and 0.73 and mean adjusted CMDs were 0.96 and 0.97. It is concluded that the maximum repeatability is achieved if the same operator reassesses the patient on the same day. It is hoped that the methodology described will form the basis for further research that will enable greater understanding of what characteristics of PA movements inform manual palpation and thereby enable improvement in both manual therapy treatment teaching efficiency of manual therapy skills.
Publisher: Elsevier BV
Date: 12-2017
DOI: 10.1016/J.MSKSP.2017.07.007
Abstract: Interest in measurement of tactile acuity in musculoskeletal practice has emerged following its link to functional reorganization of the somatosensory cortex in ongoing pain states. Several tactile acuity measurement methods have been described but have not been thoroughly investigated in the cervical region. This study examined reliability, concurrent validity and responsiveness of four tests of tactile acuity-Two-point discrimination, Point-to-point, Graphesthesia, and Localisation tests-at the cervical region. Forty-two healthy participants were included. In Part 1 (n = 22), participants' tactile acuity was assessed at two time points, 30 min apart, to determine the test-retest reliability and concurrent validity of each of the tests. In Part 2 (n = 20), participants received five daily tactile training sessions, delivered via a vibro-tactile device. Tactile acuity was assessed pre- and post-training to examine responsiveness of each test. Two-point discrimination demonstrated excellent test-retest reliability (ICC = 0.85, SEM = 3.7 mm), Point-to-point and Localisation tests demonstrated good reliability (ICC = 0.60, SEM = 2.8 mm ICC = 0.60, SEM = 8.8%), and Graphesthesia demonstrated fair reliability (ICC = 0.48, SEM = 1.9/20). There was no significant correlation among measures. Only Graphesthesia failed to show responsiveness to change following training. The reliability of Two-point discrimination appears superior to other examined tests of tactile acuity, however measurement variability should be considered. Two-point discrimination, Point-to-point, and Localisation tests appear responsive to change, although testing in clinical s les is needed. The lack of concurrent validity among tests suggests that they cannot be used interchangeably.
Publisher: Elsevier BV
Date: 12-2019
DOI: 10.1016/J.MSKSP.2019.07.003
Abstract: Previous studies have used orientation and translation of whole-vertebrae to describe three-dimensional cervical segmental kinematics. Describing kinematics using facet joint movement may be more relevant to pathology and effects of interventions but has not been investigated in the cervical spine. This study compared the reliability of two different methods (whole-vertebrae vs facet joint) to evaluate cervical kinematics. Two healthy adults each had six cervical (C1 to T1) magnetic resonance imaging scans, two each in neutral and left and right rotation. A semi-automated method of segmentation and alignment determined the relative orientation and translation of each whole-vertebrae and translation of each facet joint. Intra-rater and inter-rater reliability was determined using limits of agreement (LOA) with 95% confidence intervals and intraclass correlation coefficients (ICC The LOA for intra-rater evaluation of facet movement was superior to whole vertebra translation. Both methods showed excellent intra-rater ICC Measurement of three-dimensional segmental kinematics using either the facet joint or the whole-vertebrae method demonstrated excellent and comparable reliability. These findings support the use of the facet joint method as an option for describing and investigating cervical segmental kinematics.
Publisher: Springer Science and Business Media LLC
Date: 24-10-2012
Publisher: Elsevier BV
Date: 08-2018
DOI: 10.1016/J.MSKSP.2018.04.005
Abstract: Posterio-anterior (PA) movements are one type of passive intervertebral movement used to assess and treat perceived deficits in localized segmental mobility. To describe: 1) The specific effects that reductions in segmental mobility would be expected to have on PA movements 2) How differences in PA movements in clinical situations compare to what would be expected with reduced segmental mobility and 3) Whether such differences in PA movements are likely to be perceivable by manual palpation. Multiple modelling studies and in vivo measurements of PA movements are described. The findings indicate the differences in PA movements present in clinical conditions corresponds with the differences that would be expected with decreased segmental mobility. The differences both predicted from the modelling and found in clinical conditions were greatest at low levels of force. Additionally, the differences are large enough that in iduals with training are likely to be capable of 1) consistently producing controlled movements with sufficiently small magnitudes of force to assess the movements, and 2) detecting the differences in stiffness expected from modelling and found in clinical situations. Implications for clinical practice and teaching include the need to attend to the stiffness of PA movements at lower levels of force than those typically described. The authors recommend a three tiered approach to assessment of PA movements which may assist in both clinical practice and teaching manual therapy skills.
Publisher: Royal Society of Chemistry (RSC)
Date: 1987
DOI: 10.1039/P19870001243
Publisher: CSIRO Publishing
Date: 1987
DOI: 10.1071/CH9870157
Abstract: The hex-5-enyl (1), 3-oxahex-5-enyl (6), 2-oxahex-5-enyl (9) and 2,2-dimethylbut-3- enoyloxymethyl (13) radicals have been generated by interaction of the corresponding bromides with trialkyltin or trialkylgermanium radicals, and their rate constants and activation parameters for cyclization have been determined by kinetic e.s.r . spectroscopy. The 3-oxa species (6) undergo 1,5-ring closure more rapidly than does hex-5-enyl radical (1) because of favourable stereoelectronic factors. Spectral evidence has been obtained for restricted rotation about the O-CH2* bond in the 2-oxa radical (9) as a consequence of which its ring closure is relatively slow. Similarly, 1,5-ring closure of the ester derived radical (13) is slow because of unfavourable conformational effects arising from restricted rotation about the CO-O bond. The radical (22) formed from allyl bromoacetate does not undergo ring closure. Spectral data have been obtained for various radicals (16), (19), (23), (24) formed by intermolecular addition.
Publisher: Mark Allen Group
Date: 02-06-2015
Publisher: Informa UK Limited
Date: 10-1010
DOI: 10.1080/00140130701584910
Abstract: The height of the front of the seat is the primary determinant of appropriate seat size in the school setting. In the present study, this dimension was fixed at 445 mm and, using a brief adjustment period, students adjusted the angle of the seat to their preferred rear seat height (PRSH) under three fixed and one adjustable desk height conditions and for one desk height, under two time conditions. PRSH was significantly greater at an 800 mm desk height (454+/-14 mm) compared to 735 mm (447+/-15 mm) and 720 mm (444+/-16 mm). When desk height as well as rear seat height were adjustable, PRSH was 446+/-15 mm and preferred desk height 751+/-25 mm. Taller students or those with larger popliteal heights selected lower PRSHs at all desk heights, with PRSH more strongly related to popliteal height (r = -0.54 to -0.59) than stature (r = -0.44 to -0.50). No differences were found in PRSH between short (<5 min) and long (30 min) adjustment periods for the 735 mm desk height. The nearly horizontal seat positions found in this study were between those recommended by other authors.
Publisher: CSIRO Publishing
Date: 1995
DOI: 10.1071/CH9950353
Abstract: N,N′-Diacyl-N,N′-dialkoxyhydrazines have been shown to decompose thermally to esters and nitrogen. An intramolecular crossover experiment has shown that the formation of esters is consistent with a three- centred rearrangement process which is characteristic of N-alkoxy N-amino amides. The four-centred mechanism previously proposed by earlier workers is less favourable energetically. AM1 molecular orbital calculations support these experimental findings.
Publisher: Royal Society of Chemistry (RSC)
Date: 1986
DOI: 10.1039/P29860000645
Publisher: Elsevier BV
Date: 12-2021
DOI: 10.1016/J.MSKSP.2021.102457
Abstract: An observational cohort study to determine whether localised manual therapy results in a preferential increase in mobility of the targeted motion segment. Eighteen participants with mechanical neck pain had three MRIs of their cervical spine. The first two were taken prior to treatment in neutral and at the end of active rotation in their more limited rotation. Participants received localised manual therapy targeting a motion segment deemed to be relevant to their presentation until either their range increased by > 10° or 8 min, whichever came first. A third MRI was performed immediately after treatment with their head in the same rotated position as pre-treatment. In the images, each vertebra was segmented using a semi-automated process. Movement between neutral and rotated positions was calculated as Euler angles and distance of facet translations for each motion segment. Rotation and lateral flexion at the targeted location increased by 40% (mean 0.86° (CI: 0.24-1.48) and 15% (mean 0.52° (CI: 0.17-1.21) respectively with only the CIs for rotation not containing zero. The mean changes for the non-targeted locations were less than 0.1° for each axis and all CIs contained zero. Facet translations at the targeted location increased by 25% (0.419 mm) and decreased by >4% (>0.01 mm) at the untreated locations but the wide CIs both contained zero. Localised manual therapy seems to have a preferential effect on mobility of the targeted motion segment. The findings support considering segmental dysfunction in clinical reasoning and the use of specifically targeted manual therapy interventions.
Publisher: Springer Science and Business Media LLC
Date: 12-2019
DOI: 10.1186/S41077-019-0102-0
Abstract: Simulated learning environments (SLEs) are being embraced as effective, though potentially costly tools, by health educators in a variety of contexts. The selection of scenarios, however, can be arbitrary and idiosyncratic. We conducted a stakeholder audit to determine priorities for student learning which would inform scenario design. The process consisted of (1) the identification of stakeholders, (2) consultation with stakeholders to identify their priorities, (3) determination of priorities that could be addressed in the SLE being developed, and (4) incorporating these priorities into scenarios. The identified stakeholders were the funding body, educational institution and discipline, regulatory agency, accreditation agency, external clinical placement providers, employers of new graduates, patients, and learners. Stakeholder input included a combination of surveys, consultation of online resources, and semi-structured interviews. Identified areas where student learning could be improved included (1) all students not having experience of all populations or ‘essential’ conditions, (2) situations where adverse events had occurred, (3) working with people from erse backgrounds or those with psychosocial issues including those in chronic pain, (4) communication, (5) situation awareness, and (6) ethical issues. Ten scenarios were developed considering the stakeholder input. Facilitator notes were written to ensure all facilitators addressed the areas that had been identified. Where possible, simulated patients, with erse backgrounds, were hired to portray roles even though such areas of ersity were not explicitly written into the scenarios. Whilst the ex le concerns physiotherapy students within Australia, the principles may be applicable across a range of health disciplines.
Publisher: FapUNIFESP (SciELO)
Date: 10-2015
Publisher: Journal of Orthopaedic & Sports Physical Therapy (JOSPT)
Date: 03-2011
Abstract: Design and evaluation, technical note. To describe the design of a simple, low-cost device for providing feedback of manually applied forces to the cervical spine, and to assess the device against specific design criteria. The forces applied during manual therapy may vary by as much as 500% between practitioners. But consistency can be improved in students when they are provided with contemporaneous feedback. The current methods of providing feedback, however, are expensive, complex, and/or preclude their performance in a clinically relevant manner. The design of the device was assessed in accordance of the following criteria: (1) ease of use, (2) low cost, (3) minimal interference with technique, (4) ability to provide feedback with suitable accuracy at forces up to 50 N, and (5) no requirement of specialized skills to construct. A device is described that interfaces with standard computers through the sound card and measures force, using thin, low-cost, force-sensing resistors. Evaluated against the design criteria, the device (1) is easy to set-up and use, (2) can be produced for under $30 US dollars, (3) creates minimal interference with performance of a variety of techniques, (4) has limits of agreement from -3.8 to 4.2 N for forces of 5 to 45 N and repeatability coefficients of ± 2.0 N or 12%, and (5) can be constructed without specialized skills or knowledge. A device is described that fulfills most of the design criteria for providing feedback on forces for physical therapy students and may have applications in other fields.
Publisher: Elsevier BV
Date: 06-2009
DOI: 10.1016/J.JMPT.2009.04.002
Abstract: Systematic assessment of a patient's progress after an intervention is frequently used to inform decision making in ongoing conservative management of patients with musculoskeletal symptoms. Although reassessment of impairments immediately after treatment is commonplace in clinical practice, relatively little research has considered whether this method is reasonable. The history of, rationale behind, and evidence for the use of patient responses to inform clinical reasoning are explored in this commentary. Although the evidence is not conclusive, an argument is presented suggesting it is more reasonable to use a patient's response to treatment to inform ongoing clinical reasoning than to follow predetermined protocols. A methodical approach that considers change in parameters such as patient impairments is likely to be a useful guide for decision making during ongoing patient management but only when the change being reassessed can be directly linked to functional goals. Changes in active range of movement or centralization of pain appear to be better indicators of treatment effectiveness than changes in either pain intensity or assessment of joint position. There is limited evidence to support the use of changes in segmental stiffness to guide ongoing management. Although reassessment of some impairments has been found to be useful, the author suggests that care is required in the selection of reassessments used to guide ongoing management. The usefulness of any reassessment is considered to rely on how well a change in the selected impairment predicts that in idual patient's ability to achieve their goals.
Publisher: Elsevier BV
Date: 03-2023
Publisher: Elsevier BV
Date: 02-2009
DOI: 10.1016/J.MATH.2007.09.003
Abstract: In order to determine how posteroanterior movements (PAs) are related to tenderness and thus possibly symptom production, we measured PA movements to a force of 25N on each side of the cervical spines of asymptomatic subjects. From 10 subjects (six females and four males mean age 37.2, range 21-50), 10 locations with a difference in tenderness to pressure between sides were used for analysis. The force-displacement and stiffness-force curves for tender and control sides were compared in four ways: simultaneous confidence bands (SCBs) for each side width of SCBs for each side SCBs of the difference between pairs of the tender and control curves and simultaneous prediction bands (SPBs) from the tender side were compared to in idual curves of the controls. The tender side demonstrated greater variation of both displacement and stiffness. The tender sides demonstrated greater within-subject stiffness for all force levels above 12N. All in idual stiffness-force curves of the tender sides were significantly different from the control side. Expected differences in single measures of either displacement or stiffness were not detected. The results suggest that the pattern of stiffness is a more effective method of characterizing PA mobility than single measures used in previous studies.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-2008
Publisher: Elsevier BV
Date: 03-1999
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 10-2011
Publisher: Elsevier BV
Date: 06-1998
Publisher: Oxford University Press (OUP)
Date: 04-2016
DOI: 10.2522/PTJ.20150172
Abstract: History taking is an important component of patient/client management. Assessment of student history-taking competency can be achieved via a standardized tool. The ECHOWS tool has been shown to be valid with modest intrarater reliability in a previous study but did not demonstrate sufficient power to definitively prove its stability. The purposes of this study were: (1) to assess the reliability of the ECHOWS tool for student assessment of patient interviewing skills and (2) to determine whether the tool discerns between novice and experienced skill levels. A reliability and construct validity assessment was conducted. Three faculty members from the United States and Australia scored videotaped histories from standardized patients taken by students and experienced clinicians from each of these countries. The tapes were scored twice, 3 to 6 weeks apart. Reliability was assessed using interclass correlation coefficients (ICCs) and repeated measures. Analysis of variance models assessed the ability of the tool to discern between novice and experienced skill levels. The ECHOWS tool showed excellent intrarater reliability (ICC [3,1]=.74–.89) and good interrater reliability (ICC [2,1]=.55) as a whole. The summary of performance (S) section showed poor interrater reliability (ICC [2,1]=.27). There was no statistical difference in performance on the tool between novice and experienced clinicians. A possible ceiling effect may occur when standardized patients are not coached to provide complex and obtuse responses to interviewer questions. Variation in familiarity with the ECHOWS tool and in use of the online training may have influenced scoring of the S section. The ECHOWS tool demonstrates excellent intrarater reliability and moderate interrater reliability. Sufficient training with the tool prior to student assessment is recommended. The S section must evolve in order to provide a more discerning measure of interviewing skills.
Publisher: MDPI AG
Date: 27-10-2022
Abstract: Palpation remains essential for evaluating lymphoedema to detect subtle changes that may indicate progression. As palpation sense is not quantifiable, this study investigates the utility of ultrasound elastography to quantify stiffness of lymphoedema tissue and explore the influence of the pitting test on tissue stiffness. Fifteen women with unilateral arm lymphoedema were scanned using a Siemens S3000 Acuson ultrasound (Siemens, Germany) with 18 MHz and 9 MHz linear transducers to assess tissue structure and tissue stiffness with Acoustic Radiation Force Impulse elastography. Ninety sites were assessed, three on each of the lymphoedema-affected and contralateral unaffected arms. A subgroup of seven lymphoedema-affected sites included additional elastography imaging after a 60-s pitting test. Dermal tissue stiffness was greater than subcutaneous tissue stiffness regardless of the presence of pathology (p 0.001). Lymphoedematous tissue exhibited a higher dermal to subcutaneous tissue stiffness ratio than contralateral sites (p = 0.005). Subgroup analysis indicated that the pitting test reduces dermal tissue stiffness (p = 0.018) and may alter the stiffness of the subcutaneous tissue layer. Elastography demonstrates potential as a complement to lymphoedema palpation assessment. The novel pre-test and post-pitting elastography imaging protocol yielded information representative of lymphoedema tissue characteristics that could not be ascertained from pre-test elastography images alone.
Publisher: Royal Society of Chemistry (RSC)
Date: 1999
DOI: 10.1039/A904575I
Publisher: CSIRO Publishing
Date: 1987
DOI: 10.1071/CH9870701
Abstract: Trimethylsilyloxy and ethoxy iminyls (4a-i) have been generated by photolysis of solutions of the corresponding trimethylsilyl and ethyl N- chloro imidates , in the cavity of an e.s.r. spectrometer. The unpaired electron resides in a 2py orbital on nitrogen in concurrence with the results of MNDO and INDO calculations. The bimolecular rate constants for decay of trimethylsilyloxy t-butyl iminyl (4c) have been evaluated. Trimethylsilyloxy 1,l-dimethylbut-3-enyl iminyl (4e) undergoes an N-C δ cyclization.
No related grants have been discovered for Neil Tuttle.