Notes

Probability of hospitalised comes and cool breaks within operating age older people receiving mental health care.
Nursing faculty may be reluctant to fail students for a variety of reasons. Faculty may fear being viewed as discriminatory when failing nursing students with disabilities.

Schools of nursing may still be using technical standards that are outdated and noncompliant with the Americans with Disabilities Act (ADA) to determine eligibility for admission and may confuse essential functions with academic expectations. Lack of faculty awareness of the ADA may make faculty reluctant to fail nursing students with disabilities.

All nursing students should be assessed based on whether-not how-they meet academic and clinical standards safely. Disability accommodations should not affect the standards that must be met.

Faculty should base decisions on whether to assign failing grades to students on factors unrelated to a disability. Technical standards, when written correctly, should clarify whether inability or disability contributed to failure. Policies regarding failing should be clear, equitable, and accessible.
Faculty should base decisions on whether to assign failing grades to students on factors unrelated to a disability. Technical standards, when written correctly, should clarify whether inability or disability contributed to failure. Policies regarding failing should be clear, equitable, and accessible.
Cutrufello, PT, Landram, MJ, Venezia, AC, and Dixon, CB. A comparison of methods used to determine percent body fat, minimum wrestling weight, and lowest allowable weight class. J Strength Cond Res 35(3) 633-637, 2021-The National Collegiate Athletic Association's weight management program allows for the use of skinfold measurements (SF), air displacement plethysmography (ADP), and hydrostatic weighing in the assessment of percent body fat (%BF) and determination of a wrestler's minimum wrestling weight (MWW). Dual energy x-ray absorptiometry (DXA) and ultrasound (US) may offer alternative assessment methods. The purpose of this study was to examine %BF, MWW, and the lowest allowable weight class as determined by SF, ADP, DXA, and US. Thirty-three college-aged men (20.8 ± 1.1 years) participated. Urine specific gravity (Usg) was assessed to ensure proper hydration (1.006 ± 0.006). Percent body fat and MWW were then determined using the 4 assessment methods. Each method was significantly different from one akg) and US (69.3 ± 6.0 kg) determined the lowest MWW, whereas those determined by SF (70.8 ± 6.8 kg) and ADP (70.9 ± 6.6 kg) were significantly greater (p less then 0.05). The SEEs for MWW when compared with SF were 3.2, 3.4, and 2.4 kg for ADP, DXA, and US, respectively. Compared with SF, DXA and US would allow wrestlers to certify at a lower weight class 64 and 33% of the time, respectively. When comparing the approved methods (SF and ADP), approximately 50% of subjects would certify at a different weight class depending on the method used. The use of different methods in assessing %BF offer a wide variability in the determination of MWW.
Watkins, CM, Gill, ND, Maunder, E, Downes, P, Young, JD, McGuigan, MR, and Storey, AG. The effect of low-volume preseason plyometric training on force-velocity profiles in semiprofessional rugby union players. J Strength Cond Res 35(3) 604-615, 2021-Rugby union is a physically demanding and complex team sport requiring athletes across all positions to express speed and acceleration. Plyometrics can effectively improve speed profiles by enhancing both force- and velocity-(FV) characteristics; however, the optimal dose and exercise direction for trained athletes is still relatively unknown. Therefore, the aim of this investigation was to determine the efficacy of a low-dose, directionally specific plyometric training program for improving speed profiles in semiprofessional rugby players. Players were randomly allocated to one of 2 plyometric training groups that performed low-volume (40-60 ground contacts per session) plyometrics twice weekly, or a control group that did not participate in any plyometric traicteristics. Correlational analyses (r2 = -0.568 to 0.515) showed sprint improvements were hindered in athletes with lower initial aerobic fitness, suggesting accumulated fatigue may have limited the magnitude of adaptation. Therefore, including low-volume plyometric training may be beneficial for improving sprint profiles or attenuating decrements realized during periods of high-volume sport-specific training.Myxopapillary ependymomas (MPEs) have an indolent clinical course, corresponding to World Health Organization Grade I. A total of 13 pediatric MPEs have been reported in the literature with "anaplastic features," including elevated proliferative activity (≥5 mitoses/10 high-power fields), necrosis, and microvascular proliferation. No consensus exists regarding the prognostic significance of such features. A retrospective clinicopathologic review of pediatric MPEs diagnosed between 1996 and 2018 at Mayo Clinic was performed. Totally, 8 pediatric MPEs (6 male; age 7.52 to 16.88 y) were identified. Totally, 3 had disseminated disease at presentation. All patients underwent surgical resection (7 gross total; 1 subtotal). Totally, 5 cases harbored ≥5 mitoses/10 high-power fields (range 5 to 9), 3 of which showed necrosis (2 with disseminated disease). Postsurgery, 2 patients received radiation; one with disseminated disease and another with increased mitotic activity/necrosis; neither has recurred (follow-up 1.18 and 3.19 y). In all, 2 patients with disseminated disease, elevated mitotic activity, and necrosis had new metastatic disease/progression of nonresected metastatic foci (2.6 and 26.8 mo), received radiation therapy, and remain progression free (3.01 and 9.34 y). All patients are alive (median follow-up 1.31 y, range 0.66 to 11.75). Among pediatric MPEs, the concurrent presence of elevated mitotic activity and necrosis may be associated with an aggressive clinical course, warranting closer surveillance and consideration of adjuvant therapies.
To investigate whether rotational malalignment of tibia, after fracture management with minimally invasive plate osteosynthesis technique (MIPO), leads to impaired results in knee and ankle joint functional scores.

Prospectively collected data was retrospectively analyzed for this study.

Level III academic trauma center.Patients/Participants 65 consecutive patients who applied between October 2010 and January 2014 with a unilateral distal tibia fracture and had full bone union at their last visit were analyzed. Patients were excluded if they had a pathological fracture, Gustilo-Anderson type II or III open fracture, additional ligamentous trauma, were pregnant, or had any deformity. A total of 27 patients were accepted into the study.

All patients were treated with a MIPO technique after a mean of 2.8 days. The fibular fracture, when present, was fixed first.

The main outcome of this study was the relation between tibial malrotation after a MIPO procedure, and LEFS, AOFAS, KOOS scores and range of motions of adjacent joints.ResultsFourteen patients (51.8%) had a rotation higher than 10°. The mean malrotation angle was 14.6°. Concomitant fibular fractures were present in 13 patients, which did not seem to have a significant influence on malrotation. There was no significant difference between groups regarding functional scores and range of motions of the knee and ankle joints.

Despite high rates of malrotation following tibial metaphyseal-diaphyseal fractures treated with MIPO technique, this finding does not seem to have a significantly negative effect on knee and ankle joint functions. Meticulous intraoperative evaluation, through a range of different techniques, should be performed to avoid malrotation.

Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
To define the mean angle of a series of diaphyseal non-unions based on radiographic analysis.

Retrospective cohort study.

Two level-1 trauma centers.

One hundred and twenty patients presenting with non-union.

A mean non-union angle was calculated from a series of AP and lateral X-rays using a standardised technique. The non-union angle was then estimated in a single plane by considering the greater of the two measured angles. Additional data collected included patient age, sex, non-union site, initial fracture angle and original fracture pattern.

Single plane non-union angle.

The mean angles of all non-union in coronal plane was 42 degrees (SD 17 degrees) and 42 degrees in sagittal plane (SD 18 degrees) and 48 degrees (SD 15 degrees) in single plane. The single plane non-union angle in fractures which were originally multiplanar was steeper to those occurring in originally single plane fractures (p 0.002) although both were close to 45 degrees. There was no significant difference in the non-union angles on sub-group analysis of cohort location, sex or anatomic location.

This study demonstrates the mean angle of diaphyseal non-unions from long bones of the lower limb approaches 45 degrees. This is noted in all types of fractures and is irrespective of anatomic location or sex. This confirms the hypothesis that shear is likely to play a role in the development of a non-union. This study provides further evidence that non-unions occur primarily due mechanical instability.

Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Prognostic Level III. selleck inhibitor See Instructions for Authors for a complete description of levels of evidence.
To describe in detail the variability of the attachments of the IPF and its relation to the external iliac vessels in order to inform surgical approaches and help prevent injury to the adjacent vascular structures.

A cadaveric study was performed on sixteen specimens. The IPF was identified from the lateral and medial perspectives of the II and AIP approaches respectively, and its anatomic characteristics were described.

The IPF originates in the fascia of the psoas muscle, it has variable attachments in the pelvic brim, and it inserts in the medial surface of the iliac bone where it is continuous with the obturator internus fascia. Two variants were found in relation to the external iliac vessels. In one variant found in four cadavers the IPF formed a sail- like structure that surrounds the external iliac vessels. In the other variant observed in four cadavers, the IPF overlaid the iliac fossa, under the external iliac vessels which laid free in the iliac fossa.

The anatomic variants of the attachment of the IPF to the pelvic brim and its variants in relation to the external iliac vessels must be accounted for when performing acetabular surgery to prevent vascular injury and attain adequate exposure.
The anatomic variants of the attachment of the IPF to the pelvic brim and its variants in relation to the external iliac vessels must be accounted for when performing acetabular surgery to prevent vascular injury and attain adequate exposure.
The goal of this study was to establish if pre-operative radiographs could predict the rate of syndesmotic injury.

Level 1 trauma center.

Retrospective cohort studyPatients/Participants There were 548 OTA/AO 44-B2.1 fractures that were reviewed and 287 patients were included in the study.

Ankle radiographs were used to determine the zone of distal extent of the proximal fracture fragment. Syndesmotic injury was defined as positive intraoperative stress exam that required syndesmotic fixation.

There were 191 zone 1 (ending below the plafond) injuries, 57 zone 2 (ending between the physeal scar and the plafond) injuries, and 39 zone 3 (ending above the physeal scar) injuries. Of these, 17% (33 patients) of zone 1, 42% (24) of zone 2, and 74% (29) of zone 3 fractures had syndesmotic injuries. The relative risk of syndesmotic injury of Zone 1 compared to Zone 2 was 2.4 (p<0.001), Zone 1 to Zone 3 was 4.3 (p<0.001), Zone 2 to Zone 3 was 1.8 (p=0.002). The inter- and intra-observer reliability was excellent (κ=0.
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