NOTES AND QUERIES最新文献

Background: Shoulder range of motion (ROM) is traditionally measured using universal goniometry. However, novel devices to measure shoulder ROM digitally are becoming increasingly available. We aimed to synthesise the current evidence to answer: 1) what technologies are currently in use? 2) Are they reliable? 3) How do they compare to goniometry?

Methods: Systematic review of the literature was conducted according to PRISMA guidelines. MEDLINE, Embase, CINAHL, Emcare and Cochrane databases were searched to identify studies comparing a digital device measuring shoulder ROM to goniometry in participants > = 18years. Quality of studies was assessed using COSMIN risk of bias tool. End points included device validity compared to goniometry and intra-rater reliability.

Results: 15 articles were included, representing 372 participants and 608 shoulders, and reporting data for five device categories; infrared/RGB-D, 3D-motion-analysis, combined 3D/infra-red, 2D-video-analysis and virtual-reality. Nine studies reported mean bias and 95% limits of agreement (LOA) compared to goniometry. Pooled mean bias was -0.25 degrees (-1.25, 0.75 95% LOA, random effects model) overall. This did not differ by device type (p = 0.83), sensor or non-sensor-based devices (p = 0.62) or plane of movement (p = 0.91).

Conclusions: These devices compare well to goniometry and represent a possible means of increasing efficiency and facilitating telemedicine.

Background: Distal humerus fracture in the elderly is a challenging fracture for orthopedic surgeons. Non-union is one of the serious complications of distal humerus fracture after surgery. This retrospective multicenter study aimed to estimate the incidence of distal humeral non-union after open reduction and internal fixation, determine factors related to non-union, and compare the postoperative results of cases with non-union to cases with the union.

Methods: Among 423 patients diagnosed with distal humeral fracture and who were treated by surgical therapy in 2010-2020 from our database called TRON. Only 190 subjects met the inclusion criteria. We performed a logistic regression analysis with the presence of non-union as the response variable to examine risk factors. We compare the Mayo Elbow Performance Scores of cases with non-union to cases with the union.

Results: Non-union occurred after surgery in 15 patients (7.9%). The logistic regression analysis showed that body mass index<20 kg/m² and ≥25 kg/m², and ≤3 screws in the articular segment were significant explanatory factors for non-union (odds ratio 10.4 and 47.8, respectively). The Mayo Elbow Performance Scores were significantly worse in patients with non-union.

Discussion: Low and high body mass index and three or fewer screws in the articular segment might be risk factors for non-union of distal humerus fracture in the elderly. Non-union is associated with poor clinical outcomes.

[This corrects the article DOI: 10.1177/19433875221125644.].

Although stigma has been associated with people living with HIV defaulting from care, there is a gap in understanding the specific impact of individual stigma and community-level concern about HIV on defaulting.

Methods: This is a secondary analysis of a unique dataset that links health facility-based medical records to a population-representative community survey conducted in 2018 in rural Mpumalanga province, South Africa. We used the parametric g-formula to estimate associations among individual anticipated stigma, low perceived community and local leader concern about HIV, and defaulting from care in the prior year. In addition, we estimated the population-level effects of intervening to reduce stigma and increase concern on defaulting.

Results: Among 319 participants on treatment, 42 (13.2%) defaulted from care during the prior year. Anticipated stigma (risk ratio [RR] 1.22, 95% confidence interval [CI]: 0.72, 2.74), low perceived concern about HIV/AIDS from community leadership (RR 1.12, 95% CI 0.76, 3.38), and low shared concerns about HIV/AIDS in the community (RR 1.37; 95% CI 0.79, 3.07) were not significantly associated with default. Hypothetical population intervention effects to remove individual anticipated stigma and low community concerns yielded small reductions in default (~1% reduction).

Conclusions: In this sample, we found limited impact of reducing anticipated stigma and increasing shared concern about HIV on retention in care. Future studies should consider the limitations of this study by examining the influence of other sources of stigma in more detail and assessing how perceptions of stigma and concern impact the full HIV testing and care cascade.

Children with disabilities or specialized healthcare needs were legally excluded from U.S. public education for decades, but in the last 45 years, they have gained tremendous ground in receiving comparable educational opportunities as their non-disabled peers. The purpose of this article is to provide a historical review of the educational laws which affect children with disabilities, so that school nurses who work with these children understand the impact of these laws and the resulting changes in school nursing practice. Review of the United States' educational history provides school nurses the working background necessary to recognize their key role to support the education of children with disabilities and to advocate for these children's educational rights with their parents, school officials and policy makers.