The effect of limb dominance on lower limb functional performance – a systematic review

Lower limb dominance (or lateral preference) could potentially effect functional performance. Clinicians are often asked to make judgements as to when a patient has sufficiently “recovered” from an injury, typically using strength and dynamic performance outcome measures. The primary purpose of this study was to systematically review the literature in relation to limb dominance within active adult populations and discuss some limitations to current methods and relate this to current clinical practice. A search of MEDLINE and CINAHL and EMBASE databases and reference lists of those articles identified was performed. Eleven articles were selected for meta-analysis. There was no statistical effect of limb dominance for any of the functional tests: isokinetic quadriceps and hamstring tests, hamstring:quadriceps ratios, single-leg hop for distance, single-leg vertical jump and vertical ground reaction force following a single-leg vertical jump. Pooled symmetry values varied from 94.6% to 99.6% across the tests, above the clinically accepted benchmark of 90% used in clinical practice. Although the results of this study must be used with discretion, asymmetries in the tasks described in this analysis should be viewed as undesirable and remedied accordingly. Further research is needed to quantify asymmetries, particularly in relation to sport-specific contexts.     

Provider documentation of patient education: a lean investigation

Purpose

The study evaluates how providers give patient education materials and identifies improvements to comply with Meaningful Use (MU) requirements.

Methods

Thirty-eight patient-provider interactions in two health care outpatient clinics were observed.

Results

Providers do not uniformly know MU patient education requirements. Providers have individual preferences and find gaps in what is available. Accessing and documenting patient education varies among providers. Embedded electronic health record (EHR) materials, while available, have technical access barriers.

Conclusions

Providers'' EHR skills and knowledge levels contribute to non-standardized patient education delivery.     

Maltreatment of children in The Netherlands: an update after ten years

Governmental consultation and advice on child abuse and neglect in the Netherlands started in 1972 as a two-year experiment with four offices for "confidential doctors" in four major cities of the country. After these two experimental years, a governmental institute for prevention of child abuse and neglect was organized. Over the ensuing decade the number of offices increased to ten, covering the whole country. The State Department of Welfare, Public Health, and Environment collected data from the confidential doctors and their coworkers every year. This study compares the data of the first year 1974 with those of 1983 in order to detect changing patterns over a 10-year period. The major changes are as follows: a threefold increase in cases, an extraordinary increase in cases of emotional maltreatment, an increase in detection of child fatalities but decrease in severity of physical abuse. Sexual abuse was hardly recognized in 1974 but gradually was recognized more frequently during the study decade and accounted for an alarming 7.2% of detected cases of maltreatment in 1983. No change was found in the social conditions of the family and the identity of the perpetrators--primarily fathers and/or mothers. A decrease was noted in the percentage of married parents. The increased percentage of single parents was primarily represented by mothers alone. An increase in the numbers of victims residing at home and a decrease in the need for children's homes as a temporary or permanent residence is attributed to aftercare. The discrepancy between the results of this voluntary notification system in the Netherlands and the results of a mandatory reporting system as used in the U.S.A. is still very high. The hope is that the government will decide to make reporting of maltreatment mandatory for everyone.     

Effects of writing instruction and assessment on functional composition performance

In this study the relationships between writing instruction and functional composition performance were analyzed. The data were obtained in a national assessment on the language proficiency of students in the third year of Dutch secondary education (age ±15). Multivariate multilevel analysis showed that 10 out of 36 instructional characteristics were related to functional composition performance. The effective instructional characteristics included: instruction and exercises in writing functional texts, writing for a specific purpose, tailoring to a particular audience, global rating of writing products by the teacher, and frequent evaluation of Dutch language proficiency through teacher-made tests and written assignments. No effects were found for the rather popular subskill exercises on idiom, syntax, spelling and punctuation, and for pre-writing activities, text revisions and peer-review. Furthermore, the effect of instructional characteristics was often different on one task than on another. Finally, there was little differential effectiveness for different groups of students. If one instructional characteristic was more effective than the other, this was generally true, to an equal degree, for boys and girls and for promoted and non-promoted students.     

Against the current: A grounded theory study on the estrangement experiences of a select group of Filipino gay older persons

According to Healthy People (2011), in order to understand the health concerns of the Lesbian, Gay, Bisexual, and Transgender (LGBT), the oppression and discrimination that they have faced must be scrutinized. Among the many issues they face, their estrangement experiences are one of the most understudied. However, little is known about how it is experienced by the gay elderly population, hence, this investigation. This grounded theory purports to describe the process by which estrangement is experienced among the Filipino gay older adults. Strauss and Corbin’s Grounded Theory (1990) design was utilized. A total of 10 gay older persons were purposively chosen to participate in semi-structured interviews. Field texts were subjected to thematic analysis involving open, axial, and selective coding. The study generated The Sailing Model of Estrangement. Remarkably, three phases relative to estrangement emerged, namely: sequestering, striving, and surviving. Primarily, the sequestering phase involves the gay persons’ need to express self, search for acceptance, and its subsequent reactions. The striving phase typifies the struggle in dealing with estrangement leading to either feelings of depression, remorse and shame or positivity, hopefulness, and motivation. Finally, in the surviving phase, gay persons may either feel contented and fulfilled or sad, lonely, and remorseful as they acquiesce aging with estrangement. Findings of the study offer an understanding of how Filipino gay older adults employ coping strategies in response to estrangement.     

Various ways to determine rational number size: an exploration across primary and secondary education

European Journal of Psychology of Education - Understanding rational numbers is a complex task for primary and secondary school students. Previous research has shown that a possible reason is...     

Reading Comprehension of Dutch Deaf Children

In this study, the reading comprehension of deaf children and adolescents in the Netherlands is examined along with their word identification. The reading comprehension of 464 deaf students and the word identification of 504 deaf students between 6 and 20 years of age was examined. The results show the reading comprehension scores of deaf children to be far below the scores of hearing children. On average, the deaf subjects scored at a level equivalent to a hearing child in the first grade. The word identification scores of the deaf children, however, were almost equivalent to the scores of hearing children. Although reading comprehension and word identification appear to be related, this relation does not completely explain the comprehension difficulties encountered by deaf children. Additional factors are required to explain deaf children’s difficulties with reading comprehension.     

Picking the winners by consensus: Grant-giving practice in the Netherlands

The Netherlands form a consensus democracy. In such a society the legitimacy of decisions is of great concern to all. An elaborate system of checks and balances tends to exist and the pressure to join an emerging consensus at meetings is both subtle and tremendously powerful. In the Dutch system of higher education and research the manifestations of the consensus ideal are numerous. This paper highlights them where appropriate. It reviews the Dutch research effort in an international perspective and concludes that R&D expenditure in the Netherlands, measured as a proportion of GDP, is declining. Fairly radical changes in science policy orientation since the 1960s are reviewed and the current frameworks for policy formulation, academic foresight and the organisation of support are sketched. After discussing NWO's different funding instruments, the practices of picking the winners are described in some detail. Three different peer review models are then discussed with special attention to their strengths and weaknesses. The paper's final section is focussed on the evaluation practices in force.