Journal of Strength and Conditioning Research, 2010
Serpell, BG, Ford, M, and Young, WB. The development of a new test of agility for rugby league. J... more Serpell, BG, Ford, M, and Young, WB. The development of a new test of agility for rugby league. J Strength Cond Res 24(12): 3270-3277, 2010-Agility requires change of direction speed (CODS) and also perceptual and decision-making skills and reaction speed. The purpose of this study was to develop a reliable and valid agility test for rugby league, which stressed all those dimensions. Players from a subelite rugby league team were tested twice on a sport-specific reactive agility test (RAT) and CODS test. Data were analyzed for reliability. For validity results from the subelite groups, first test was compared with data from an elite group. The RAT required participants to run toward an unpredictable life-size video of an attacking opponent and react to that video by changing direction. The CODS test required the same movement patterns however direction changes were preplanned. The subelite group's mean time to complete the CODS test and RAT on their first test was 1.67 6 0.15 and 1.98 6 0.16 seconds, respectively, and 1.62 6 0.14 and 1.91 6 0.17 seconds, respectively, on their second test (results are 6 s). Statistical analyses revealed no significant difference in means (p , 0.05) and good correlation (intraclass correlation coefficient = 0.87 and 0.82, respectively). The elite group's mean time to complete the tests was 1.65 6 0.09 and 1.79 60.12 seconds, respectively. Statistical analyses revealed a significant difference in mean RAT time between the elite group and the subelite group (p , 0.05). The RAT was reliable and valid. Performance differences on the RAT were attributed to differences in perceptual skills and/or reaction ability. Testing and training agility should therefore stress those dimensions of agility and not just CODS. CL = confidence limit; SEM = standard error of measurement; ICC = intraclass correlation; ES = effect size. *95% confidence interval. †Significantly different to lower performance group test 1 (p , 0.05).
The safety and efficacy of supplemental allograft combined with iliac crest autograft as a treatm... more The safety and efficacy of supplemental allograft combined with iliac crest autograft as a treatment for cleft alveolus defects is poorly characterized. The authors report the safety and efficacy of supplemental demineralized bone matrix and cancellous allograft with iliac crest bone autograft in cleft alveolar bone defects. A retrospective review of one institution's experience with cleft alveolar bone defects treated with traditional open iliac crest bone graft alone (group 1) or minimal access iliac crest bone graft plus demineralized bone matrix and cancellous allograft (group 2) was performed. All patients (n = 36) were treated with alveolar fistula repair with primary closure. Twenty-two patients [17 unilateral and five bilateral clefts (n = 27)] were treated in group 1 and 14 [six unilateral clefts and eight bilateral clefts (n = 22)] in group 2. The average operative time per alveolus was 147 minutes in group 1 and 111 minutes in group 2. Average engraftment (Enemark Scale) was 1.96 in group 1 and 1.20 in group 2. In group 1, canine eruption was complete in 71.4 percent, partial in 21.4 percent, and unerupted in 3.5 percent; in group 2, canine eruption was complete in 22 percent, partial in 55 percent, and unerupted in 18 percent. Bone graft extrusion occurred in six patients in group 1. There were no wound infections or deaths. The addition of supplemental demineralized bone matrix and cancellous allograft in cleft alveolar defects is safe and effective. The authors' allograft supplemental surgical technique is associated with low morbidity, shorter operative times, and higher rates of bone graft survival.
Diagnosis of submucous cleft palate (SMCP) is frequently delayed, adversely affecting speech outc... more Diagnosis of submucous cleft palate (SMCP) is frequently delayed, adversely affecting speech outcomes. Previous studies show that MRI reliably identifies structural abnormalities in velopharyngeal musculature. This information has potential to assist with diagnosis and treatment decisions. The objectives of this study were to (1) develop a clinician-friendly MRI grading scale of SMCP anatomy, (2) identify correlations between radiographic cleft severity and clinical severity using Pittsburgh Weighted Speech Scores (PWSS), and (3) determine if MRI is a predictor of surgical efficacy in improving PWSS. Thirty patients presenting to our Cleft Palate-Craniofacial Clinic for evaluation of velopharyngeal insufficiency (VPI) and suspected SMCP were reviewed. VPI severity was clinically graded using PWSS. All patients underwent MRI to grade palatal abnormalities, using a novel MRI grading scale. PWSS and cleft severity on MRI were compared. A subgroup of patients (n = 19) underwent palatoplasty. Preoperative and postoperative PWSS were compared. Degree of PWSS improvement was then correlated with the preoperative MRI grade. Twenty-nine out of 30 MRIs demonstrated abnormal palate anatomy. Of the 30 patients evaluated, 5 clinically improved with speech therapy alone. In this subgroup, MRI severity did not correlate with PWSS (P = 0.06-0.6). Nineteen patients underwent palatoplasty. Of these, 14 demonstrated improved postoperative PWSS. There were no significant correlations between severity of cleft on imaging and preoperative PWSS or score improvement (P = 0.056-0.65). While MRI accurately identifies structural abnormalities of the soft palate, these abnormalities do not reliably correspond to clinical severity. Clinical examination including speech scores and dynamic speech testing, rather than static MRI, should guide treatment decisions and surgical indications.
Progress in Industrial Ecology, An International Journal, 2007
Industrial ecology has devoted almost exclusive attention to the flows that connect industrial pr... more Industrial ecology has devoted almost exclusive attention to the flows that connect industrial processes. Though understandable given its metaphorical roots in natural ecosystems, it has neglected the exchanges that necessarily accompany the flows found in human-designed systems. After reviewing the seminal literature of institutional theory for a better understanding of exchanges, several current examples involving industrial flows are used to illustrate the relevance of exchange to the enactment of systems in line with the norms of industrial ecology.
The safety and efficacy of supplemental allograft combined with iliac crest autograft as a treatm... more The safety and efficacy of supplemental allograft combined with iliac crest autograft as a treatment for cleft alveolus defects is poorly characterized. The authors report the safety and efficacy of supplemental demineralized bone matrix and cancellous allograft with iliac crest bone autograft in cleft alveolar bone defects. A retrospective review of one institution's experience with cleft alveolar bone defects treated with traditional open iliac crest bone graft alone (group 1) or minimal access iliac crest bone graft plus demineralized bone matrix and cancellous allograft (group 2) was performed. All patients (n = 36) were treated with alveolar fistula repair with primary closure. Twenty-two patients [17 unilateral and five bilateral clefts (n = 27)] were treated in group 1 and 14 [six unilateral clefts and eight bilateral clefts (n = 22)] in group 2. The average operative time per alveolus was 147 minutes in group 1 and 111 minutes in group 2. Average engraftment (Enemark Scale) was 1.96 in group 1 and 1.20 in group 2. In group 1, canine eruption was complete in 71.4 percent, partial in 21.4 percent, and unerupted in 3.5 percent; in group 2, canine eruption was complete in 22 percent, partial in 55 percent, and unerupted in 18 percent. Bone graft extrusion occurred in six patients in group 1. There were no wound infections or deaths. The addition of supplemental demineralized bone matrix and cancellous allograft in cleft alveolar defects is safe and effective. The authors' allograft supplemental surgical technique is associated with low morbidity, shorter operative times, and higher rates of bone graft survival.
Background: Nonsynostotic occipital plagiocephaly remains a diagnosis of concern in infancy. This... more Background: Nonsynostotic occipital plagiocephaly remains a diagnosis of concern in infancy. This study evaluates factors affecting the onset, treatment, and outcomes of nonsynostotic occipital plagiocephaly. Methods: A retrospective chart review and telephone survey were performed. A posterior occipital deformation severity score was used. Factors such as demographics, behavioral and helmet therapy, feeding patterns, torticollis, multiple gestation pregnancies, prematurity, and congenital nonsynostotic occipital plagiocephaly were evaluated. Results: One hundred five infants were identified. Of these, 95 percent were Caucasian, 93 percent were from two-parent households, and 70 percent were from households earning more than $50,000. Repositioning was attempted in 95 percent, and 45 percent progressed to helmet therapy. When comparing change in posterior occipital deformation severity score with helmet therapy to repositioning, a difference was found (p Ͻ 0.05). Forty-nine percent of patients were breast-fed, and when compared with the general population, a difference was found (p Ͻ 0.05). Twenty percent of infants had torticollis, and when compared with population norms, a difference was found (p Ͻ 0.05). Twelve percent of patients were twins, and when compared with population norms, more twinning occurred (p Ͻ 0.05). Congenital nonsynostotic occipital plagiocephaly was found in 10 percent of patients and did not result in an increased risk of progression to helmet therapy. Conclusions: This study demonstrates trends that may predict additional risks for developing nonsynostotic occipital plagiocephaly, including torticollis, plural births, and increased socioeconomic affluence. In addition, the nonsynostotic occipital plagiocephaly cohort was breast-fed less than the general population, demonstrating that breast-feeding may be preventative, as breast-fed infants are repositioned more frequently and sleep for shorter periods. As in other studies, cranial molding helmet therapy was more effective in correcting nonsynostotic occipital plagiocephaly than repositioning alone. (Plast. Reconstr. Surg. 119:
Journal of Strength and Conditioning Research, 2010
Serpell, BG, Ford, M, and Young, WB. The development of a new test of agility for rugby league. J... more Serpell, BG, Ford, M, and Young, WB. The development of a new test of agility for rugby league. J Strength Cond Res 24(12): 3270-3277, 2010-Agility requires change of direction speed (CODS) and also perceptual and decision-making skills and reaction speed. The purpose of this study was to develop a reliable and valid agility test for rugby league, which stressed all those dimensions. Players from a subelite rugby league team were tested twice on a sport-specific reactive agility test (RAT) and CODS test. Data were analyzed for reliability. For validity results from the subelite groups, first test was compared with data from an elite group. The RAT required participants to run toward an unpredictable life-size video of an attacking opponent and react to that video by changing direction. The CODS test required the same movement patterns however direction changes were preplanned. The subelite group's mean time to complete the CODS test and RAT on their first test was 1.67 6 0.15 and 1.98 6 0.16 seconds, respectively, and 1.62 6 0.14 and 1.91 6 0.17 seconds, respectively, on their second test (results are 6 s). Statistical analyses revealed no significant difference in means (p , 0.05) and good correlation (intraclass correlation coefficient = 0.87 and 0.82, respectively). The elite group's mean time to complete the tests was 1.65 6 0.09 and 1.79 60.12 seconds, respectively. Statistical analyses revealed a significant difference in mean RAT time between the elite group and the subelite group (p , 0.05). The RAT was reliable and valid. Performance differences on the RAT were attributed to differences in perceptual skills and/or reaction ability. Testing and training agility should therefore stress those dimensions of agility and not just CODS. CL = confidence limit; SEM = standard error of measurement; ICC = intraclass correlation; ES = effect size. *95% confidence interval. †Significantly different to lower performance group test 1 (p , 0.05).
The safety and efficacy of supplemental allograft combined with iliac crest autograft as a treatm... more The safety and efficacy of supplemental allograft combined with iliac crest autograft as a treatment for cleft alveolus defects is poorly characterized. The authors report the safety and efficacy of supplemental demineralized bone matrix and cancellous allograft with iliac crest bone autograft in cleft alveolar bone defects. A retrospective review of one institution's experience with cleft alveolar bone defects treated with traditional open iliac crest bone graft alone (group 1) or minimal access iliac crest bone graft plus demineralized bone matrix and cancellous allograft (group 2) was performed. All patients (n = 36) were treated with alveolar fistula repair with primary closure. Twenty-two patients [17 unilateral and five bilateral clefts (n = 27)] were treated in group 1 and 14 [six unilateral clefts and eight bilateral clefts (n = 22)] in group 2. The average operative time per alveolus was 147 minutes in group 1 and 111 minutes in group 2. Average engraftment (Enemark Scale) was 1.96 in group 1 and 1.20 in group 2. In group 1, canine eruption was complete in 71.4 percent, partial in 21.4 percent, and unerupted in 3.5 percent; in group 2, canine eruption was complete in 22 percent, partial in 55 percent, and unerupted in 18 percent. Bone graft extrusion occurred in six patients in group 1. There were no wound infections or deaths. The addition of supplemental demineralized bone matrix and cancellous allograft in cleft alveolar defects is safe and effective. The authors' allograft supplemental surgical technique is associated with low morbidity, shorter operative times, and higher rates of bone graft survival.
Diagnosis of submucous cleft palate (SMCP) is frequently delayed, adversely affecting speech outc... more Diagnosis of submucous cleft palate (SMCP) is frequently delayed, adversely affecting speech outcomes. Previous studies show that MRI reliably identifies structural abnormalities in velopharyngeal musculature. This information has potential to assist with diagnosis and treatment decisions. The objectives of this study were to (1) develop a clinician-friendly MRI grading scale of SMCP anatomy, (2) identify correlations between radiographic cleft severity and clinical severity using Pittsburgh Weighted Speech Scores (PWSS), and (3) determine if MRI is a predictor of surgical efficacy in improving PWSS. Thirty patients presenting to our Cleft Palate-Craniofacial Clinic for evaluation of velopharyngeal insufficiency (VPI) and suspected SMCP were reviewed. VPI severity was clinically graded using PWSS. All patients underwent MRI to grade palatal abnormalities, using a novel MRI grading scale. PWSS and cleft severity on MRI were compared. A subgroup of patients (n = 19) underwent palatoplasty. Preoperative and postoperative PWSS were compared. Degree of PWSS improvement was then correlated with the preoperative MRI grade. Twenty-nine out of 30 MRIs demonstrated abnormal palate anatomy. Of the 30 patients evaluated, 5 clinically improved with speech therapy alone. In this subgroup, MRI severity did not correlate with PWSS (P = 0.06-0.6). Nineteen patients underwent palatoplasty. Of these, 14 demonstrated improved postoperative PWSS. There were no significant correlations between severity of cleft on imaging and preoperative PWSS or score improvement (P = 0.056-0.65). While MRI accurately identifies structural abnormalities of the soft palate, these abnormalities do not reliably correspond to clinical severity. Clinical examination including speech scores and dynamic speech testing, rather than static MRI, should guide treatment decisions and surgical indications.
Progress in Industrial Ecology, An International Journal, 2007
Industrial ecology has devoted almost exclusive attention to the flows that connect industrial pr... more Industrial ecology has devoted almost exclusive attention to the flows that connect industrial processes. Though understandable given its metaphorical roots in natural ecosystems, it has neglected the exchanges that necessarily accompany the flows found in human-designed systems. After reviewing the seminal literature of institutional theory for a better understanding of exchanges, several current examples involving industrial flows are used to illustrate the relevance of exchange to the enactment of systems in line with the norms of industrial ecology.
The safety and efficacy of supplemental allograft combined with iliac crest autograft as a treatm... more The safety and efficacy of supplemental allograft combined with iliac crest autograft as a treatment for cleft alveolus defects is poorly characterized. The authors report the safety and efficacy of supplemental demineralized bone matrix and cancellous allograft with iliac crest bone autograft in cleft alveolar bone defects. A retrospective review of one institution's experience with cleft alveolar bone defects treated with traditional open iliac crest bone graft alone (group 1) or minimal access iliac crest bone graft plus demineralized bone matrix and cancellous allograft (group 2) was performed. All patients (n = 36) were treated with alveolar fistula repair with primary closure. Twenty-two patients [17 unilateral and five bilateral clefts (n = 27)] were treated in group 1 and 14 [six unilateral clefts and eight bilateral clefts (n = 22)] in group 2. The average operative time per alveolus was 147 minutes in group 1 and 111 minutes in group 2. Average engraftment (Enemark Scale) was 1.96 in group 1 and 1.20 in group 2. In group 1, canine eruption was complete in 71.4 percent, partial in 21.4 percent, and unerupted in 3.5 percent; in group 2, canine eruption was complete in 22 percent, partial in 55 percent, and unerupted in 18 percent. Bone graft extrusion occurred in six patients in group 1. There were no wound infections or deaths. The addition of supplemental demineralized bone matrix and cancellous allograft in cleft alveolar defects is safe and effective. The authors' allograft supplemental surgical technique is associated with low morbidity, shorter operative times, and higher rates of bone graft survival.
Background: Nonsynostotic occipital plagiocephaly remains a diagnosis of concern in infancy. This... more Background: Nonsynostotic occipital plagiocephaly remains a diagnosis of concern in infancy. This study evaluates factors affecting the onset, treatment, and outcomes of nonsynostotic occipital plagiocephaly. Methods: A retrospective chart review and telephone survey were performed. A posterior occipital deformation severity score was used. Factors such as demographics, behavioral and helmet therapy, feeding patterns, torticollis, multiple gestation pregnancies, prematurity, and congenital nonsynostotic occipital plagiocephaly were evaluated. Results: One hundred five infants were identified. Of these, 95 percent were Caucasian, 93 percent were from two-parent households, and 70 percent were from households earning more than $50,000. Repositioning was attempted in 95 percent, and 45 percent progressed to helmet therapy. When comparing change in posterior occipital deformation severity score with helmet therapy to repositioning, a difference was found (p Ͻ 0.05). Forty-nine percent of patients were breast-fed, and when compared with the general population, a difference was found (p Ͻ 0.05). Twenty percent of infants had torticollis, and when compared with population norms, a difference was found (p Ͻ 0.05). Twelve percent of patients were twins, and when compared with population norms, more twinning occurred (p Ͻ 0.05). Congenital nonsynostotic occipital plagiocephaly was found in 10 percent of patients and did not result in an increased risk of progression to helmet therapy. Conclusions: This study demonstrates trends that may predict additional risks for developing nonsynostotic occipital plagiocephaly, including torticollis, plural births, and increased socioeconomic affluence. In addition, the nonsynostotic occipital plagiocephaly cohort was breast-fed less than the general population, demonstrating that breast-feeding may be preventative, as breast-fed infants are repositioned more frequently and sleep for shorter periods. As in other studies, cranial molding helmet therapy was more effective in correcting nonsynostotic occipital plagiocephaly than repositioning alone. (Plast. Reconstr. Surg. 119:
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