Dissertations / Theses on the topic 'Radiographic outcomes'

The purpose of this study was to investigate if the addition of biologic materials and/or oral steroids would affect horizontal bone gain, or the bone density of the grafted bone in horizontal alveolar ridge augmentations. A retrospective chart review was completed to assess the clinical and radiographic outcomes of 53 ridge augmentation patients. An average bone gain of 3.6mm of width was found in our study based on radiographic analysis. There were no statistically significant differences found in the linear bone gain with the addition of biologic materials and steroids. A marginally statistically significant difference was found in the bone density when biologics were added (p-value=0.0653). No statistically significant difference found in the bone density with the addition of oral steroids. The use of tenting screws and resorbable occlusive membranes and a combination of allograft and xenograft bone materials provides significant clinical and radiographic dimensional changes in alveolar ridge width.

Background: Obtura-II injectable thermoplasticised gutta-percha technique has been available for several years. However, thus far, there are no published studies that have evaluated its clinical and radiographic success in non-vital young traumatised permanent incisors in children where teeth are expected to survive for the life-span of the patient. Aim: Evaluating the clinical and radiographic success of Obtura-II system in the root canals of non-vital young traumatised permanent incisors in children; studying the effect of different demographic and prognostic factors on the success rate of the technique; and investigating the outcome for this technique when used to obturate auto-transplanted teeth in children and adolescents. Method: This study was a retrospective study evaluating the Obtura-II treatment outcomes. Clinical dental records and periapical radiographs of 667 patients who attended the trauma clinic at the Paediatric Dentistry Department at Leeds Dental Institute during the period 2003–2011 were screened. The obturated teeth were classified as either successful or failure according to criteria developed for this study. Various prognostic factors that could influence the clinical and radiographic outcome of the technique were recorded using a special data extraction proforma. The data were entered into SPSS, with simple descriptive analysis and bivariate analyses conducted subsequently. Furthermore, a logistic regression analysis was carried out with the aim of obtaining the relation between different prognostic factors and the treatment outcomes. iv Results: According to the study criteria, 235 cases with 275 non-vital young permanent incisors with various stages of root development were included, in addition to 49 auto-transplanted teeth. The mean age of patients at the time of trauma was 10.2 years. The cases considered clinically successful accounted for 92.7% whilst the cases considered radiographically successful were 85.4% over a mean follow-up period of 51 months for the traumatised teeth. In addition, the clinical and the radiographic success for the auto-transplanted teeth were 97.9% and 93.8%, respectively. The logistic regression analysis showed a significant association between some of the prognostic factors, such as the type of trauma, the duration of Ca(OH)2 dressing, and the quality of obturation and the Obtura-II technique treatment outcomes in treating traumatised teeth. However, none of the factors associated significantly with the treatment outcomes in the cases of the auto-transplanted teeth. Conclusion: Obtura-II technique in the root canal treatment of the traumatised teeth was considered clinically successful in 92.7% and radiographically in 85.4% of the cases over a long follow-up period. In addition, when treating auto-transplanted teeth, the technique was clinically successful in 97.9% and radiographically in 93.8% of cases.

Aim: To study patient-related functional outcome measures, implant survival and radiographic loosening after total wrist arthroplasty (TWA) using four different implants. To evaluate a new TWA design biomechanically and clinically. Methods: The studies included two cohort studies with prospectively collected data (n=206 and n=219), an anatomic and kinematic analysis in a cadaveric model and a pilot study (n=20). Results: The Maestro TWA had a significantly greater improvement of radial/ulnar deviation than the Biax and Remotion TWAs. Summarized patientrelated functional outcome was significantly better for the Maestro than for the Remotion TWA. Cumulative implant survival after 8 years was 94% for Remotion, and 95% for Maestro implants. Radiographic loosening five years postoperatively was present in 26% of the Biax wrists, 18% of those with Remotion, and 2% of those with Maestro. Following TWA with the new implant design in a cadaveric model, there were no statistically significant changes compared to a native wrist regarding flexion, extension, radial deviation, the extension/radial deviation component of the dart-thrower’s motion, or the circumduction range of motion. Clinically, there was significant improvement of COPM, PRWE and VAS pain scores. Wrist extension and ulnar deviation improved, while grip strength remained largely unchanged. Conclusions: TWA is a surgical procedure which may offer a high level of patient satisfaction. Implant design may affect patient-related functional outcome after TWA. Implant survival as well as the frequency of radiographic loosening differed considerably between the four types of implants and might be a result of different implant design. Kinematic analysis of the new TWA design suggests that a stable and functional wrist is achievable with this design. Surgical placement of the new total wrist implant was reproducible and the implant yielded good patient-related outcome measures in the short term. Since TWA is an evolving procedure, further studies are warranted in order to refine indications and the place for TWA in modern hand surgery.

Published Article<br>This article describes a process of student learning outcomes assessment for a health sciences programme in radiography at a university in South Africa. Its purpose is to demonstrate that while the process of student learning outcomes assessment is universal, it can be used both nationally and internationally. As long as underlying premises are met, assessment needs to be considered within the context of a country's unique culture, society and history. Underlying premises include understanding the institution's mission and vision, determining that the programme's mission and vision are congruent with those of the institution, and involving faculty early in the assessment process.

Thesis (M.S.)--University of North Carolina at Chapel Hill, 2009.<br>Title from electronic title page (viewed Jun. 4, 2010). "... in partial fulfillment of the requirements for the degree of Master of Science in the Department of Endodontics, School of Dentistry." Discipline: Endodontics; Department/School: Dentistry.

Psoriatic arthritis is an inflammatory arthritis affecting a fifth of patients with skin psoriasis. Inflammation of the joints and tendons causes pain, stiffness, reduced function and disability. Work disability is increasingly recognised as an important, patient centred, functional measure of disease yet little is known about work disability in psoriatic arthritis. The overall aim of my thesis is to examine patient reported work disability in psoriatic arthritis by undertaking the following; • A systematic review of the relevant literature • Classification of a cohort of patients to study • Validation of a commonly used work outcome measure used in other rheumatic diseases • Selection of a suitable measure of structural damage to inflamed joints for investigating the associations of work disability in longitudinal observational studies. The results of the systematic review identified limited data reporting high levels of work disability associated with a wide variety of disease and non-disease related factors. The review also identified the lack of a validated outcome measure for use in psoriatic arthritis. I report the classification of a large single centre longitudinal cohort of patients with psoriatic arthritis and evidence supporting the retrospective application of a psoriatic arthritis classification criterion. Subsequently I report a preliminary validation study of the work productivity and activity impairment questionnaire to measure work disability in psoriatic arthritis and a further study comparing the existing measures of structural damage in psoriatic arthritis. Finally I developed and supervised a multicentre observational study to examine the associations of work disability in psoriatic arthritis. The study identified reduced work effectiveness to be associated with measures of disease activity, whereas unemployment was associated with recent disease onset, greater age and worse physical function. The study will provide a valuable cohort for prospective study of work disability and the effect of medical treatment and will form part of my planned post-doctoral studies.

The purpose of this study was primarily to explore the conceptualization of critical thinking development in radiologic science students by radiography program directors. Seven research questions framed three overriding themes including 1) perceived definition of and skills associated with critical thinking; 2) effectiveness and utilization of teaching strategies for the development of critical thinking; and 3) appropriateness and utilization of specific assessment measures for documenting critical thinking development. The population for this study included program directors for all JRCERT accredited radiography programs in the United States. Questionnaires were distributed via Survey Monkey©, a commercial on-line survey tool to 620 programs. A forty-seven percent (n = 295) response rate was achieved and included good representation from each of the three recognized program levels (AS, BS and certificate). Statistical analyses performed on the collected data included descriptive analyses (median, mean and standard deviation) to ascertain overall perceptions of the definition of critical thinking; levels of agreement regarding the effectiveness of listed teaching strategies and assessment measures; and the degree of utilization of the same teaching strategies and assessment measures. Chi squared analyses were conducted to identify differences within each of these themes between various program levels and/or between program directors with various levels of educational preparation as defined by the highest degree earned. Results showed that program directors had a broad and somewhat ambiguous perception of the definition of critical thinking, which included many related cognitive processes that were not always classified as attributes of critical thinking according to the literature, but were consistent with definitions and attributes identified as critical thinking by other allied health professions. These common attributes included creative thinking, decision making, problem solving and clinical reasoning as well as other high-order thinking activities such as reflection, judging and reasoning deductively and inductively. Statistically significant differences were identified for some items based on program level and for one item based on program director highest degree. There was general agreement regarding the appropriateness of specific teaching strategies also supported by the literature with the exception of on-line discussions and portfolios. The most highly used teaching strategies reported were not completely congruent with the literature and included traditional lectures with in-class discussions and high-order multiple choice test items. Significant differences between program levels were identified for only two items. The most highly used assessment measures included clinical competency results, employer surveys, image critique performance, specific course assignments, student surveys and ARRT exam results. Only one variable showed significant differences between programs at various academic levels.<br>Ed.D.<br>Department of Educational and Human Sciences<br>Education<br>Education EdD

Uvod: Povezanost dijabetesa melitusa i&nbsp; tuberkuloze je odavno primećena i bila je predmet ispitivanja mnogih studija. Dijagnoza &scaron;ećerne bolesti pre otkrića insulina značila je smrtni ishod u roku od pet godina, a najče&scaron;ći uzrok smrti su bile infekcije, uključujući tuberkulozu. Poslednjih godina incidenca tuberkuloze je u padu, ali je i dalje prisutan značajan broj obolelih od tuberkuloze u zemljama u razvoju. Sa druge strane incidenca dijabetes melitusa je u porastu, pre svega zbog tendencije porasta broja gojaznih osoba. Procenjeno je da će prevalencija obolelih od dijabetes melitusa dostići 438 miliona obolelih do 2030, a 80% svih slučajeva će biti stanovnici zemalja u razvoju gde je i dalje visoka prevalencija tuberkuloze. Kao rezultat ovakve epidemiolo&scaron;ke situacije ove dve bolesti će se sve če&scaron;će javljati uporedo, modifikujući tok jedna drugoj. Preduslov za uspe&scaron;no lečenje dijabetičara obolelih od tuberkuloze je postizanje zadovoljavajuće metaboličke regulisanosti &scaron;ećerne bolesti. smrtni ishod u roku od pet godina, a najče&scaron;ći uzrok smrti su bile infekcije, uključujući tuberkulozu. Poslednjih godina incidenca tuberkuloze je u padu, ali je i dalje prisutan značajan broj obolelih od tuberkuloze u zemljama u razvoju. Sa druge strane incidenca dijabetes melitusa je u porastu, pre svega zbog tendencije porasta broja gojaznih osoba. Procenjeno je da će prevalencija obolelih od dijabetes melitusa dostići 438 miliona obolelih do 2030, a 80% svih slučajeva će biti stanovnici zemalja u razvoju gde je i dalje visoka prevalencija tuberkuloze. Kao rezultat ovakve epidemiolo&scaron;ke situacije ove dve bolesti će se sve če&scaron;će javljati uporedo, modifikujući tok jedna drugoj. Preduslov za uspe&scaron;no lečenje dijabetičara obolelih od tuberkuloze je postizanje zadovoljavajuće metaboličke regulisanosti &scaron;ećerne bolesti. Cilj istraživanja: Cilj rada je bilo ispitivanje uticaja dijabetesa melitusa na tok plućne tuberkuloze, prvenstveno na bakteriolo&scaron;ki status, radiolo&scaron;ku prezentaciju bolesti, dužinu terapijskog režima i učestalost recidiva bolesti. Materijal i metode: Ispitivanjem su obuhvaćene dve grupe od po pedeset bolesnika koji su hospitalizovani u Institutu za plućne bolesti Vojvodine. Prvu grupu činili su bolesnici sa plućnom tuberkulozom i pridruženom &scaron;ećernom bole&scaron;ću, a drugu grupu bolesnici sa plućnom tuberkulozom bez pridružene &scaron;ećerne bolesti. Svi bolesnici su analizirani po sledećim karakteristikama: starost, pol, klinička slika, bakteriolo&scaron;ki status, radiolo&scaron;ka prezentacija, prisustvo neželjenih efekata antituberkulotika, prisustvo rezistencije M. tuberculosis na lekove, trajanje terapijskog režima, ishod lečenja, pojava recidiva i dužina hospitalizacije. Oboleli od &scaron;ećerne bolesti bili su dodatno analizirani prema: tipu bolesti, dužini trajanja bolesti, metaboličkoj regulisanosti bolesti i prisustvu komplikacija. Svi bolesnici obuhvaćeni ispitivanjem bili su podvrgnuti standardnom dijagnostičkom algoritmu koji obuhvata: anamnezu i fizikalni pregled, direktnu mikroskopiju sputuma, kultivaciju sputuma, radiogram grudnog ko&scaron;a, CT grudnog ko&scaron;a u slučaju postavljenih kliničkih indikacija. Invazivna dijagnostika će se sprovesti kod bolesnika kod kojih dijagnoza nije mogla biti postavljena prethodno sprovedenom neinvazivnom dijagnostikom. Terapijski režim će biti započet tokom hospitalizacije u Institutu za plućne bolesti Vojvodine, a nastavljen ambulantno pod kontrolom Dispanzera za plućne bolesti. Po zavr&scaron;etku terapijskog režima predviđena je kontrola u Institutu za plućne bolesti Vojvodine koja obuhvata procenu kliničke slike, bakteriolo&scaron;kog statusa, radiolo&scaron;kog nalaza i eventualnu potrebu za produženjem terapijskog režima. Rezultati: Istraživanje je pokazalo da je u grupi obolelih od tuberkuloze bez pridruženog dijabetes melitusa bio sličan broj bolesnika mu&scaron;kog i ženskog pola, a veći broj ispitanika se nalazio u starosnim kategorijama do 50 godina starosti, dok je u grupi obolelih od tuberkuloze sa dijabetes melitusom bio značajno vi&scaron;e zastupljen mu&scaron;ki pol i značajno vi&scaron;e ispitanika se nalazilo u starosnim kategorijama preko 50 godina starosti. Beleži se statistički značajno veći broj recidiva u grupi obolelih od tuberkuloze sa dijabetes melitusom (p=0,001). Između ispitvanih grupa se ne beleži statistički značajna razlika u kliničkoj prezentaciji bolesti. U grupi obolelih od tuberkuloze sa dijabetes melitusom, statistički značajno je veći broj direktno pozitivnih nalaza sputuma (p=0,046). Utvrđeno je postojanje statistički značajne razlike u prosečnoj dužini vremena potrebnoj za direktnu konverziju sputuma (p=0,000) i prosečnoj dužini vremena potrebnoj za konverziju kulture sputuma (p=0,000). U oba slučaja je grupa obolelih od tuberkuloze sa pridruženim dijabetes melitusom imala duže prosečno vreme potrebno za konverziju. U grupi obolelih od tuberkuloze sa pridruženim dijabetes melitusom bilo je statistički značajno vi&scaron;e bolesnika sa prisustvom kaverne (p=0,006) i lokalizacijom promena u sva tri režnja (p=0,000). Nije zapažena statistički značajna razlika u trajanju terapijskog režima, ispoljavanju neželjenih efekata lekova, pojavi rezistencije na lekove i ishodu lečenja između dve ispitivane grupe. Grupa obolelih od tuberkuloze sa pridruženim dijabetesom imala je statistički značajno veći broj bolničkih dana (p=0,000). Poređenjem grupa obolelih od tuberkuloze sa pridruženim zadovoljavajuće regulisanim dijabetesom i grupe obolelih od tuberkuloze sa lo&scaron;e regulisanim dijabetesom uočeno je statistički značajno duže trajanje terapijskog režima kod dijabetičara sa lo&scaron;e regulisanom bole&scaron;ću (p=0,018). Nije bilo statistički značajne razlike u zastupljenosti recidiva, kliničke prezentacije bolesti, bakteriolo&scaron;kog i radiolo&scaron;kog statusa, ispoljavanju neželjenih efekata lekova, pojavi rezistencije na lekove, ishoda lečenja i broja bolničkih dana između dve ispitivane grupe. Dodatnim poređenjem grupa (oboleli od tuberkuloze bez pridruženog dijabetesa, oboleli od tuberkuloze sa pridruženim zadovoljavajuće regulisanim dijabetesom i oboleli od tuberkuloze sa pridruženim lo&scaron;e regulisanim dijabetesom) primećeno je da je grupi bolesnika obolelih od tuberkuloze sa lo&scaron;e regulisanim dijabetesom potrebno najduže vreme za direktnu konverziju i konverziju kultura sputuma na MT i da imaju najveći broj bolničkih dana. U grupi obolelih od tuberkuloze sa pridruženim lo&scaron;e regulisanim dijabetesom je bilo statistički značajno veći broj bolesnika koji su lečeni osam meseci u odnosu na druge dve grupe (p=0,011). Poređenjem grupa obolelih od tuberkuloze sa tipom 1 dijabetesa tipom 2 dijabetesa nije uočena statističk značajna razlika između grupa po svim ispitivanim varijablama. U grupi dijabetičara sa dobro regulisanim dijabetesom nalazi se veći broj onih koji imaju tip 2 bolesti, u odnosu na grupu bolesnika sa lo&scaron;e regulisanim dijabetesom. Grupa dijabetičara sa lo&scaron;e regulisanom bolesti ima statistički značajno veći broj komplikacija &scaron;ećerne bolesti. Zaključak: Dokazano je da &scaron;ećerna bolest značajno utiče na bakteriolo&scaron;ki status, radiolo&scaron;ku prezentaciju, dužinu terapijskog režima, učestalost recidiva tuberkuloze i broj bolničkih dana obolelih od tuberkuloze,kao i da je regulisanost &scaron;ećerne bolesti imala značajan uticaj na dužinu terapijskog režima.<br>Introduction: The association of diabetes mellitus and tuberculosis has long been observed and has been the subject of many studies. The diagnosis of diabetes before the discovery of insulin meant death within five years, a leading cause of death were infections, including tuberculosis. Last years the incidence of tuberculosis has declined, but there is still a significant number of TB patients in developing countries. On the other hand, the incidence of diabetes is on the rise, primarily due to the tendency of an increasing number of obese people. It is estimated that the prevalence of patients with diabetes will reach 438 million sufferers by 2030, and 80% of all cases will be people in developing countries where it is still a high prevalence of tuberculosis. As a result of the epidemiological situation, these two diseases will increasingly occur in parallel, modifying the current one another. Aim: The aim of this study was to investigate the influence of diabetes mellitus on the course of pulmonary tuberculosis, primarily in the bacteriological status, radiological presentation of disease, duration of the treatment regimen and the frequency of disease relapse. Materials and Methods: The study included two groups of fifty patients who were hospitalized at the Institute for pulmonary diseases. The first group consisted of patients with pulmonary tuberculosis and concomitant diabetes mellitus, a second group consisted of patients with pulmonary tuberculosis without associated diabetes. All patients were analyzed by the following characteristics: age, gender, clinical picture, bacteriological status, radiological presentation, the presence of side effects of antituberculosis drugs, the presence of M. tuberculosis resistant to the drugs, the duration of the therapeutic regimen, treatment outcome, recurrence and length of hospitalization. Diabetics were further analyzed with respect to: the type of disease, duration of disease, a metabolic disease and the regulation for the presence of a complication. All patients completed this study were subjected to a diagnostic algorithm comprising: history and physical examination, direct microscopy of sputum, cultivation of sputum, radiographs of the chest, chest CT scan in case positioned on clinical indications. Invasive diagnostic will be performed in patients in whom the diagnosis could not be set previously conducted noninvasive diagnostics. The treatment regimen will be started during the hospitalization in the Institute of pulmonary diseases and is set under the control of ambulatory pulmonary dispensaries. Results: The study showed that in the group of TB patients without concomitant diabetes mellitus was a similar number of patients male and female, a greater number of respondents was in the age groups up to the age of 50, while in the group of TB patients with diabetes mellitus was significantly more frequent male half and significantly more respondents were in the age groups over 50 years of age. Significantly higher number of relapses is recorded in a group of TB patients with diabetes mellitus (p = 0,001). Between the two study groups was not significant difference in the clinical presentation of the disease. In the group of TB patients with diabetes mellitus, is statistically significant higher number of smear positive findings (p = 0,046). There is a statisticaly significant difference in the average length of time required for the smear conversion (p = 0,000) and average length of time needed for the conversion of sputum cultures (p = 0,000). In both cases, the group of TB patients with associated diabetes mellitus had a longer average time needed for the conversion. In the group of patients with tuberculosis associated with diabetes mellitus was statistically significantly more patients with the presence of the cavern (p = 0,006), and the localization of the pulmonary changes in all three lobes (p = 0,000). Between the two study groups was not observed a statistically significant difference in duration of the treatment regimen, the expression of adverse drug effects, develop resistance to the drugs, and the outcome of the treatment. Group of patients with tuberculosis associated with diabetes had a statistically significantly greater number of hospital days (p = 0,000). Between the groups of patients with tuberculosis associated with satisfactory controlled diabetes and the group of TB patients with poorly controlled diabetes was statistically significantly longer duration of the therapeutic regimen in diabetic patients with poor regulation of the disease (p = 0,018). There was no significant difference in the appearance of relapses, the clinical presentation of disease, the bacteriological status, radiology, the expression of adverse drug effects, develop resistance to the drugs, outcome of the treatment, number of hospital days between the two study groups. Comparing the three groups (tuberculosis without associated diabetes mellitus, TB patients with associated satisfactorily controlled diabetes and TB patients with associated poorly controlled diabetes), it was observed that the group of patients suffering from tuberculosis with poorly controlled diabetes takes the longest time to smear conversion and conversion of sputum culture and to have the highest number of hospital days. In the group of patients with tuberculosis associated with poorly controlled diabetes was significantly greater number of patients who were treated for eight months compared to the other two groups (p = 0,011). Comparing the group of TB patients with type 1 diabetes and type 2 diabetes is not a statistically significant difference between the groups in all variables. In the group of diabetic patients with satisfactorily controlled diabetes, there are a large number of those with type 2 disease, in comparison to the group of patients with poorly controlled diabetes. Group of diabetics with poorly regulated disease has a significantly greater number of diabetes comlications. Conclusion: It has been shown that diabetes mellitus has a significant effect on the bacteriological status, radiological presentation, the length of the treatment regimen, the frequency of recurrence of tuberculosis and the number of hospital days of patients with tuberculosis, and that the adjustment of diabetes had a significant effect on the length of the treatment regimen.

Assessment of image interpretation competency is commonly undertaken through review of a defined image test bank. Content of these image banks has been criticised for the high percentage of abnormal examinations which contrasts with lower reported incidences of abnormal radiographs in clinical practice. As a result, questions have been raised regarding the influence of prevalence bias on the accuracy of interpretive decision making. This article describes a new and novel approach to the design of musculoskeletal image test banks. Three manufactured image banks were compiled following a standard academic menu in keeping with previous studies. Three further image test banks were constructed to reflect local clinical workload within a single NHS Trust. Eighteen radiographers, blinded to the method of test bank composition, were randomly assigned 2 test banks to review (1 manufactured, 1 clinical workload). Comparison of interpretive accuracy was undertaken. Inter-rater agreement was moderate to good for all image banks (manufactured: range k = 0.45–0.68; clinical workload: k = 0.49–0.62). A significant difference in mean radiographer sensitivity was noted between test bank designs (manufactured 87.1%; clinical workload 78.5%; p = 0.040, 95% CI = 0.4–16.8; t = 2.223). Relative parity in radiographer specificity and overall accuracy was observed. This study confirms the findings of previous research that high abnormality prevalence image banks over-estimate the ability of observers to identify abnormalities. Assessment of interpretive competency using an image bank that reflects local clinical practice is a better approach to accurately establish interpretive competency and the learning development needs of individual practitioners.

A research project submitted to the Postgraduate Committee in partial fulfilment of the requirements for the degree of Master of Dentistry in the branch of Orthodontics. 5 December 2017.<br>Background: Every orthodontist has a signature on the treatment that he/she provides to his/her patients. Treatment outcomes have been evaluated in a variety of ways, some of which have been considered to be ideal for teaching programs. This has not been done at Wits, which is the purpose of this study. Objectives: To evaluate the treatment outcomes of patients treated in the graduate orthodontics programme at Wits with respect to the registrars and consultants who managed the cases. Material and Methods: The post-treatment study casts and radiographs of patients treated by the graduating class of 2015 at Wits were evaluated using the ABO Cast and Radiographic Examination score (CRE). The scores were categorized into four groups: less than or equal (LE) to 20; greater than (GT) 20 but LE 25; GT 25 but LE 30; and CRE GT 30. Frequency data analysis were employed to assess the data. Trend tests were applied to establish the presence of a pattern, if any, with respect to time of graduation of the Consultants, the place of their training and treatment outcomes. Results: A total of 105 records met the requisite criteria with 54 records coming from two registrars and the remaining 51 from a third. Only five records had a score GT25 and were excluded as outliers. Seventy six of the records scored LE20 and 24 recorded CRE scores of GT20 but LE25. The GLM procedure showed significant differences in the scores of the three registrars (p=0.002). The Scheffe test found that two registrars received exactly the same score while the third had a significantly lower score. The LSMeans were 14.26, 17.23 and 17.92. No significant differences could be established among the consultants. Conclusion: All the registrars provided excellent treatment since 76% of the cases scored LT20. The treatment supervision provided by the consultants was consistent as there were no significant differences between their scores.<br>LG2018

Ho, Ka Ming.<br>Thesis D.Nurs. Chinese University of Hong Kong 2015.<br>Includes bibliographical references (leaves 135-141).<br>Abstracts and some appendixes also in Chinese.<br>Title from PDF title page (viewed on 19, September, 2016).

OBJECTIVE: The overall goal of this study was to examine the relationship between preoperative, 1-year post-operative, and 2-year postoperative self-image in adolescents with idiopathic scoliosis undergoing spinal fusion surgery. In addition, a minor goal was to examine the relationship between pre-surgical mental health and post-surgical self-image and satisfaction. Additionally, spinal curvature and preoperative pain were explored in relation to the effect of pre-surgical mental health on post-surgical self-image. Analyses were performed in order to better understand the relationship of corrective surgery to self-image, and self-image's relationship to persistent postoperative pain, which has been recognized as a common clinically significant problem. METHODS: The Scoliosis Research Society Questionnaire-30 and Spinal Appearance Questionnaire were administered to 219 patients enrolled in the Prospective Pediatric Scoliosis study at pre-operative, 1-year post-operative, and 2-year post-operative time points. A subset (n=163) of these patients had complete data. The Scoliosis Research Society Questionnaire-30 includes pain and mental health subscales, which were examined preoperatively for the purpose of this study. Measurements of preoperative curve (Cobb) angle percentage correction were used in the analysis of this data, which were determined using operative notes. The Spinal Appearance Questionnaire (SAQ) includes self-image appearance and expectations subscales, which were examined at the preoperative, 1-year postoperative, and 2-year postoperative time points. RESULTS: There were significant improvements in self-image after surgical intervention in children with idiopathic scoliosis undergoing spinal fusion surgery. Cobb angle percentage correction, preoperative pain scores as determined by the SRS-30, and preoperative mental health scores as determined by the SRS-30 were not significant predictors of postoperative self-image as measured by the SAQ. There is little to no correlation between the preoperative measures and postoperative self-image. CONCLUSIONS: Prior studies have confirmed that pediatric persistent postsurgical pain is a significant health concern, and that presurgical mental health and self-image are factors that contribute to a pediatric patient's longitudinal experience with postsurgical pain. This study shows that there are clinically significant improvements in self-image after surgical intervention in patients with adolescent idiopathic scoliosis undergoing spinal fusion surgery. These findings suggest that preoperative pain, degree of spinal curvature correction, and preoperative mental health are not determinative of postoperative self-image in pediatric populations. Future studies should be conducted on more diverse populations, and take into account measures that may be predictors of poor postoperative self-image, specifically depression and anxiety. In summary it is important to explore the biological mechanisms pertaining to pediatric post-surgical chronic pain and their relation to differences in somatosensory phenotypes in this patient population.

yes<br>Objectives To investigate the impact of radiographer advanced practice on patient outcomes and health service quality. Methods Using the World Health Organisation definition of quality, this review followed the Centre for Reviews and Dissemination guidance for undertaking reviews in healthcare. A range of databases were searched using a defined search strategy. Included studies were assessed for quality using a tool specifically developed for reviewing studies of diverse designs and data were systematically extracted using electronic data extraction proforma. Results 407 articles were identified and reviewed against the inclusion/exclusion criteria. Nine studies were included in the final review, the majority (n=7) focussing on advanced radiography practice within the UK. Advanced practice activities considered were radiographer reporting, leading patient review clinics and barium enema examinations. The papers were generally considered to be of low to moderate quality with most evaluating advanced practice within a single centre. With respect to specific quality dimensions, included studies considered cost reduction, patient morbidity, time to treatment and patient satisfaction. No papers reported data relating to time to diagnosis, time to recovery or patient mortality. Conclusions Radiographer advanced practice is an established activity both in the UK and internationally. However, evidence of the impact of advanced practice in terms of patient outcomes and service quality is limited. Advances in knowledge This systematic review is the first to examine the evidence base surrounding advanced radiography practice and its impact on patient outcomes and health service quality. Powered by

The motivation for this study was the comments by supervisors in the radiography workplace about the students' lack of critical skills when they went for experiential learning. Higher education institutions are required to teach all students the critical crossfield outcomes (CCFOs) so that they can apply them in the world of work. The purpose of the study was to understand the problems in the workplace so that training gaps could be identified. The training gaps were to be used to improve the current curriculum so as to prepare the students more adequately for the workplace. The Durban Institute of Technology (DIT) prepares students to function as radiographers in hospitals and private practices where all the CCFOs are needed. This is done using the Outcomes Based Education (OBE) approach to teaching, where students work collaboratively in groups of various sizes ranging from two to six doing theory and practical activities. The training programme includes experiential learning that is done in accredited hospitals where students work under the supervision of qualified radiographers. The study focussed on the first year student radiographers at DIT who had been placed in the Pietermaritzburg hospitals for their experiential learning. All the supervisors in these hospitals were included in the study as well. Students were interviewed at the end of their first experiential learning block, before they commenced with their second year programme. A qualitative research approach was used to explore the perceptions of the students and supervisors in terms of the development of workplace skills by students. Questionnaires were given to the supervisors and students were interviewed. All questions asked in both the questionnaires and the interviews related to the CCFOs. The findings showed that the perceptions of the students and supervisors were not very different in terms of which skills had been developed and which ones had not. The results also showed that the teaching strategies used at DIT were effective in teaching the CCFOs. A number of issues emerged that affected the way students learnt these skills. These were related to teaching and learning, the institutions and the students themselves. These were found to have both negative and positive effects on the learning of CCFOs. The research also found that neither the DIT nor the hospitals were successful in teaching the art of reflective practice, possibly due to the type of assessment strategies currently used to assess experiential learning. From the findings a number of training gaps were identified and recommendations have been made to address them. The current curriculum should be reviewed and it has been suggested that a shift towards the emancipatory paradigm would be more effective in producing a critical reflective radiographer who possessed all the CCFOs. The first year curriculum should be reduced so that only relevant subjects are taught. The assessment of experiential learning should be restructured to align it with the DIT experiential learning policy and clinical tutors should be trained to work with students in the hospitals.<br>Thesis (M.Ed.) - University of KwaZulu-Natal, Pietermaritzburg, 2005

Pre-publication drafts are reproduced with permission and copyright © 2013 of the Journal of Orthopaedic Trauma [Mutch J, Rouleau DM, Laflamme GY, Hagemeister N. Accurate Measurement of Greater Tuberosity Displacement without Computed Tomography: Validation of a method on Plain Radiography to guide Surgical Treatment. J Orthop Trauma. 2013 Nov 21: Epub ahead of print.] and copyright © 2014 of the British Editorial Society of Bone and Joint Surgery [Mutch JAJ, Laflamme GY, Hagemeister N, Cikes A, Rouleau DM. A new morphologic classification for greater tuberosity fractures of the proximal humerus: validation and clinical Implications. Bone Joint J 2014;96-B:In press.]<br>Les fractures isolées de la Grosse Tubérosité (GT) de l’humerus proximal sont rares et peu étudiées. Trois problèmes importants existent: 1: Même si 5mm + de déplacement supérieur du GT est cité comme indication chirurgicale, les mesures basées sur radiographie peuvent errer de plus que 10mm. 2: Les classifications de Neer et l’AO décrivent seulement un type de fracture de GT (gros fragment, ligne de fracture verticale). Deux autres types de fracture existent: type fracture-avulsion avec petit fragment osseux et type Hill-Sachs très latéral. 3: On manque d’études de pronostic ou de traitement des fractures de GT selon la morphologie. Article 1 montre et évalue une méthode simple de mesurer le déplacement supérieur de la GT (le GT ratio) sur les radiographies standard; ceci corrèle très bien avec tomographie (CT). Article 2 introduit une méthode de classification Morphologique des fractures de GT (Avulsion, Split, Dépression) qui a une fiabilité de bonne à excellente. Les données échographiques, radiologiques, et cliniques de 54 patients porteurs de fracture de GT (suivie moyenne 2.5 années) sont aussi incluses. Les patients <50 ans ont eu plus de déchirures de la coiffe et ceux avec fractures déplacées (≥ 5mm) avaient plus d’atrophie du susépineux. Les déchirures complètes de la coiffe et l’atrophie du susépineux augmentaient l’atteinte permanente. La morphologie des fractures de GT n’a pas eu un impact significatif sur le pronostic. Cependant, l’âge, le sexe, et le taux de luxation glénohumérale étaient différents selon le type de fracture et ceci pourrait refléter la pathophysiologie. Une évaluation plus précise de l’impact de la Morphologie des fractures de GT sur le pronostic et traitement nécessitera une étude prospective multicentrique.<br>Isolated fractures of the Greater Tuberosity (GT) of the proximal humerus are rare and a challenge to study. Three main problems arise: 1: Though 5mm+ superior GT displacement is often a surgical indication, measurement errors on radiographs may surpass 10mm. 2: The Neer and AO classifications describe only one type of GT fracture (large fragment, vertical fracture line). Two other fracture types have been described: an avulsion-type (small fragment), and a very lateral Hill-Sachs-type. 3: There are no studies on the treatment or prognosis of GT fractures according to fracture morphology. Article 1 introduces and tests a simple method to measure superior GT displacement (the GT ratio) using standard radiographs; this correlates very well with computed tomography (CT). Article 2 presents the Morphologic classification for GT fractures. It describes three fracture types (Avulsion, Split, Depression) and has good to excellent reliability. The ultrasonographic, radiologic, and clinical results of 54 patients (average follow-up 2.5 years) with isolated GT fractures are then described. Patients <50 years had higher rates of rotator cuff tears and displaced (≥ 5mm) GT fractures were associated with supraspinatus atrophy. Both full rotator cuff tears and supraspinatus atrophy resulted in poor outcomes. The impact of fracture morphology on prognosis was not significant. However, age, sex, and associated glenohumeral dislocation differed by fracture type and this may reflect their pathophysiology. A more thorough evaluation of the prognosis and treatment of GT fractures by morphologic type would require a prospective multicenter study.

No<br>AIM: To demonstrate the benefits of fluoroscopy-guided intra-articular steroid injection in the hip with varying degrees of disease severity, and to investigate the financial aspects of the procedure and impact on waiting time. MATERIALS AND METHODS: A prospective study was undertaken of patients who underwent fluoroscopic intra-articular steroid injection over the 9-month study period. Comparative analysis of the Oxford hip pain score pre- and 6-8 weeks post-intra-articular injection was performed. Hip radiographs of all patients were categorised as normal, mild, moderate, or severe disease (four categories) based on the modified Kellgren-Lawrence severity scale, and improvement on the Oxford hip pain score on each of these four severity categories were assessed. RESULTS: Within the study cohort of 100 patients, the mean increase in post-procedure hip score of 7.32 points confirms statistically significant benefits of the therapy (p<0.001, 95% confidence interval: 5.55-9.09). There was no significant difference in pre-injection hip score or change in score between the four severity categories (p=0.51). Significant improvement in hip score (p<0.05) was demonstrated in each of the four severity categories 6-8 weeks post-injection. No associated complications were observed. CONCLUSION: The present study confirms that fluoroscopy-guided intra-articular steroid injection is a highly effective therapeutic measure for hip osteoarthritis across all grades of disease severity with significant cost savings and the potential to reduce waiting times.