Construct validity of functional status scores of patients with lymphedema.

During treatment of lymphedema, routine use of patient-reported outcomes measures (PROMs) is recommended to monitor patient progress; however, the validity functional status (FS) PROMs in these patients is unknown. Our aims were to examine construct validity of the shoulder computerized adaptive testing (CAT) and the foot-and-ankle CAT, as a measure of FS for patients selecting the shoulder or the foot-and-ankle as their main body part affected by their lymphedema. We assessed the ability of the FS scores to distinguish between patient groups in clinically expected ways at admission and discharge from physical therapy. At admission (n=1600), patients who were younger and had more acute symptoms, less severe lymphedema, less co-morbidities, no relevant surgical history, did not use medications for chronic conditions, and exercised regularly, had higher FS. At discharge (n=611), patients who were younger and had less advanced lymphedema, fewer co-morbidities, no relevant surgical history, did not use medications for chronic conditions, exercised regularly, and had more acute symptoms had higher FS change, after controlling for their baseline FS score. Low participation rates in FS outcomes data collection could have biased results. Overall, the CAT-based FS PROMs used in this study discriminated between patient groups in clinically logical ways both at intake and at discharge from lymphedema treatment.

Clinical databases in physical therapy.

Clinical databases in physical therapy provide increasing opportunities for research into physical therapy theory and practice. At present, information on the characteristics of existing databases is lacking. The purpose of this study was to identify clinical databases in which physical therapists record data on their patients and treatments and to investigate the basic aspects, data sets, output, management, and data quality of the databases. Identification of the databases was performed by contacting members of the World Confederation for Physical Therapy, searching Pubmed, searching the Internet, and snowball sampling. A structured questionnaire was used to study the characteristics of the databases. The search was restricted to North America, Australia, Israel, and Western Europe. Seven clinical databases on physical therapy were identified. Four databases collected data on specific patient categories, whereas the others collected data on all patients. All databases collected data on patient characteristics, referrals, diagnoses, treatments, and closure, whereas some databases also collected functional status information. The purposes of the databases were diverse, but they can be summarized as quality improvement, research, and performance management. Although clinical databases are new to the field, they offer great potential for physical therapy research. Potential can be increased by further cooperation among databases allowing international comparative studies.

The current status of breeding for protein quality in corn.

The current rapid expansion of the human population on earth, particularly in the less developed countries, raises the possibility of widespread, serious malnutrition and starvation for many unless agricultural technology can intervene with appropriate answers to these problems. Plant breeders have been charged with developing varieties that will yield larger quantities of improved quality protein. Since the realization that maize having the opaque-2 gene has markedly improved protein quality, much work has been done in many areas of research to apply this discovery as well as to learn more about alternative methods to attain the same goals. This discussion will be a review of the advances so far attained by plant breeders in their efforts to develop maize with improved protein quantity and quality. Work concerning the utilization of mutant genes that improve protein quality and efforts at exploiting the naturally occurring variation for protein quality and quantity will be examined. Work that has been done in other related fields that has relevance to the protein improvement problem will also be examined. Screening and subsequent regeneration of tissue cultures as well as work concerning the biochemical energetics of yield and protein improvement will be examined in order to bring the problem of breeding for protein improvement into perspective. Finally, the corn industry's experience with improving protein quality and quantity will provide a basis for discussing the economic considerations of such improvement.