The expert eye? An inter-rater comparison of elite tennis serve kinematics and performance.

This study examined the reliability of expert tennis coaches/biomechanists to qualitatively assess selected features of the serve with the aid of two-dimensional (2D) video replays. Two expert high-performance coaches rated the serves of 150 male and 150 female players across three different age groups from two different camera viewing angles. Serve performance was rated across 13 variables that represented commonly investigated and coached (serve) mechanics using a 1-7 Likert rating scale. A total of 7800 ratings were performed. The reliability of the experts' ratings was assessed using a Krippendorffs alpha. Strong agreement was shown across all age groups and genders when the experts rated the overall serve score (0.727-0.924), power or speed of the serve (0.720-0.907), rhythm (0.744-0.944), quality of the trunk action (0.775-1.000), leg drive (0.731-0.959) and the likelihood of back injury (0.703-0.934). They encountered greater difficulty in consistently rating shoulder internal rotation speed (0.688-0.717). In high-performance settings, the desire for highly precise measurement and large data sets powered by new technologies, is commonplace but this study revealed that tennis experts, through the use of 2D video, can reliably rate important mechanical features of the game's most important shot, the serve.

Impact of a major hurricane on surgical services in a University Hospital

Hurricane Hugo struck Charleston, South Carolina, on September 21, 1989. This report analyzes the impact this storm had upon surgical care at university medical center. Although disaster planning began on September 17, hurricane damage by high winds and 8.7 foot tidal surge led to loss of emergency power and water. Consequently, system failures occurred in air consitionaing, vacuum suction, steam and ethylene oxide sterilization, plumbing, central paging, lighting, and refrigiration. The following surgical support services were affected. In the blood bank, lack of refrigeration meant no platelet packs for 2 days. In radilogy, loss of electrical power damaged CT/MRI scanners and flooding ruined patient files, resulting in lost information. In the intensive care unit, loss of electricity meant no monitors and hand ventilation was used for 4 hours. In the operating room, lack of tenperature and humidity control (steam, water, and suction supply) halted elective surgery until October 2. Ground and air transportation were limited by unsafe landing sites, impassable roads, and personnel exhaustion. Surgical planning for a major hurricane should include 1) a fail-safe source of electrical power, 2) evacuation of as many critically ill patients as possible before the storm, 3) cancellation of all elective surgery, and 4) augmented ancillary service staffing with some, although limited, physician support (AU)