The Effectiveness of a Functional Movement Assessment and 4-Week Exercise Training Program for Female High School Athletes.

ABSTRACT: Boucher, BK, Rich, AJ, Gobert, D, Gardner, B, Metzner, P, King, C, and Buse, M. The effectiveness of a functional movement assessment and 4-week exercise training program for female high school athletes. J Strength Cond Res 35(1): 102-110, 2021-The extent to which young females participate in school-sponsored athletics has grown significantly over the past 2 decades. The number of females in high school sports increased for the 25th consecutive year in 2012-2013, reaching an all-time record. Unfortunately, sports-related injury rates for female athletes have also continued to rise. A body of research exists to suggest that dysfunctional movement may be linked to increased risk of injury, and training programs designed to improve movement patterns are effective to both enhance performance and reduce the risk of injury. Effective training programs incorporate corrective exercises to retrain dysfunctional movement patterns. The Functional Movement ScreenTM (FMSTM) is a tool developed to assess 7 fundamental movement patterns. The FMSTM has been used extensively with a wide range of athletes at various levels of performance. The aim of this study was to investigate the effectiveness of a movement-training program with female high school athletes using the FMSTM. The overall purpose was to assess the effectiveness of a 4-week corrective exercise-training program at improving FMSTM scores. Data analysis using Wilcoxon signed-rank test revealed a statistically significant change in total group FMSTM scores (Z = -2.214, p = 0.027) after the corrective exercise-training program. Mean total group FMSTM scores increased from 14.43 ± 1.90 (pretest) to 17.29 ± 1.38 (posttest). Findings suggest that positive outcomes to a corrective exercise-training program, which targets specific movement impairments, can be achieved in a relatively short period of time.

Preferences and actual chemotherapy decision-making in the greater plains collaborative breast cancer study.

INTRODUCTION: There is renewed interest in identifying breast cancer patients' participation in decision-making about adjuvant chemotherapy. There is a gap in the literature regarding the impact of these decisions on quality of life (QOL) and quality of care (QOC). Our aims were to determine similarities and differences in how patients diagnosed with breast cancer preferred to make decisions with providers about cancer treatment, to examine the patient's recall of her role when the decision was made about chemotherapy and to determine how preferred and actual roles, as well as congruence between them, relate to QOL and perceived QOC. MATERIAL AND METHODS: Greater Plains Collaborative clinical data research network of PCORnet conducted the 'Share Thoughts on Breast Cancer' survey among women 12-18 months post-diagnosis at eight sites in seven Midwestern United States. Patients recalled their preferred and actual treatment decision-making roles and three new shared decision-making (SDM) variables were created. Patients completed QOL and QOC measurements. Correlations and t-tests were used. RESULTS: Of 1235 returned surveys, 873 (full sample) and 329 (subsample who received chemotherapy) were used. About one-half of women in both the full (50.7%) and subsample (49.8%,) preferred SDM with providers about treatment decisions, but only 41.2% (full) and 42.6% (subsample) reported experiencing SDM. Significant differences were found between preferred versus actual roles in the full (p < .001) and subsample (p < .004). In the full sample, there were no relationships between five decision-making variables with QOL, but there was an association with QOC. The subsample's decision-making variables related to several QOL scales and QOC items, with a more patient-centered decision than originally preferred related to higher physical and social/family well-being, overall QOL and QOC. CONCLUSIONS: Patients benefit from providers' efforts to identify patient preferences, encourage an active role in SDM, and tailor decision making to their desired choice.

Percentage of Hormone Receptor Positivity in Breast Cancer Provides Prognostic Value: A Single-Institute Study.

BACKGROUND: A majority of breast cancer tumors express estrogen receptor (ER) and/or progesterone receptor (PR); however, the percentage of cancer cells expressing these receptors can range from 0-100%. The prognostic and therapeutic impact of the percentage of cells expressing hormone receptors in breast cancer is not fully understood. METHODS: A retrospective analysis of 411 breast cancer patients who were treated at the University of Nebraska Medical Center between 2010 and 2017 was performed. Patient tumors were evaluated for percentage of cells expressing ER and PR in conjunction with clinical outcomes. RESULTS: Patient tumors demonstrated a highly bimodal pattern of ER and PR staining with a majority of tumors demonstrating either a high percentage (> 80% of cells) or lack of cells (0%) staining for ER or PR. An increase in the percentage of ER positivity correlated with decreased local recurrence and improved overall survival. An increase in the percentage of PR positivity demonstrated a trend towards decreased local recurrence and improved overall survival, but was not statistically significant. CONCLUSIONS: Results based on both continuous and categorical evaluation of ER expression revealed that increasing expression correlated with improved patient outcomes. Similar evaluation of PR expression demonstrated a trend towards improved patient outcomes though not statistically significant. These findings suggest that the degree of hormone receptor positivity and not a Boolean representation of positivity could provide additional prognostic value in the treatment and management of breast cancer.

Incorporating a location-based socioeconomic index into a de-identified i2b2 clinical data warehouse.

OBJECTIVE: Clinical research data warehouses are largely populated from information extracted from electronic health records (EHRs). While these data provide information about a patient's medications, laboratory results, diagnoses, and history, her social, economic, and environmental determinants of health are also major contributing factors in readmission, morbidity, and mortality and are often absent or unstructured in the EHR. Details about a patient's socioeconomic status may be found in the U.S. census. To facilitate researching the impacts of socioeconomic status on health outcomes, clinical and socioeconomic data must be linked in a repository in a fashion that supports seamless interrogation of these diverse data elements. This study demonstrates a method for linking clinical and location-based data and querying these data in a de-identified data warehouse using Informatics for Integrating Biology and the Bedside. MATERIALS AND METHODS: Patient data were extracted from the EHR at Nebraska Medicine. Socioeconomic variables originated from the 2011-2015 five-year block group estimates from the American Community Survey. Data querying was performed using Informatics for Integrating Biology and the Bedside. All location-based data were truncated to prevent identification of a location with a population <20 000 individuals. RESULTS: We successfully linked location-based and clinical data in a de-identified data warehouse and demonstrated its utility with a sample use case. DISCUSSION: With location-based data available for querying, research investigating the impact of socioeconomic context on health outcomes is possible. Efforts to improve geocoding can readily be incorporated into this model. CONCLUSION: This study demonstrates a means for incorporating and querying census data in a de-identified clinical data warehouse.

Mechanism of Action of Selective Laser Trabeculoplasty and Predictors of Response.

Purpose: This study was designed to evaluate the changes in aqueous humor dynamics (AHD) produced by selective laser trabeculoplasty (SLT) and to explore if baseline AHD parameters are predictive of IOP response to SLT. Methods: Thirty-one consecutive subjects diagnosed with ocular hypertension or primary open-angle glaucoma scheduled to undergo SLT as their primary IOP-lowering therapy were enrolled in this prospective observational study. Subjects underwent baseline assessment of AHD in both eyes. Variables assessed were IOPs at 9 AM and noon, aqueous humor flow rate (fluorophotometry), episcleral venous pressure (EVP, venomanometry), outflow facility (pneumatonography and fluorophotometry) and uveoscleral outflow (calculated using modified Goldmann equation). All subjects underwent 360 degrees SLT and AHD measurements were repeated 3 months later. Results: Compared with baseline, IOPs after SLT were significantly lower at 9 AM (22.9 ± 5.1 vs. 19.7 ± 3.0 mm Hg; P = 0.001) and noon (23.4 ± 4.6 vs. 20.0 ± 3.5 mm Hg; P < 0.001). Outflow facility by fluorophotometry was significantly increased from 0.17 ± 0.11 µL/min/mm Hg at baseline to 0.24 ± 0.14 µL/min/mm Hg at 3 months (P = 0.008). Outflow facility by tonography (baseline: 0.16 ± 0.07 µL/min/mm Hg vs. 3 months: 0.22 ± 0.16 µL/min/mm Hg; P = 0.046) was similarly increased. No change in aqueous flow or EVP was observed. There were no changes in IOP or AHD in the contralateral untreated eye. Using multiple linear regression models, higher baseline aqueous flow, lower baseline outflow facility, and possibly lower uvescleral outflow were associated with more IOP lowering with SLT. Conclusions: The IOP-lowering effect of SLT is mediated through an increase in outflow facility. There is no contralateral effect. Higher aqueous flow and lower outflow facility may be predictive of better response to SLT.