Validity and reliability of the novel three-item occupational violence patient risk assessment tool.

AIM: To develop and psychometrically test an occupational violence (OV) risk assessment tool in the emergency department (ED). DESIGN: Three studies were conducted in phases: content validity, predictive validity and inter-rater reliability from June 2019 to March 2021. METHODS: For content validity, ED end users (mainly nurses) were recruited to rate items that would appropriately assess for OV risk. Subsequently, a risk assessment tool was developed and tested for its predictive validity and inter-rater reliability. For predictive validity, triage notes of ED presentations in a month with the highest OV were assessed for presence of OV risk. Each presentation was then matched with events recorded in the OV incident register. Sensitivity and specificity values were calculated. For inter-rater reliability, two assessors-trained and untrained-independently assessed the triage notes for presence of OV risk. Cohen's kappa was calculated. RESULTS: Two rounds of content validity with a total of N = 81 end users led to the development of a three-domain tool that assesses for OV risk using aggression history, behavioural concerns (i.e., angry, clenched fist, demanding, threatening language or resisting care) and clinical presentation concerns (i.e., alcohol/drug intoxication and erratic cognition). Recommended risk ratings are low (score = 0 risk domain present), moderate (score = 1 risk domain present) and high (score = 2-3 risk domains present), with an area under the curve of 0.77 (95% confidence interval 0.7-0.81, p < .01). Moderate risk rating had a 61% sensitivity and 91% specificity, whereas high risk rating had 37% sensitivity and 97% specificity. Inter-rater reliability ranged from 0.67 to 0.75 (p < .01), suggesting moderate agreement. CONCLUSIONS: The novel three-domain OV risk assessment tool was shown to be appropriate and relevant for application in EDs. The tool, developed through a rigorous content validity process, demonstrates acceptable predictive validity and inter-rater reliability. IMPACT: The developed tool is currently piloted in a single hospital ED, with a view to extend to inpatient settings and other hospitals.

Do compression garments enhance the active recovery process after high-intensity running?

Lovell, DI, Mason, DG, Delphinus, EM, and McLellan, CP. Do compression garments enhance the active recovery process after high-intensity running? J Strength Cond Res 25(12): 3264-3268, 2011-This study examined the effect of wearing waist-to-ankle compression garments (CGs) on active recovery after moderate- and high-intensity submaximal treadmill running. Twenty-five male semiprofessional rugby league players performed two 30-minute treadmill runs comprising of six 5-minute stages at 6 km·h, 10 km·h, approximately 85% VO(2)max, 6 km·h as a recovery stage followed by approximately 85% VO(2)max and 6 km·h wearing either CGs or regular running shorts in a randomized counterbalanced order with each person acting as his own control. All stages were followed by 30 seconds of rest during which a blood sample was collected to determine blood pH and blood lactate concentration [La]. Expired gases and heart rate (HR) were measured during the submaximal treadmill tests to determine metabolic variables with the average of the last 2 minutes used for data analysis. The HR and [La] were lower (p ≤ 0.05) after the first and second 6 km·h recovery bouts when wearing CGs compared with when wearing running shorts. The respiratory exchange ratio (RER) was higher and [La] lower (p ≤ 0.05) after the 10 km·h stage, and only RER was higher after both 85% VO(2)max stages when wearing CGs compared with when wearing running shorts. There was no difference in blood pH at any exercise stage when wearing the CGs and running shorts. The results of this study indicate that the wearing of CGs may augment the active recovery process in reducing [La] and HR after high-intensity exercise but not effect blood pH. The ability to reduce [La] and HR has important consequences for many sports that are intermittent in nature and consist of repeated bouts of high-intensity exercise interspersed with periods of low-intensity exercise or recovery.

A comparison of asynchronous and synchronous arm cranking during the Wingate test.

PURPOSE: The aim of this study was to compare asynchronous (ASY) arm cranking (cranks at 180° relative to each other) with synchronous (SYN) arm cranking (parallel crank setting) during the 30 s Wingate anaerobic test. METHODS: Thirty two physically active men (aged 22.1 ± 2.4 y) completed two Wingate tests (one ASY and one SYN) separated by 4 d in a randomized counterbalanced order. The Wingate tests were completed on a modified electromagnetically braked cycle ergometer. Performance measures assessed during the two tests include peak power, mean power, minimum power, time to peak power, rate to fatigue and maximum cadence (RPMmax). Blood lactate concentration was also measured before and 5 min after the tests. RESULTS: Peak and mean power (both absolute and relative to body weight) during SYN arm cranking were significantly (p < 0.001) less than during ASY arm cranking. Rate to fatigue and RPMmax were also significantly (p = 0.012) lower during SYN arm cranking compared with ASY arm cranking. No significant difference was found between test conditions for minimum power, time to peak power or blood lactate concentration. CONCLUSIONS: These findings demonstrate that ASY arm cranking results in higher peak and mean anaerobic power compared with SYN arm cranking during the Wingate test. Therefore, an ASY arm crank configuration should be used to assess anaerobic power in most individuals although specific population groups may require further testing.