Knee Kinematics During Landing: Is It Really a Predictor of Acute Noncontact Knee Injuries in Athletes? A Systematic Review and Meta-analysis.

BACKGROUND: Although knee kinematics during landing tasks has traditionally been considered to predict noncontact knee injuries, the predictive association between noncontact knee injuries and kinematic and kinetic variables remains unclear. PURPOSE: To systematically review the association between kinematic and kinetic variables from biomechanical evaluation during landing tasks and subsequent acute noncontact knee injuries in athletes. STUDY DESIGN: Systematic review; Level of evidence, 2. METHODS: Databases used for searches were MEDLINE, LILACS, IBECS, CINAHL, SPORTDiscus, SCIELO, IME, ScienceDirect, and Cochrane from database inception to May 2020. Manual reference checks, articles published online ahead of print, and citation tracking were also considered. Eligibility criteria included prospective studies evaluating frontal and sagittal plane kinematics and kinetics of landing tasks and their association with subsequent acute noncontact knee injuries in athletes. RESULTS: A total of 13 studies met the eligibility criteria, capturing 333 acute noncontact knee injuries in 8689 participants. A meta-analysis revealed no significant effects for any kinematic and kinetic variable with regard to subsequent noncontact knee injuries. CONCLUSION: No kinetic or kinematic variables from landing tasks had a significant association with acute noncontact knee injuries. Therefore, the role and application of the landing assessment for predicting acute noncontact knee injuries are limited and unclear, particularly given the heterogeneity and risk of bias of studies to date.

Quality of Life and Dependence Degree of Chronic Patients in a Chronicity Care Model.

BACKGROUND: The complex chronic patient is a person with one or several long-term diseases, the clinical management of which are considered difficult and related to cognitive or functional impairment. The chronicity care model deeply affects the quality of life and degree of dependence. OBJECTIVES: The objective of this study was to analyse the perceived quality of life and dependence degree in complex chronic patients within a chronicity care model in the Autonomous Communities of Cantabria and the Balearic Islands (Spain). DESIGN: This was a multicentred, transversal, descriptive, and observational study on a cohort of 206 chronic patients included in a chronicity care program. METHODS: Patients' sociodemographic variables, integral valuation, nurse follow-up records, nursing outcomes classification (NOC)/nursing interventions classification (NIC), nurse diagnoses, and hospitalization data were analysed. A descriptive analysis of all data was carried out. The bivariate analysis assessed the relation between covariables and the overall scoring in European Quality of Life Scale (EuroQuol-5D), Barthel, Braden, and Chronic Patient eXperience Assessment Instrument (IEXPAC in the Spanish abbreviation). A multivariate linear regression analysis was conducted. RESULTS: The mean age was 79.4 years (standard deviation (SD) = 9.12; range: 39-94). A percentage of 79.3% of the study population shows functional impairment in one or more activities of daily life. A percentage of 83.3% of patients showed a physical dependence. There is a significant relationship between the gender and kinship degree of the caregiver (χ2 = 18.2; p = 0.001). An overall mean score of 55.38 points in EuroQuol-5D was obtained, along with a 36.87-point satisfaction with the care given in IEXPAC. The overall score correlated positively and significantly with Barthel, Braden, and IEXPAC. The dependence levels improved slightly in the observed patients, which was a very significant outcome in statistical terms (t = 2.08; p = 0.039). A percentage of 66% (R2 = 0.66) of the score variability at the Barthel index could be predicted from Braden scale scoring. CONCLUSIONS: Dependence is not only affected by the related pathology, but also by the effect on mobility and daily-life activities, which cause a worse perception of the quality of life. The health-care model based on the case management nurse is having positive effects, especially on dependence and patients with ulcer issues.

Predictive capability of the injury severity score versus the new injury severity score in the categorization of the severity of trauma patients: a cross-sectional observational study.

PURPOSE: The AIS scale is a measurement tool for single injuries. The ISS is considered the gold standard for determining the severity of injured patients, and the NISS was developed to improve the ISS with respect to loss of information, as well as to facilitate its calculation. The aim of this study was to analyse what injury severity measure, calculated according to the Abbreviated Injury Scale (AIS), 1998 and 2005 (update 2008) versions, performs better with mortality, cost and hospital length of stay healthcare indicators. METHODS: This cross-sectional observational study was carried out between February 1st 2012 and February 1st 2013. Inclusion criteria were injured patients due to external causes admitted to trauma service through the emergency department. Manual coding of all injuries was performed and ISS and NISS scores were calculated for both versions of the AIS scale. Severity was then compared to mortality (in-hospital and at 30 days), healthcare cost, and length of hospital stay. RESULTS: The index with the best predictive capability for in-hospital mortality was NISS 05 (AUC = 0.811). There was a significant increase in hospital stay and healthcare cost in the most severe patients in all indexes, except for ISS 05. CONCLUSIONS: NISS is found to be an index with higher predictive capability for in-hospital mortality and correlates better to length of hospital stay and healthcare cost.

Comparison of injury severity scores (ISS) obtained by manual coding versus "Two-step conversion" from ICD-9-CM.

BACKGROUND: The International Classification of Diseases (ICD) is the standard diagnostic tool for classifying and coding diseases and injuries. The Abbreviated Injury Scale (AIS) is the most widely used injury severity scoring system. Although manual coding is considered the gold standard, it is sometimes unavailable or impractical. There have been many prior attempts to develop programs for the automated conversion of ICD rubrics into AIS codes. OBJECTIVE: To convert ICD, Ninth Revision, Clinical Modification (ICD-9-CM) codes into AIS 2005 (update 2008) codes via a derived map using a two-step process and, subsequently, to compare Injury Severity Score (ISS) resulting from said conversion with manually coded ISS values. METHODS: A cross-sectional retrospective study was designed in which medical records at the Hospital Universitario Marqués de Valdecilla of Cantabria (HUMV) and the Complejo Hospitalario of Navarra (CHN), both in Spain, were reviewed. Coding of injuries using AIS 2005 (update 2008) version was done manually by a certified AIS specialist and ISS values were calculated. ICD-9-CM codes were automatically converted into ISS values by another certified AIS specialist in a two-step process. ISS scores obtained from manual coding were compared to those obtained through this conversion process. RESULTS: The comparison of obtained through conversion versus manual ISS resulted in 396 concordant pairs (70.2%); the analysis of values according to ISS categories (ISS<9, ISS 9-15, ISS 16-24, ISS>24) showed 493 concordant pairs (87.4%). Regarding the criterion of "major trauma" patient (i.e., ISS> 15), 538 matching pairs (95.2%) were obtained. The conversion process resulted in underestimation of ISS in 112 cases (19.9%) and conversion was not possible in 136 cases (19%) for different reasons. CONCLUSIONS: The process used in this study has proven to be a useful tool for selecting patients who meet the ISS>15 criterion for "major trauma". Further research is needed to improve the conversion process.

Classification of the severe trauma patient with the Abbreviated Injury Scale: degree of correlation between versions 98 and 2005 (2008 update). / Grado de correlación entre las versiones 98 y 2005 (actualización 2008) de la Abbreviated Injury Scale (AIS) en la categorización del paciente traumatológico grave.

OBJECTIVES: To explore differences in severity classifications according to 2 versions of the Abbreviated Injury Scale (AIS): version 2005 (the 2008 update) and the earlier version 98. To determine whether possible differences might have an impact on identifying severe trauma patients. MATERIAL AND METHODS: Descriptive study and cross-sectional analysis of a case series of patients admitted to two spanish hospitals with out-of-hospital injuries between February 2012 and February 2013. For each patient we calculated the Injury Severity Score (ISS), the New Injury Severity Score (NISS), and the AIS scores according to versions 98 and 2005. RESULTS: The sample included 699 cases. The mean Severity (SD) age of patients was 52.7 (29.2) years, and 388 (55.5%) were males. Version 98 of the AIS correlated more strongly with both the ISS (2.6%) and the NISS (2.9%). CONCLUSION: The 2008 update of the AIS (version 2005) classified fewer trauma patients than version 98 at the severity levels indicated by the ISS and NISS.

OBJETIVO: Estudiar si existen diferencias en la asignación de gravedad entre las versiones 98 y 2005 ­actualización 2008­ de la escala Abbreviated Injury Scale (AIS) y determinar si estas posibles diferencias podrían tener repercusión en la definición de paciente traumatológico grave. METODO: Estudio descriptivo de una serie de casos con análisis transversal que incluyó a pacientes ingresados por lesiones debidas a causas externas en dos hospitales españoles, llevado a cabo entre febrero de 2012 y febrero de 2013. Se calculó el Injury Severity Score (ISS) y el New Injury Severity Score (NISS) de cada uno de los casos con ambas versiones de la escala AIS. RESULTADOS: La muestra estuvo compuesta por 699 casos, con una edad media de 52,7 (DE 29,2) años, de los cuales 388 (55,5%) fueron varones. Se obtuvo una mayor clasificación de pacientes graves con la versión AIS 98, tanto para el ISS (2,6%) como el NISS (2,9%). CONCLUSIONES: La versión AIS 2005 ­actualización 2008­ clasifica un menor número de pacientes como graves en comparación con la versión AIS 98.

Grado de correlación entre las versiones 98 y 2005 (actualización 2008) de la Abbreviated Injury Scale (AIS) en la categorización del paciente traumatológico grave / Classification of the severe trauma patient with the Abbreviated Injury Scale: degree of correlation between versions 98 and 2005 (2008 update)

Objetivos. Estudiar si existen diferencias en la asignación de gravedad entre las versiones 98 y 2005 -actualización 2008- de la escala Abbreviated Injury Scale (AIS) y determinar si estas posibles diferencias podrían tener repercusión en la definición de paciente traumatológico grave. Método. Estudio descriptivo de una serie de casos con análisis transversal que incluyó a pacientes ingresados por lesiones debidas a causas externas en dos hospitales españoles, llevado a cabo entre febrero de 2012 y febrero de 2013. Se calculó el Injury Severity Score (ISS) y el New Injury Severity Score (NISS) de cada uno de los casos con ambas versiones de la escala AIS. Resultados. La muestra estuvo compuesta por 699 casos, con una edad media de 52,7 (DE 29,2) años, de los cuales 388 (55,5%) fueron varones. Se obtuvo una mayor clasificación de pacientes graves con la versión AIS 98, tanto para el ISS (2,6%) como el NISS (2,9%). Conclusiones. La versión AIS 2005 -actualización 2008- clasifica un menor número de pacientes como graves en comparación con la versión AIS 98 (AU)

Objectives. To explore differences in severity classifications according to 2 versions of the Abbreviated Injury Scale (AIS): version 2005 (the 2008 update) and the earlier version 98. To determine whether possible differences might have an impact on identifying severe trauma patients. Methods. Descriptive study and cross-sectional analysis of a case series of patients admitted to two Spanish hospitals with out-of-hospital injuries between February 2012 and February 2013. For each patient we calculated the Injury Severity Score (ISS), the New Injury Severity Score (NISS), and the AIS scores according to versions 98 and 2005. Results. The sample included 699 cases. The mean Severity (SD) age of patients was 52.7 (29.2) years, and 388 (55.5%) were males. Version 98 of the AIS correlated more strongly with both the ISS (2.6%) and the NISS (2.9%). Conclusion. The 2008 update of the AIS (version 2005) classified fewer trauma patients than version 98 at the severity levels indicated by the ISS and NISS (AU)

De practicante a ATS 1857-1953 / From hospital intern/practioner to "ATS", Technical Sanitary Assistant, 1857-1953

En este artículo se analizan veinte disposiciones, relacionadas con la profesión de Enfermería, publicadas en la "Gaceta de Madrid" y el "Boletín Oficial del Estado" entre 1857, año en el que se crea el título de Practicante, a 1953, momento en el que se unifican los estudios de Practicante, Matrona y Enfermera en una única enseñanza: Ayudante Técnico Sanitario (ATS). Numerosos cambios se han producido en el transcurso de estos noventa y seis años; entre ellos cabe destacar el incremento progresivo en la exigencia y duración de las enseñanzas de Practicante, Matrona y Enfermera, así como el número de funciones otorgadas a estos profesionales. No obstante, se mantienen durante todo este periodo ciertas connotaciones que la convierten en una profesión considerada como auxiliar y subalterna de la Medicina y fuertemente marcada por el género (AU)

De ATS a Diplomado en Enfermería (1953-2002) / From "ATS", Technical Sanitary Assistant, to a Licensed Nurse, 1953-2002

Se analizan veinte disposiciones oficiales relacionadas con la Enfermería que, en forma de Orden, Decreto, Real Decreto y Ley se han dictado en el periodo de tiempo comprendido entre 1953 y 2002 y han aparecido publicadas en el B.O.E. Son muchos los cambios que la Enfermería ha experimentado en estos cuarenta y nueve años analizados, entre ellos cabe destacar: el incremento progresivo en la exigencia de su enseñanza, la aparición de las especialidades, la desaparición de las diferencias de género asociadas al sexo de sus estudiantes, la inclusión de los estudios en la Universidad y la orientación, cada vez mayor, de los estudios hacia conocimientos propios y específicos de la Enfermería (AU)

[From health technical aid to nursing graduate]. / De ATS a diplomado en enfermería.

The author analyzes twenty official publications related to Nursing which, as Orders, Decrees, Royal Decree and Law, have been dictated over the time period stretching from 1953 to 2002 and which have been published in the "BOE", Official Register of State Documents. There are many changes which the Nursing Profession has undergone during these 49 years, of which the following deserve to be highlighted: the progressive increase in the educational demands for nurses, the start of specialties, the disappearance of differences associated to students' sex, the inclusion of Nursing studies at University level, and the focus, increasing all the time, of courses oriented directly towards knowledge specifically related to the Nursing Profession itself.

[From practitioner to health technical aid. 1857-1953]. / De practicante a ATS. 1857-1953.

In this article the author analyzes twenty documents related to the Nursing Profession which were published in the publication "Gaceta de Madrid" and the "BOE", Official Register of State Documents, between the year 1857, when the degree of Hospital Intern/Practitioner was created, and 1953, when the courses of Hospital Intern/Practitioner, Midwife and Nurse were unified under one combined course of studies: Technical Sanitary Assistant. "ATS". Many changes have occurred over these 96 years; the following deserve to be highlighted: the progressive increase in the demands and the duration of course studies for Hospital Intern/Practitioner, Midwife and Nurse, as well as the number of functions granted to these professionals. However, over this time period certain connotations which converted this profession into one considered auxiliary and sub-alternate to Medicine, strongly influenced by the sex of its members, were maintained.