Participation in physical activity by adolescents with physical disability: cross-sectional snapshot and future priorities ("Youth Experience Matters" protocol).

Young people with physical disability experience challenges to being physically active. To attain the health benefits of physical activity (PA) and sustain engagement, it is essential that participation is meaningful and enjoyable. This study aims to describe current participation in PA by adolescents with physical disability in Ireland, and to establish consensus on their priorities for enhancing physical activity participation.

Identifying the top 10 priorities of adolescents with a physical disability regarding participation in physical activity: A Delphi study.

Aim: To establish consensus among adolescents with a physical disability regarding their priorities for enhancing participation in physical activity and help inform the design of future interventions for participation in physical activity.

Method: We conducted a national multi-round Delphi study involving adolescents with a physical disability aged 13 to 17 years. Round 1 of the initial survey consisted of open-ended questions.

The effects of weight gain over time on gait in children with cerebral palsy: Comparison to a matched healthy weight cerebral palsy control group.

Background: Children with cerebral palsy (CP) have demonstrated higher rates of overweight and obesity than their typically developed peers. Limited studies have assessed how being overweight or obese affect lower limb kinematics during gait in these children.

Research Question: How are lower limb kinematics during gait affected in children with CP who progress from a healthy weight to being overweight or obese compared to a well-matched healthy weight CP control group?

Methods: A retrospective analysis of the movement analysis laboratory database was conducted.

The progression of BMI status over time in Irish ambulant children with cerebral palsy.

Background: An increasing prevalence of overweight and obesity in children has been reported globally. Most studies examining the trajectory of BMI in children over time have tended to focus on children with typical development. Our group previously reported static prevalence rates in children with cerebral palsy.

Centre of pressure error with increasing gait velocity: The clinical impact on predicted inverse dynamics during gait in children with typical development.

Background: Centre of pressure (CoP) location error is common when predicting inverse dynamic parameters during gait. Tolerance levels of error have been previously reported. However, the clinical impact of gait velocity on CoP error has not been considered.

Prevalence of overweight and obesity in Irish ambulant children with cerebral palsy.

Background: Children with cerebral palsy may be at greater risk of being overweight or obese than their typically developed peers due to a number of biomechanical, behavioural, or medical issues that restrict participation. It has been a concern of our multi-disciplinary team that a greater number of children with cerebral palsy were presenting as overweight or obese. However, there are conflicting results in the literature as to prevalence and trends of overweight and obesity in these children.

The impact of centre of pressure error on predicted joint kinetics during cerebral palsy and typically developed gait: A clinical perspective.

Centre of Pressure (CoP) location error is common when using kinematic and kinetic data to predict intersegmental forces and net joint moments during gait. Changes in peak moments due to CoP error have been reported in the literature. However, debate exists as to what levels of error are acceptable.

A Systematic Review of the Reliability and Validity of Behavioural Tests Used to Assess Behavioural Characteristics Important in Working Dogs.

Background: Working dogs are selected based on predictions from tests that they will be able to perform specific tasks in often challenging environments. However, withdrawal from service in working dogs is still a big problem, bringing into question the reliability of the selection tests used to make these predictions.

Methods: A systematic review was undertaken aimed at bringing together available information on the reliability and predictive validity of the assessment of behavioural characteristics used with working dogs to establish the quality of selection tests currently available for use to predict success in working dogs.

Successful Implementation of an Enhanced Recovery Pathway: The Nurse's Role.

Enhanced recovery pathways (ERPs) are standardized, multidisciplinary approaches to caring for patients with a goal of decreasing length of stay and care costs without negatively affecting patient outcomes. One facility successfully implemented ERPs for patients undergoing abdominal surgery. For implementation to be successful, nurses were found to be key in providing education, perioperative care, and postoperative evaluation, as well as cost containment.

An interprofessional quality improvement project to implement maternal/infant skin-to-skin contact during cesarean delivery.

Immediate skin-to-skin contact between a mother and her newborn has been associated with successful breastfeeding outcomes. One of the challenges nurses face in promoting skin-to-skin occurs in the operating room during a cesarean delivery. Utilizing an interprofessional approach for this quality improvement project, we successfully implemented skin-to-skin contact for all eligible mother/infant couplets after cesarean birth.

Evaluation of inflammatory markers as predictors of hospital stay and unplanned readmission after colorectal surgery.

Unlabelled: Hospital length of stay (LOS) and readmissions continue to be expensive and unexpected events following colorectal surgery (CRS) whether patients follow enhanced recovery pathways or traditional care. Predictors of these adverse events could facilitate identification and optimization of CRS patients.

The Aim Of The Study: To examine the impact of white blood cell count (WBC) and C-reactive protein (CRP) levels as predictors of delayed recovery or hospital readmission following CRS.

Transversus abdominis plane blocks and enhanced recovery pathways: making the 23-h hospital stay a realistic goal after laparoscopic colorectal surgery.

Background: Although enhanced recovery pathways (ERPs) may permit early recovery and discharge after laparoscopic colorectal surgery (LC), most publications report that the mean hospital stay is 4 and 6 days. This study evaluates the addition of a transversus abdominis plane (TAP) block to the standard ERP.

Methods: In this study, 35 consecutive elective patients received a TAP block at the end of LC.

Discharge within 24 to 72 hours of colorectal surgery is associated with low readmission rates when using Enhanced Recovery Pathways.

Background: Enhanced Recovery Pathways (ERPs) have demonstrated reduced hospital length of stay and improved outcomes after colorectal surgery. Concerns exist about increases in readmission rates. Laparoscopic colorectal surgery with an ERP can permit earlier discharge without compromising safety or increasing readmission rates.

Towards optimizing perioperative colorectal care: outcomes for 1,000 consecutive laparoscopic colon procedures using enhanced recovery pathways.

Background: Learning curves and efficiency concerns have slowed the integration of laparoscopy into colorectal practice. We evaluated our experience with laparoscopic colorectal (LC) surgery using enhanced recovery pathways (ERPs).

Methods: One thousand consecutive LC procedures performed by 2 surgeons over a 5-year period using previously published, standardized ERPs were assessed.

Effect of local anesthetics on postoperative pain and opioid consumption in laparoscopic colorectal surgery.

Background: Several studies have evaluated use of local anesthetic, specifically, administration of intraperitoneal anesthetic, during laparoscopic general surgery and gynecologic operations, with varying results. There have been no studies to determine the role of local anesthetic in laparoscopic colorectal surgery. This study evaluates the efficacy of subcutaneous and intraperitoneal anesthetic in reducing postoperative pain following common laparoscopic colorectal procedures, in patients managed with enhanced recovery care pathways.

Predictors and outcome of readmission after laparoscopic intestinal surgery.

Background: Previous studies have failed to identify predictors of early readmission after major intestinal operations. The objectives of this study were to determine readmission rates, outcomes, and predictors of readmission for patients undergoing laparoscopic colon and rectal operations.

Methods: Patients readmitted (PR) to the hospital within 30 days of discharge after laparoscopic colon and rectal operations were identified from a prospectively maintained database.

Risk behaviors for disease transmission among petting zoo attendees.

Objective: To evaluate risk behaviors for transmission of zoonotic diseases at petting zoos during a period without a recognized disease outbreak.

Design: Observational survey with environmental microbiologic sampling.

Sample Population: 6 petting zoos in Tennessee.

Outcome of laparoscopic colectomy for polyps not suitable for endoscopic resection.

Background: Large colonic polyps or polyps that lie in anatomical locations that are difficult to access at endoscopy may not be suitable for endoscopic resection and therefore may require partial colectomy. This approach eradicates the polyp and allows an oncologic resection should the polyp prove to be malignant. The purpose of this study was to assess outcomes of a laparoscopic approach for the management of these polyps.

Is laparoscopic colectomy applicable to patients with body mass index >30? A case-matched comparative study with open colectomy.

Purpose: The benefits of early postoperative recovery, reduced postoperative pain, pulmonary dysfunction, and hospitalization after laparoscopic colectomy may improve outcome over open colectomy in obese patients. This case-matched study compares outcomes after open and laparoscopic colectomy.

Methods: A total of 94 laparoscopic colectomy patients with a body mass index >30 (Jan 1999-June 2003) were identified from a prospective database and matched to open colectomy cases for age, gender, body mass index, American Society of Anesthesiologists class, procedure, indication, and date of surgery.

Diagnosis-related group assignment in laparoscopic and open colectomy: financial implications for payer and provider.

Purpose: In carefully matched patients, the length of hospital stay after laparoscopic colectomy is shorter than after open surgery. Higher operating room costs for laparoscopic surgery are offset by lower costs for hospitalization because of less utilization of pharmacy, laboratory, and nursing services. Clinical outcome is comparable.

Does conversion of a laparoscopic colectomy adversely affect patient outcome?

Purpose: Conversion during laparoscopic colectomy varies in frequency according to the surgeon's experience and case selection. However, there remains concern that conversion is associated with increased morbidity and higher hospital costs.

Methods: From January 1999 to August 2002, 430 laparoscopic colectomies were performed by two surgeons, with 51 (12 percent) cases converted to open surgery.

Standardized approach to laparoscopic right colectomy: outcomes in 70 consecutive cases.

Background: The purpose of this article is to describe a standard operative technique, postoperative care plan, and outcomes for laparoscopic right hemicolectomy.

Study Design: A consecutive series of patients requiring laparoscopic right colectomy for neoplasia from March 1999 to April 2003 at the Cleveland Clinic Foundation, Cleveland, OH, were analyzed. Data collected included age, gender, indication for surgery, American Society of Anesthesiology class, body-mass index, operative duration, length of hospital stay, complications, mortality, and 30-day readmission rate.

Case-matched comparison of clinical and financial outcome after laparoscopic or open colorectal surgery.

Objective: Comparison of outcome and costs after laparoscopic and open colectomy.

Summary Background Data: Previous studies comparing laparoscopic and open colectomy report conflicting results with regard to clinical outcome and costs.

Methods: Laparoscopic colectomy patients from a prospective database were matched for age, gender, and disease-related grouping to patients who underwent the same operation by the open approach over the same period (2000 to 2001).

Laparoscopic colectomy in obese and nonobese patients.

Obese patients carry a higher risk of wound complications and cardiopulmonary complications along with a higher incidence of comorbidity, all of which have the potential to affect outcome after a variety of surgical procedures. The data regarding outcomes after laparoscopic colectomy in obese and nonobese patients are limited. The purpose of this report was to compare the outcome of laparoscopic bowel resection in obese and nonobese patients.

Results of a standardized technique and postoperative care plan for laparoscopic sigmoid colectomy: a 30-month experience.

Introduction: Laparoscopic sigmoid colectomy has been accepted slowly despite potential advantages because of the perceptions of a steep learning curve and increased operative times and costs. The purpose of this article is to review the outcome of a standardization of all the intraoperative and postoperative processes used in our department for the performance of laparoscopic sigmoid colectomy.

Methods: A consecutive series of patients requiring laparoscopic sigmoid colectomy from March 1999 through December 2001 at the Cleveland Clinic Foundation, Cleveland, Ohio, was analyzed.