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J G Warren

Publications and source records attributed to J G Warren.

7 recordsLinked to original sources

Effect of same-sided and cross-body load carriage on 3D back shape in young adults.

UNLABELLED: Regular carriage of heavy loads such as backpacks, satchels and mailbags results in a variety of acute medical problems and increased potential for back injury. There is a paucity of information about the specific changes in back posture that occur in response to asymmetrical loading. The purpose of this study was to examine the changes in back shape that occurred in response to asymmetrical load carriage, either on one shoulder (same-side) or across the body (cross-body), in healthy young adults. METHODS: A convenience sample of 21 physiotherapy students randomly performed three trials (unloaded, same-side loaded, cross-body loaded) in standing with a 15% body load. The Microscribe 3DX digitiser (Immersion Group Ltd) recorded the three dimensional coordinates of 15 Key anatomical landmarks on the back in the three conditions. RESULTS: A one-way ANOVA with repeated measures and post-hoc tests was implemented to highlight statistical differences in the data collected (p<0.05). Significant differences were found in the x, y and z coordinates of the anatomical landmarks in the upper back between unloaded and loaded conditions. Results demonstrated significantly less impact on spinal posture from cross-body loading as compared to same-sided loading. CONCLUSION: This study confirms that there are significant three-dimensional changes in back shape in response to asymmetrical loading. Further work is needed to evaluate the optimal carriage type and maximal body load that results in the least spinal impact and injury potential in young adults.

Adult↗

3D back shape in healthy young adults: an inter-rater and intra-rater reliability study.

UNLABELLED: Whilst postural evaluation of spinal dysfunction is routine in physiotherapy practice, objective measurements are rarely undertaken due to the scarcity of reliable low cost assessment tools. Warren et al [12] found high intrarater reliability but inter-rater reliability has not as yet been evaluated. The purpose of this study was to assess both the intra-rater and inter-rater reliability of the Middlesbrough Integrated Digital Assessment system (MIDAS). METHODS: A convenience sample of twenty-five healthy University of Teesside students was recruited for the study. One rater palpated fifteen key landmarks on each subjects back. Each of three raters took two measurements on each subject in a standardized upright posture. Rater order was randomized to minimize data recording bias. X (medio-lateral), Y (antero-posterior) and Z (height) landmark positions were recorded via a computer interface. DATA ANALYSIS: Intraclass Correlation Coefficients (ICC 2,1) were used to analyse data using SPSS v13. RESULTS: Both intra-rater agreement (mean ICCs - rater 1 r= 0.970, rater 2 r= 0.965 and rater 3 r= 0.965, p<0.001) and inter-rater agreement (mean ICCs r = 0.967, p<0.001 was very high between repeated measures and between markers. Error values for the z-axis (height) were lowest. CONCLUSIONS: The system demonstrated both high inter-rater and intra-rater reliability. Before the system is used on a clinical population, data output needs to be converted from raw format to a clinically applicable format. Work is currently being undertaken to develop an interactive visual display and control for postural sway.

Adult↗

3D back shape in normal young adults.

In today's climate of evidence based medicine, there is an increasing emphasis on objective assessment to monitor treatment effectiveness. Although spinal posture and back shape are commonly assessed by clinicians, current practice is based on subjective findings and unreliable objective tools. Numerous management protocols aim to improve both posture and shape, however data related to normal back shape is quite scarce. The aim of this study was to investigate normal back shape in young adults, in order to produce normative values against which deformity could be defined. The Integrated Shape Imaging System (ISIS) was used to measure the three-dimensional back shape. A convenience sample of 48 normal adults, aged 18-28 volunteered to participate in this study. A small minority of individuals showed no curve (8%), 55% showed a single curve and the rest showed a double one. Right spinal asymmetry was more frequent than the left (77% to 52%). Mean values and 95% confidence intervals were 14.1 degrees (11.7 degrees-16.5 degrees) for upper Lateral asymmetry, 5.6 degrees (3.3 degrees - 7.9 degrees) for lower lateral asymmetry, 24.9mm (20.6mm -29.2mm) for thoracic kyphosis and 14.9mm (12.5mm -17.2mm) for lumbar lordosis. Increasing upper lateral asymmetry correlated with decreasing thoracic kyphosis (p=0.01). Maximum skin surface angle correlated positively with only upper lateral asymmetry (p<0.0001). Similar topographical interrelationships have been demonstrated in scoliosis. It is important that clinicians in relevant disciplines objectively assess all three dimensions of back shape, as our research shows that changes in one plane are associated with changes in the other two planes.

Adolescent↗

3-D measurement of posture and back shape using a low cost, portable system--a reliability study.

The reliability and accuracy in the measurement of landmark points using a 3-D digitizer on a static back phantom are reported. The results show the systems clinical reliability as a low cost, portable and flexible method for recording back posture. Consistent results are demonstrated for a single measurer and good agreement was found between two measurers. Few intrinsic errors were found in the devices performance.

Back↗

Motivating and rewarding the staff nurse.

In meeting the economic and professional need for staff nurses to stay at the bedside, a system established at one medical center uses four methods to motivate and reward the staff nurse. They are: recognition and monetary reward, rural nursing experience, cross-training, and inservice participation.

Career Mobility↗

Surface runoff losses of phosphorus from Virginia soils amended with turkey manure using phytase and high available phosphorus corn diets.

Many states have passed legislation that regulates agricultural P applications based on soil P levels and crop P uptake in an attempt to protect surface waters from nonpoint P inputs. Phytase enzyme and high available phosphorus (HAP) corn supplements to poultry feed are considered potential remedies to this problem because they can reduce total P concentrations in manure. However, less is known about their water solubility of P and potential nonpoint-source P losses when land-applied. This study was conducted to determine the effects of phytase enzyme and HAP corn supplemented diets on runoff P concentrations from pasture soils receiving surface applications of turkey manure. Manure from five poultry diets consisting of various combinations of phytase enzyme, HAP corn, and normal phytic acid (NPA) corn were surface-applied at 60 kg P ha(-1) to runoff boxes containing tall fescue (Festuca arundinacea Schreb.) and placed under a rainfall simulator for runoff collection. The alternative diets caused a decrease in manure total P and water soluble phosphorus (WSP) compared with the standard diet. Runoff dissolved reactive phosphorus (DRP) concentrations were significantly higher from HAP manure-amended soils while DRP losses from other manure treatments were not significantly different from each other. The DRP concentrations in runoff were not directly related to manure WSP. Instead, because the mass of manure applied varied for each treatment causing different amounts of manure particles lost in runoff, the runoff DRP concentrations were influenced by a combination of runoff sediment concentrations and manure WSP.

6-Phytase↗