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Context: Popularity of using handheld devices in clinical settings has increased, especially the use of motion analysis applications (MAAs). Video-based measurement tools have been found reliable in measuring knee valgus in subjects without anterior cruciate ligament (ACL) injury. However, there is a need for validation of using a MAA to measure knee valgus in an injured population, given that they may exhibit higher degrees of knee valgus. Objective: To examine the reliability and validity of using a MAA to measure knee valgus during functional activities used to assess return to sport after ACL reconstruction (ACLR). Design: Reliability and validity study. Setting: University laboratory. Participants: Twelve participants with ACLR and 20 healthy individuals. Interventions: Each subject performed single-leg drop landing, single-leg hop, and 90° cut with simultaneous 3-dimensional (3D) motion capture and video recording on an iPad. Main Outcome Measures: Peak knee valgus during the landing phase was measured using a MAA and 3D analysis. To obtain reliability, peak knee valgus was measured on 2 separate days. Reliability was determined using intraclass correlation coefficients and standard errors of measurement. Validity was assessed using Pearson correlation coefficients by comparing peak knee valgus between the MAA and 3D analysis. The t tests were used to compare knee valgus obtained between raters, within raters, and between the MAA and 3D analysis. Results: Our data revealed excellent intrarater and interrater reliability with low standard errors of measurement of using a MAA for both groups. Significant, moderate to large associations were found in comparing peak knee valgus between the MAA and 3D analysis. However, knee valgus was significantly different between the MAA and 3D analysis across all tasks in both groups. Conclusion: Although a MAA is reliable for measuring peak knee valgus in individuals with ACLR and healthy controls, the actual values obtained by a MAA should be viewed with caution.

Background The development of hospital-acquired pressure ulcers (HAPUs) is a common complication associated with immobilization and prolonged hospitalization in trauma patients. Our semi-annual Trauma Quality Improvement Program report identified HAPUs as an outlier complication. We used a hospital-wide initiative to reduce the incidence of HAPUs among our trauma patient population. Our study aimed to determine whether the implemented measures would decrease HAPUs incidence rates. Study Design We reviewed adult trauma patients during a 3-year period. The novel care-based platform and preventive measures for reducing HAPUs included the following components: pressure-reducing beds; improved and protocolized nutritional support; mandatory 2-hour change of posture; turning clocks; early surgical intervention; spot checks by our wound care nurse; and education to patients and caregivers. Paired-sample t-test and chi-square analyses were used, with significance defined as p Results A total of 9,755 patients were admitted to our trauma services in the study period. Of these, HAPUs developed in 89 patients (mean age 57.9 years and 48 [54%] were female). The Injury Severity Score ranged from 1 to 75, with a mean of 20 in patients with HAPUs compared with 8 in patients without HAPUs during the same study period. The incidence of HAPUs at our institution was initially 1.36%, which decreased to 0.98% in year 2 and to 0.39% in year 3 (p = 0.002). Conclusions The novel 7-step care-based process changes, acquisition of specialized equipment, and educational initiatives implemented were associated with a significant decrease in the incidence rates of HAPUs.

Background The state of Florida continues to report significant gender, ethnic and racial disparities in trauma incidence, access to care and outcomes in the adult population. Our objective was to assess pediatric injury profiles and ethnic/racial disparities of specific injuries in a Regional Trauma Center (TC) in South Florida. Methods Retrospective data from November 2011 to December 2015 were obtained from the Level 2 TC registry for children ≤21 years old. Demographic, injury pattern, geographic area, injury scores and treatment data were analyzed. Results One thousand six hundred ten patients, ages 0–21 years were cared for at the TC from 2011 to 2015.73% were males. Mean age = 15.7 years. Mortality was 2.3%. Using zip code data and using geographic mapping, we identified two main clusters where injuries were occurring. A multinomial regression analysis demonstrated that Hispanics had higher risks of falls (RR 10.4, 95% CI 2.7–29), motorcycle accidents (RR 3.7, 95% CI 1.7–8.2) and motor vehicle accidents (RR 6.4, 95% CI 3.6–11.4). Black/African American children had higher risks of gunshot wounds and resultant mortality (p