Objective-The goal of the paper is to determine inter-rater reliability of trained examiners performing standardized strength assessments using manual muscle testing (MMT).Design, subjects, and setting-The authors report on 19 trainees undergoing quality assurance within a multi-site prospective cohort study.Intervention-Inter-rater reliability for specially trained evaluators ("trainees") and a reference rater, performing MMT using both simulated and actual patients recovering from critical illness was evaluated.Measurements and results-Across 26 muscle groups tested by 19 trainee-reference rater pairs, the median (interquartile range) percent agreement and intraclass correlation coefficient (ICC; 95% CI) were: 96% (91, 98%) and 0.98 (0.95, 1.00), respectively. Across all 19 pairs, the ICC (95% CI) for the overall composite MMT score was 0.99 (0.98-1.00). When limited to actual patients, the ICC was 1.00 (95% CI 0.99-1.00). The agreement (kappa; 95% CI) in detecting clinically significant weakness was 0.88 (0.44-1.00).Correspondence to: Eddy Fan, eddy.fan@jhmi.edu. Electronic supplementary material The online version of this article (doi: 10.1007/s00134-010-1796-6) contains supplementary material, which is available to authorized users. Conclusions-MMT has excellent inter-rater reliability in trained examiners and is a reliable method of comprehensively assessing muscle strength.
Conflicts of interest statement
ObjectivesWe conducted a trial to assess the treatment fidelity of an individual‐based oral health education intervention utilising motivational interviewing (MI) techniques and its efficacy when compared to a group‐based traditional oral health education intervention (TOHE) and a standard of care group (SC) in a sample from Philadelphia during a 12‐month follow‐up.BackgroundThere is lack of information on how different types of oral health educational interventions affect older adults on non‐clinical outcomes including changes in oral health‐related quality of life (OHRQoL), oral health self‐efficacy (SE) and oral health knowledge (OHK).Materials and methodsOne hundred and eighty patients were randomly allocated to TOHE, MI and SC groups. Treatment fidelity was measured in 16 non‐study patients. The MI intervention was administered by a public health dental hygienist (PHDH). All interviews were audio‐recorded and coded by an expert using the Motivational Interviewing Treatment Integrity (MITI) Code. Multivariable longitudinal regression analyses accounting for baseline demographics and correlated errors due to repeated measures via generalised estimating equation were conducted following an intention to treat approach.ResultsOver the 1‐year follow‐up, SE and OHRQoL scores significantly improved amongst the MI group whereas both outcomes worsened amongst the SC group. During the same period, SE and OHRQoL did not change in the TOHE group.ConclusionFindings from the study support the fidelity of this intervention and the improvement of all non‐clinical outcomes after 12 months amongst the MI group.
Objective: The curriculum for graduating dental and dental hygiene students must prepare them to contribute to the improvement or maintenance of health for individual patient's and the public's health. The objective is to describe the background for and the process used to develop a core Dental Public Health Curriculum for such students. Methods: The process used was to solicit and review existing dental public health curriculum in dental and dental hygiene schools; review curriculum for other health professionals; identify the themes needed to frame the curriculum; select usable materials and identify gaps in existing curricular materials; and develop appropriate curriculum materials that would embody the competencies developed for undergraduate dental and dental hygiene education. Results: Twenty-three topics were identified as embodying the eight competencies.
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