Search

OBJECTIVE: Although the role of reputation in determining the relative standings in the U.S. News & World Report (USNWR) annual rankings of the top 50 hospitals has received analytical attention, the role of reputation in the best children's hospitals pediatric specialty rankings has not been quantified. Our goal was to quantify the role of reputation in determining the relative standings of the top-ranked pediatric specialties and their associated hospitals in the 2008–2010 editions of the USNWR best children's hospital rankings. METHODS: A cross-sectional study of USNWR data collected from the top 30 hospitals in each of 6 (and later 10) specialties was performed. The main outcome measures were rankings based on total USNWR scores and subjective reputation scores. RESULTS: On average, rankings based on reputation scores alone correlated with USNWR overall rankings; correlation coefficients ranged from 0.80 to 0.98 (Spearman Correlation; mean P < .001). This relationship was consistent over all 3 survey years. CONCLUSIONS: The relative standings of the top 30 pediatric hospitals in each of 10 specialties are largely explained by the compelling correlation between subjective reputation scores and ranking scores.

In this study, we assessed how ungraded jogging and graded walking at the same rating of perceived exertion (RPE) affect heart rate and oxygen consumption ([Vdot]O(2)). Twenty untrained participants completed a treadmill test to determine peak [Vdot]O(2) (mean = 40.3 +/- 6.3 ml . kg(-1) . min(-1)). Participants completed separate 30-min trials of moderate exercise (RPE of 13 on the Borg 6-20 scale) in random order on the treadmill: graded walking and ungraded jogging. Treadmill speed or grade was adjusted throughout the trial by the experimenter based on participant responses to maintain an RPE of 13. The jogging trial produced a significantly higher heart rate (161 +/- 18 vs. 142 +/- 24 beats . min(-1)) and [Vdot]O(2) (7.4 +/- 1.8 vs. 5.8 +/- 1.5 METs) (P0.01) than the walking trial. Treadmill grade decreased significantly during the walking trial (11.1 +/- 2.3% to 10.0 +/- 2.2%; P0.01), but treadmill speed did not change significantly during the jogging trial (5.2 +/- 1.0 miles . h(-1) to 5.0 +/- 0.9 miles . h(-1)) (P0.05), in an effort to maintain constant RPE. These findings provide evidence that similar perceptions of effort during graded walking and ungraded jogging do not produce similar cardiovascular and metabolic responses. The results indicate that, for a given prescribed perceived effort, jogging provides a greater stimulus for fitness benefits and caloric expenditure.

The purpose of this study is to assess cardiovascular responses to lower body positive pressure (LBPP) and to examine the effects of LBPP unloading on gait mechanics during treadmill ambulation. We hypothesized that LBPP allows comfortable unloading of the body with minimal impact on the cardiovascular system and gait parameters. Fifteen healthy male and female subjects (22–55 yr) volunteered for the study. Nine underwent noninvasive cardiovascular studies while standing and ambulating upright in LBPP, and six completed a gait analysis protocol. During stance, heart rate decreased significantly from 83 ± 3 beats/min in ambient pressure to 73 ± 3 beats/min at 50 mmHg LBPP ( P < 0.05). During ambulation in LBPP at 3 mph (1.34 m/s), heart rate decreased significantly from 99 ± 4 beats/min in ambient pressure to 84 ± 2 beats/min at 50 mmHg LBPP ( P < 0.009). Blood pressure, brain oxygenation, blood flow velocity through the middle cerebral artery, and head skin microvascular blood flow did not change significantly with LBPP. As allowed by LBPP, ambulating at 60 and 20% body weight decreased ground reaction force ( P < 0.05), whereas knee and ankle sagittal ranges of motion remained unaffected. In conclusion, ambulating in LBPP has no adverse impact on the systemic and head cardiovascular parameters while producing significant unweighting and minimal alterations in gait kinematics. Therefore, ambulating within LBPP is potentially a new and safe rehabilitation tool for patients to reduce loads on lower body musculoskeletal structures while preserving gait mechanics.

This study investigated the mechanical effects that cycling has on running style which may explain the discomfort associated with the transition from cycling to running. The joint angles, angular velocities, reaction forces, and reaction moments of the left and right hip, knee, and ankle joints as well as stance time, flight time, stride length, and maximum vertical displacement of the center of gravity were measured using high-speed video and ground reaction force data. Data were collected from 11 competitive biathletes and triathletes. Each subject's running mechanics were determined from 10 trials for each of three conditions: (a) unfatigued, (b) immediately following 30 min of running, and (c) immediately following 30 min of bicycling. The results indicate that a person's running mechanics, as described by the variables above, are virtually unchanged between each of the three conditions. Therefore, awkwardness of the bicycle-to-run transition may not be related to a change in running mechanics.