Level Of Technical Skill Research Articles

Introducing the American Contact Dermatitis Society–Dermatology Nurses’ Association Interprofessional Education Initiative

The American Contact Dermatitis Society (ACDS) is an organization that was founded in 1989 to develop, promote, and support initiatives in the field of contact dermatitis and occupational skin disease. Its members include a wide range of healthcare professionals dedicated to improving education, patient care, and research in the field of contact dermatitis. Dermatologists, allergists, physicians, researchers, nurses, and physician assistants work together through the society to provide mentorship, information, and practical tools for a wide range of needs from information about novel allergens and best practices in patient education to technical aspects of patch testing (the tool to detect allergic contact dermatitis). Allergic contact dermatitis is a delayed-type hypersensitivity reaction, which is characterized by a complex immunological cascade. Providers that incorporate patch testing into their practices are successful when they have an education-centered treatment focus. Identification of a relevant allergen by patch testing warrants the prescription of avoidance measures. If these measures are implemented appropriately, then most patients will improve. The unique practice of contact dermatitis within dermatology with its high procedural–technical skill level and need for extensive patient education lends itself well to a team approach with regard to providing healthcare. These teams are often made up of medical doctors, nurse practitioners, registered nurses, medical assistants, and physician assistants, and in training programs, dermatology residents and fellows, each with critical roles. One of the strengths of the ACDS is educational support, and on this 25th anniversary year of our organization, we embraced the initiative of fostering intersocietal relationships. For example, we implemented a second track during our annual meeting and established parallel interactive sessions to develop partnerships with the members of the Society for Pediatric Dermatology and National Eczema Association (to explore common interests in atopic dermatitis and contact dermatitis) and members of the Dermatology Nurses’ Association. These outreach sessions proved to be valuable and underscored the need for our societies to continue to work together to foster support of our joint mission of providing excellent patient care and education in the field of contact dermatitis. We truly value the critical role of our nurses and the breadth of knowledge they bring to the team. To highlight this partnership, we developed what we hope will be an ongoing educational series titled “Tools of the Trade.” The initial articles in this series discuss topics in contact dermatitis and are brought to the readers of the Journal of the Dermatology Nurses’ Association by different physician–nursing (ACDS–Dermatology Nurses’ Association) teams from across the country. It is our hope that these teams will be recognized as national resources, encourage others to participate, and continue to build this resource.

PTU-014 The Use Of Kinematic Analysis Of Bile Duct Cannulation As A Means Of Objectively Assessing Endoscopic Skill At Ercp

IntroductionTraining in ERCP has become more challenging due to a reduction in diagnostic cases following the introduction of MRCP. There is a need to explore options to assist with basic...

Su1531 Requirements for Mastering Colorectal Endoscopic Submucosal Dissection Indicated by the Learning Curve of Multiple Endoscopists

Colorectal endoscopic submucosal dissection (C-ESD) is an excellent method of treatment for colorectal neoplasms. However, it is technically demanding, so the development of a training system is essential. Aim:1) To clarify pre-training requirements for C-ESD operators. 2) To clarify how many cases of C-ESD are necessary for novice operators to acquire an adequate level of technical skill.

Prioritization and Implementation of Information Technology Funding in Higher Education Institutions in the Philippines

Information Technology (IT) funding impacts the opportunities of the group as well as the opportunities of the entire organization. IT funding is among the top-ten IT issues in higher education institutions nowadays. The paper measured empirically the level of prioritization and degree of implementation of IT funding in higher education institutions (HEIs) in the Philippines. A total of 95 HEIs in the Philippines were evaluated. The respondents are all heads in the Management Information Technology units. A survey questionnaire was used that was based on the critical questions from EDUCAUSE. The study reveals that the level of prioritization of IT funding in the Philippine HEIs is high but the degree of implementation is moderate. The study shows that there is a significant positive relationship between degree of implementation of IT funding and level of technical skills possessed by the respondents. There is no significant positive relationship between degree of implementation of IT funding and the respondent’s gender, educational attainment, teaching status, human skill level, conceptual skill level, working status, extent of decision-making, and HEI’s internet bandwidth. It is concluded that there is a remarkable gap between the level of prioritization and degree of implementation of IT funding in these institutions.Keywords: IT in Education, IT funding, Higher Education Institutions (HEIs), descriptive design, Philippines

Value of temporary stents for the management of perivaterian perforation during endoscopic retrograde cholangiopancreatography.

Endoscopic retrograde cholangiopancreatography (ERCP) has become the mainstay of treatment in hepato-pancreato-biliary disease. However, ERCP requires a high level of technical skills and experience in therapeutic endoscopy, there is always a risk of complications. Especially, the perforation per se affects the patient adversely, and the clinical course may lead to a poor prognosis, even with appropriate management. The treatments for ERCP-related perforation are diverse, depending on the location and mechanism of the bowel perforation and the time of diagnosis. Thus, we reviewed the appropriate surgical and non-surgical management options for therapeutic ERCP-related perforations, especially, evaluating metallic stenting as a treatment modality in perivaterian perforation.

Estimating Emissions Benefits of Bicycle Facilities with Stand-Alone Software Tools

To improve their capability to estimate the emissions reduction benefits of new bicycle facilities, the Association of Monterey Bay Area Governments and the Monterey Bay Unified Air Pollution Control District in California sought to develop a new software tool. The tool was required not only to deliver accurate forecasts with a small development budget but also to operate independently of other models, run on a platform that could be freely distributed without special software licenses, and provide user-friendly access to planners in multiple agencies with varying levels of technical skill. For these requirements to be satisfied, an incremental nested logit mode choice model was developed that pivoted off static exports of trip tables from the Association of Monterey Bay Area Governments’ existing four-step travel model. GPS traces collected from smartphone users in the region were analyzed to estimate a path-size logit route choice model, and the California Household Travel Survey was used to estimate a scaling coefficient on the best route utility. The model was implemented in an Adobe ActionScript graphical user interface. After the user edits the bicycle network in the user interface, new bicycle levels of service are skimmed, and new shares for each mode are calculated from their original shares in the no-build alternative and the change in the bicycle level of service. Finally, the emissions reduction is estimated on the basis of the distance and average speed of the vehicle trips replaced by bicycle travel. The result is an accurate, fast, freely distributable, user-friendly tool that is consistent with the forecasts produced by the four-step model.

Caracterización de escorias metalúrgicas procedentes de yacimientos arqueológicos de Navarra (Siglos II a.C.- IV d.C.)

The Archaeology Section of the Government of Navarre put forward a proposal to undertake research in the characterization of a set of pieces from 2nd century B.C. to 4th century A.D. retrieved from excavations in different archaeological sites in this province, to obtain data related to the manufacturing process of the investigated artefacts and to compare the level of technical skills in different times and places, so as to achieve a better understanding of technological abilities and material culture. The finds discussed in this paper are of interest from an archaeometallurgical point of view, and they consist mainly of metallurgical slags, remains of manufactured pieces, and minerals residues used to obtain various metals. In addition to carrying out their chemical analyses by inductively coupled plasma (ICP), the study of six samples was performed by optical and scanning electron microscopy and energy-dispersive X-ray microanalysis (EDX) which revealed the composition of large areas of the slags, and the study was finally completed by the determination of the phases present by X rays diffraction.

Editorial Comment from Dr Kitamura to Cystectomy and urinary diversion as management of treatment-refractory benign disease: The impact of preoperative urological conditions on perioperative outcomes

As removal of the bladder followed by urinary reconstruction impairs the quality of life (QOL) of patients, cystectomy should be indicated when the benefits surpass the loss of QOL. This means that the primary diseases requiring cystectomy must be severe and oppressive for patients; for example, radiation cystitis with uncontrollable hemorrhage, treatment-refractory vesicovaginal or rectovesical fistula, atrophic bladder and so on. It is possible that the procedures in cystectomy for such benign diseases require high technical skill levels compared with those in radical cystectomy for bladder cancer, but it might depend on the primary disease. There has been no report with a large series regarding morbidity and mortality of cystectomy for benign diseases because of their rarity. Cohn et al. evaluated early and late complications after cystectomy for patients with treatment-refractory benign disease, and attempted to determine associations between the preoperative condition, including the etiology, and such outcomes. All patients with radiation-induced fistula experienced complications within 30 days after the cystectomy, and half of them were Clavien grade III or more. At 90 days, 50% of the patients with radiation-induced fistula still had the preoperative problems, whereas 83% of the rest of the cohort experienced resolution. The authors commented that the morbidity of cystectomy for benign disease might be similar to that seen in radical cystectomy, and increased in particularly complex and comorbid patients with radiation-induced fistula. Although this article has the limitations of being a retrospective review with the probability of underestimation of complications and a small number of participants that do not allow multivariate analysis, it provides informative suggestions for clinical practice. According to recent reports regarding complications of radical cystectomy after radiation therapy, morbidity rates were acceptable and slightly higher than for non-irradiated participants. Unlike salvage cystectomy after radiotherapy as a bladder-preserving strategy, however, cystectomy for patients with uncontrollable radiation-induced fistula is a challenging operation, as shown in this paper. Should we, then, avoid carrying out cystectomy for patients with radiation-induced fistula? To answer this question, much longer follow up and outcome data should be analyzed. Whether the patients who underwent cystectomy for treatment of radiation-induced fistula finally received the real benefits of cystectomy with urinary diversion must be of interest to many urologists.

A Comparison of the Physiological and Technical Effects of High-Intensity Running and Small-Sided Games in Young Soccer Players

The aim of this study was to investigate the effects of high-intensity interval running and small-sided game training programs on the physical capacity and the level of soccer-specific technical skills in young soccer players. Twenty male soccer players (U-16) were divided into two groups (running group – RG, small-sided game group – SSGG) and completed two different 8-week training programs. The intervention consisted of two training sessions a week (RG – 5×4 min running, with an active recovery period of 3 min; SSGG–3vs.3 games or 3vs.3 with a neutral player for 5×4 min, with an active recovery period of 3 min). A significant group × time interaction was found in the VO2max (p = 0.025). Moreover, the significant pre to post changes of VO2max were observed in the SSGG (p = 0.032). The differences between the results of shuttle runs and sprint tests were not significant with the exception of 5 m sprint in RG (p = 0.04). An improvement in the peak power and total work capacity was observed in the RG and SSGG. A significant improvement (p = 0.014) in soccer-specific technical skills level was noted only in the SSGG. The results of this study suggest that the small-sided games, compared with interval running, are more highly recommended training drills for the coincident development of physical capacity and technical skills in young soccer players.

The Artification of Tattoo: Transformations within a Cultural Field

Theorized as a Bourdieusian field, this article examines changes inside the tattoo world resulting in the valuation of certain tattoo practices as art and some actors taking ‘fine art’ positions within it. The category of tattoo art is distinct from tattoo because it positions the practice away from its traditional historic moorings as a lowbrow craft and occupation requiring a rudimentary level of technical skill. In contrast, tattoo art is created and evaluated within academic discourses and traditional fine art ideologies that stress innovation, creativity, and exclusivity. In addition to mastery of the medium, that is, applying the tattoo to skin, tattoo artists create original works that qualify as artistic by art world conventions. This process of artification has changed the symbolic meanings and valuation of a practice, imbuing tattoo art with cultural legitimacy from the inside.

Simulated Colonoscopy Objective Performance Evaluation (SCOPE): a non-computer-based tool for assessment of endoscopic skills

The Simulated Colonoscopy Objective Performance Evaluation (SCOPE) was developed to fill the need for a lower-cost, non-virtual-reality (VR)-based assessment tool. This study aimed to evaluate the ability of SCOPE to assess endoscopic skills objectively. Four tasks were created using the Kyoto Kagaku colonoscopy model (Kyoto Kagaku Co., Ltd., Kyoto, Japan). The SCOPE tasks included Scope Manipulation (SM) requiring torque and tip deflection to align a shape in the colon with a matching shape on the monitor; Tool Targeting (TT) requiring coordination with biopsy forceps to contact a metal target; Loop Management (LM) requiring prevention, recognition, and reduction of a redundant sigmoid colon with navigation to the cecum; and Mucosal Inspection (MI) requiring identification of simulated polyps during withdrawal and retroflexion. Key performance metrics were identified, and a normalized scoring system was developed. For the study, 35 subjects were stratified into three cohorts based on colonoscopy experience: novice (0-50 colonoscopies; n = 11), intermediate (51-139 colonoscopies; n = 13), and experienced (>140 colonoscopies; n = 11). The subjects performed two trials of all four tasks. Across all four tasks, the experienced endoscopists (E) consistently outperformed the intermediates (I), who in turn outperformed the novices (N). The mean normalized scores with 95 % confidence intervals (CI) are as follows: SM: N (54; range, 26-82), I (92; range, 79-106), E (106; range, 93-118) (p = 0.0006). TT: N (40; range, 24-55), I (77; range, 63-91), E (88; range, 72-105) (p < 0.0001). LM: N (51; range, 24-79), I (80; range, 59-101), E (101; range, 98-105) (p = 0.003). MI: N (73; range, 53-92), I (85; range, 76-95), E (100; range, 91-108) (p = 0.013). Total score: N (218; range, 155-280), I (335; range, 299-371), E (395; range, 371-419) (p < 0.0001). The test-retest reliability (0.6) for the expert total score was respectable. The validity evidence from this study shows that scores on SCOPE tasks can differentiate between groups expected to have different levels of technical skill. This model shows promise as a low-technology tool for objective assessment or training of endoscopic skills.

A Clinical Study of Transoral Pharyngectomies to Treat Superficial Hypopharyngeal Cancers

For years, it has been a major interest for surgeons and oncologists to develop a novel technique to detect hypopharyngeal cancers at an early stage and to treat the lesions in a less invasive manner. The advent of the narrow band imaging system combined endoscopy and various endoscopic approaches shed light on the new era of the minimum invasive management of superficial cancers in hypopharyngeal regions. Three endoscopic approaches, endoscopic mucosal resection, endoscopic submucosal dissection and endoscopic laryngopharyngeal surgery, were chronologically introduced at our institute. In this study, we focused on the clinical outcomes, advantages and limitations of each procedure. A total of 30 patients (42 procedures) received transoral pharyngectomies between June 2006 and May 2012. Tracheotomy was performed in 9 of 42 (21%) patients. Three patients developed local recurrence and were subsequently controlled by additional transoral pharyngectomies. The 2- and 5-year local control rates were 92.8 and 83.5%. The 2- and 5-year overall survival rates were 82.1%. Endoscopic mucosal resection, endoscopic submucosal dissection and endoscopic laryngopharyngeal surgery-transoral pharyngectomies are useful procedures for treating superficial hypopharyngeal cancers. Endoscopic mucosal resection manifested the least invasiveness and may be beneficial for resecting small superficial lesions, endoscopic submucosal dissection may be advantageous for patients with difficult laryngopharyngeal exposure and endoscopic laryngopharyngeal surgery has shown the optimal effectiveness and minimal complications and can be applied to most of the hypopharyngeal sub-sites. All three procedures require a high level of technical skill and close collaboration between otolaryngologists and gastroenterologists.

Has the Expansion of Higher Education Led to Greater Economic Growth?

There is an enduring belief by UK policymakers that a large higher education sector is an important driver of long-run economic growth, which has been part of the narrative since the Robbins Report. Back then, there was plenty of conjecture and assumption, but strikingly little concrete evidence to support such a belief. This paper asks whether the evidence base has strengthened in the 50 years since it was published. It looks at a number of different growth equation specifications and, using international education data, attempts to draw out the contribution of both the number of, and the growth in, graduates since the 1960s. There are three main findings. Firstly, many growth relationships, including those estimated elsewhere in the literature, are quite sensitive to the countries included – which often depends on the variables used – and time period of analysis. I argue that, given these issues, growth equations should always be treated with caution. Secondly, and remembering this caveat, neither the increase nor the initial level of higher education is found to have a statistically significant relationship with growth rates both in the OECD and worldwide. This result is robust to numerous different specifications. Thirdly, there is some evidence, consistent with the existing literature, that levels of technical skills at the end of compulsory education matter. The employment of higher level technical skills (proxied by the number of employed researchers in an economy) is also a strong predictor of growth. This gives a possible mechanism linking the output of (some) of the higher education sector with economic growth. However, it does not imply that mass higher education necessarily leads to higher growth. This depends on the skills produced by an expanding tertiary sector and their utilisation (or underutilisation) in the jobs available to increasing numbers of graduates.

Accurate measurement of peripheral blood mononuclear cell concentration using image cytometry to eliminate RBC-induced counting error (P3233)

Abstract Peripheral blood mononuclear cells (PBMCs) have been widely researched in the fields of immunology, infectious disease, oncology, transplantation, hematological malignancy, and vaccine development. Specifically, in immunology research, PBMCs have been utilized to monitor concentration, viability, proliferation, and cytokine production from immune cells, which are critical for both clinical trials and biomedical research. One of the common issues of PBMC isolation is red blood cell (RBC) contamination. The RBC contamination can be dependent on the donor sample and/or technical skill level of the operator. RBC contamination in a PBMC sample can introduce error to the measured concentration, which can pass down to future experimental assays performed on these cells. To resolve this issue, RBC lysing protocol can be used to eliminate potential error caused by RBC contamination. In the recent years, a rapid fluorescence-based image cytometry system has been utilized for bright-field and fluorescence imaging analysis of cellular characteristics (Nexcelom Bioscience LLC, Lawrence, MA). In this work, we demonstrate the ability of Cellometer image cytometry system to accurately measure PBMC concentration, despite RBC contamination, by comparison of five different total PBMC counting methods. The results show comparable total PBMC counting among all five methods, which validate the AO/PI staining method for PBMC measurement in the image cytometry method.

Common uses and cited complications of energy in surgery

Instruments that apply energy to cut, coagulate, and dissect tissue with minimal bleeding facilitate surgery. The improper use of energy devices may increase patient morbidity and mortality. The current article reviews various energy sources in terms of their common uses and safe practices. For the purpose of this review, a general search was conducted through NCBI, SpringerLink, and Google. Articles describing laparoscopic or minimally invasive surgeries using single or multiple energy sources are considered, as are articles comparing various commercial energy devices in laboratory settings. Keywords, such as laparoscopy, energy, laser, electrosurgery, monopolar, bipolar, harmonic, ultrasonic, cryosurgery, argon beam, laser, complications, and death were used in the search. A review of the literature shows that the performance of the energy devices depends upon the type of procedure. There is no consensus as to which device is optimal for a given procedure. The technical skill level of the surgeon and the knowledge about the devices are both important factors in deciding safe outcomes. As new energy devices enter the market increases, surgeons should be aware of their indicated use in laparoscopic, endoscopic, and open surgery.

Rationale, scope, and 20-year experience of vascular surgical training with lifelike pulsatile flow models

Vascular surgical training currently has to cope with various challenges, including restrictions on work hours, significant reduction of open surgical training cases in many countries, an increasing diversity of open and endovascular procedures, and distinct expectations by trainees. Even more important, patients and the public no longer accept a "learning by doing" training philosophy that leaves the learning curve on the patient's side. The Vascular International (VI) Foundation and School aims to overcome these obstacles by training conventional vascular and endovascular techniques before they are applied on patients. To achieve largely realistic training conditions, lifelike pulsatile models with exchangeable synthetic arterial inlays were created to practice carotid endarterectomy and patch plasty, open abdominal aortic aneurysm surgery, and peripheral bypass surgery, as well as for endovascular procedures, including endovascular aneurysm repair, thoracic endovascular aortic repair, peripheral balloon dilatation, and stenting. All models are equipped with a small pressure pump inside to create pulsatile flow conditions with variable peak pressures of ~90 mm Hg. The VI course schedule consists of a series of 2-hour modules teaching different open or endovascular procedures step-by-step in a standardized fashion. Trainees practice in pairs with continuous supervision and intensive advice provided by highly experienced vascular surgical trainers (trainer-to-trainee ratio is 1:4). Several evaluations of these courses show that tutor-assisted training on lifelike models in an educational-centered and motivated environment is associated with a significant increase of general and specific vascular surgical technical competence within a short period of time. Future studies should evaluate whether these benefits positively influence the future learning curve of vascular surgical trainees and clarify to what extent sophisticated models are useful to assess the level of technical skills of vascular surgical residents at national or international board examinations. This article gives an overview of our experiences of >20 years of practical training of beginners and advanced vascular surgeons using lifelike pulsatile vascular surgical training models.

JO GULDI. Roads to Power: Britain Invents the Infrastructure State.

Jo Guldi's study takes off from the idea, well-enshrined in the historiography, that Britain in the eighteenth and early nineteenth centuries constituted a powerful “fiscal-military state.” She suggests that this theme, which has mainly been explored in relation to warfare, had a domestic counterpart: the same years saw the state commit to the development of transport infrastructure in the form of an engineered main-road system. Guldi's account begins with the construction of military roads in the Scottish Highlands in the 1720s and 1730s. These were state-funded and involved unwonted levels of technical skill in terms of surveying and attention to the quality of the roadway. Lessons learned in this context were then absorbed by turnpike commissioners and local government. The central state, via parliament, re-entered the scene in the early nineteenth century when, in response to supportive representations from the post office and calls from Scottish and Irish MPs (the former aiming to invigorate the Scottish rural economy, the latter to facilitate travel between newly united kingdoms), several select committees pondered schemes for major highways linking London with Scotland and the Irish Sea. These projects secured parliamentary approval and were constructed at considerable expense. The experience encouraged some MPs to ask for more: they envisaged a national highways board and, although one was not established, public credit was extended to facilitate the building of new Welsh and English highways. New regulations meanwhile were issued to govern all road-making; Guldi describes this as an era of “centralization.” In the 1830s, a localist mood again set in. It was argued that these costs were not justified, and that regional bodies should decide such matters.

Gender recognition depends on type of movement and motor skill. Analyzing and perceiving biological motion in musical and nonmusical tasks

Gender recognition in point-light displays was investigated with regard to body morphology cues and motion cues of human motion performed with different levels of technical skill. Gestures of male and female orchestral conductors were recorded with a motion capture system while they conducted excerpts from a Mendelssohn string symphony to musicians. Point-light displays of conductors were presented to observers under the following conditions: visual-only, auditory-only, audiovisual, and two non-conducting conditions (walking and static images). Observers distinguished between male and female conductors in gait and static images, but not in visual-only and auditory-only conducting conditions. Across all conductors, gender recognition for audiovisual stimuli was better than chance, yet significantly less reliable than for gait. Separate analyses for two groups of conductors indicated an expertise effect in that novice conductors' gender was perceived above chance level for visual-only and audiovisual conducting, while skilled conducting gestures of experts did not afford gender-specific cues. In these conditions, participants may have ignored the body morphology cues that led to correct judgments for static images. Results point to a response bias such that conductors were more often judged to be male. Thus judgment accuracy depended both on the conductors' level of expertise as well as on the observers' concepts, suggesting that perceivable differences between men and women may diminish for highly trained movements of experienced individuals.

Accurate measurement of peripheral blood mononuclear cell concentration using image cytometry to eliminate RBC-induced counting error

Peripheral blood mononuclear cells (PBMCs) have been widely researched in the fields of immunology, infectious disease, oncology, transplantation, hematological malignancy, and vaccine development. Specifically, in immunology research, PBMCs have been utilized to monitor concentration, viability, proliferation, and cytokine production from immune cells, which are critical for both clinical trials and biomedical research. The viability and concentration of isolated PBMCs are traditionally measured by manual counting with trypan blue (TB) using a hemacytometer. One of the common issues of PBMC isolation is red blood cell (RBC) contamination. The RBC contamination can be dependent on the donor sample and/or technical skill level of the operator. RBC contamination in a PBMC sample can introduce error to the measured concentration, which can pass down to future experimental assays performed on these cells. To resolve this issue, RBC lysing protocol can be used to eliminate potential error caused by RBC contamination. In the recent years, a rapid fluorescence-based image cytometry system has been utilized for bright-field and fluorescence imaging analysis of cellular characteristics (Nexcelom Bioscience LLC, Lawrence, MA). The Cellometer image cytometry system has demonstrated the capability of automated concentration and viability detection in disposable counting chambers of unpurified mouse splenocytes and PBMCs stained with acridine orange (AO) and propidium iodide (PI) under fluorescence detection. In this work, we demonstrate the ability of Cellometer image cytometry system to accurately measure PBMC concentration, despite RBC contamination, by comparison of five different total PBMC counting methods: (1) manual counting of trypan blue-stained PBMCs in hemacytometer, (2) manual counting of PBMCs in bright-field images, (3) manual counting of acetic acid lysing of RBCs with TB-stained PBMCs, (4) automated counting of acetic acid lysing of RBCs with PI-stained PBMCs, and (5) AO/PI dual staining method. The results show comparable total PBMC counting among all five methods, which validate the AO/PI staining method for PBMC measurement in the image cytometry method.

Differences in neuromuscular control between impact and no impact roundhouse kick in athletes of different skill levels

This study aimed at investigating two aspects of neuromuscular control around the hip and knee joint while executing the roundhouse kick (RK) using two techniques: Impact RK (IRK) at trunk level and No-Impact RK at face level (NIRK). The influence of technical skill level was also investigated by comparing two groups: elite Karateka and Amateurs. Surface electromyographic (sEMG) signals have been recorded from the Vastus Lateralis (VL), Biceps Femoris (BF), Rectus Femoris (RF), Gluteus Maximum (GM) and Gastrocnemious (GA) muscles of the kicking leg in six Karateka and six Amateurs performing the RKs. Hip and knee kinematics were also assessed. EMG data were rectified, filtered and normalized to the maximal value obtained for each muscle over all trials; co-activation (CI) indexes of antagonist vs. overall (agonist and antagonist) activity were computed for hip and knee flexion and extension. Muscle Fiber Conduction Velocity (CV) obtained from VL and BF muscles was assessed as well. The effect of group and kick on angular velocity, CIs, and CVs was tested through a two-way ANOVA (p<0.05). An effect of group was showed in both kicks. Karateka presented higher knee and hip angular velocity; higher BF-CV (IRK: 5.1±1.0 vs. 3.5±0.5m/s; NIRK: 5.7±1.3 vs. 4.1±0.5m/s), higher CIs for hip movements and knee flexion and lower CI for knee extension. The results obtained suggest the presence of a skill-dependent activation strategy in the execution of the two kicks. CV results are suggestive of an improved ability of elite Karateka to recruit fast MUs as a part of training induced neuromuscular adaptation.