Answers Of Respondents Research Articles

THE INFLUENCE OF AN AUDITOR'S EXPERTISE, OBEDIENCE PRESSURE, AND INDEPENDENCE ON AUDIT JUDGMENT

This study aims to empirically test whether the auditor’s expertise, obedience pressure, and independence affects the audit judgment. The data used is the primary data through questionnaires that contain the answers of respondents. The population in this study auditor registered in the central Jakarta public accountant. The selected sample is 80 respondents with technical purposive sampling. This research uses quantitative method where the data obtained from questionnaire. Analysis of research data using multiple linear regression, with SPSS version 24. Based on the results of the analysis that has been done, this study shows that the auditor’s expertise, obedience pressure, and independence, have a positive and significant impact on the use of audit judgment compliance with adjusted R square of 74.7%. Partially, the results of this study indicate that auditor’s expertise, obedience pressure, and independence together positively and significantly influence the audit judgment.

An analysis of focus and its role in the answering systems of polar questions in Chinese and English

Abstract Instead of classifying natural languages in terms of their answering systems for polar questions, this study investigates how languages construct the answering system for the polar questions with a special concentration on the answering system of the Chinese ma particle question and English polar questions. We argue that the primarily mechanism that natural languages adopt to construct an answering system is the focus mechanism which is based on the relationship between a focus sensitive marker and its association of focus. The different answering patterns to polar questions result from different scopes of focus. In a polar question, what is being focused by the focus sensitive marker or focus operator falls into question scope (focus association). The respondent answers the polar question based on the proposition in the question scope. Answering with a positive particle expresses agreement with that question proposition while answering with a negative particle conveys that the question proposition is not true.

Motives of high school students to participate in sports

The aim of study is to expand the knowledge of motives of Slovak high school students to participate in sports (at school but also in extracurricular activities after school) and identify the differences between boys and girls in adolescent age. The research group consisted of 318 high school students (boys: n = 154, 16.77 ± 1.01 years old and girls: n = 164, 16.54 ± 1.14 years old) from various areas of Slovakia. The questionnaire Exercise Motivations Inventory was used as the research tool. The questionnaire contains 54 items to which the respondent answers on the Likert scale. Kolmogor-Smirnov’s test did not confirm the normality of the research group’s data. The nonparametric Mann-Whitney U test was used to evaluate the significance of the differences in motives between girls and boys. For effect size was calculated coefficient r. The most important motive to participate in sport for boys is motive to gain strength and endurance and for girls is motive positive health. We can see significant differences in motives to participate in sports between girls and boys, where boys have higher score in motives affiliation (p = 0.001, r = 0.18), appearance (p = 0.012, r = 0.14), social pressure (p = 0.006, r = 0.15), social recognition (0.001, r = 0.29) and strength and endurance (p = 0.001, r = 0.23). Significantly higher score girls have in motive weight management (p = 0,009, r = 0.15). Our results can help teachers of physical education, trainers, sport educators and parents to plan thematic units, sport activities, which are of interest and attractive in age of adolescence.

Entrepreneurs’ perception of the influence of the State on the development of business ethics: On the example of Slovakia

The authors perform a critical analysis of the answers of respondents from four focus groups focused on those practices of the State and State institutions which are perceived as unethical by entrepreneurs in Slovakia and thus negatively affecting the development of business ethics in this country. The article examines two questions: firstly, what the causes of the critical attitude of entrepreneurs towards the State as a body responsible for developing business ethics at the macro level are, and secondly, which specific activities of the State entrepreneurs perceive as unethical in terms of the development of business ethics.

Dynamics of sociocultural and linguistic identity in the process of socialisation in a multicultural society

The relevance of the problem of socialisation in multicultural space is extremely high. Its significance is connected with the processes of globalisation and increasing migration. In this situation, the sociocultural and, especially, linguistic identity can be analysed as a bonding and bridging social capital that helps or complicates socialisation, depending on the specifics of the social situation. These assumptions were checked in the empirical research of the sociocultural and linguistic identity of the three groups of ethnic Germans: living in Russia, in the CIS and those who moved to Germany. The obtained data showed the bilingualism of the majority of respondents. At the same time, respondents from Russia and Germany consider both Russian and German languages as native, while respondents from the CIS no longer regard German as their mother language. For them, ethnic, not linguistic, identity is the most essential for socialisation in a multicultural society. For Germans living in Russia, on the contrary, both languages help in communication and in professional activity. For the Germans, who now live in Germany, the Russian language helps in understanding their sociocultural specifics. The future is associated with the German language. Our respondents answer that the main group of socialisation for them is the family. This was especially marked in the answers of respondents living in Russia and Germany. So, we can state that in a complex multicultural environment, the family for them is not only a group for socialisation, but also an object of identity, partly playing the role of psychological defence and support in a changing world. The obtained results also showed a tendency towards individualisation. For the respondents from Russia and Germany, the main identity groups, besides family, are professional groups and groups with common interests. Thus, it can be concluded that linguistic identity plays the role of both bonding and bridging social capital. In positive socialisation, sociocultural identity plays the role of a bridging rather than a connecting capital. Mixed linguistic identity is predominantly a positive moment, increasing socialisation in a multicultural environment.
 
 Keywords: Socialisation, transitivity, identity, multicultural world.

Description Of Attitude And Consumer Purchasing Decisions Against Red Rice

The majority of Indonesian people consume rice as a daily staple food and the much consumed rice comes from white rice. Besides white rice, one type of rice is red rice. Red rice is included in broken rice skin which has advantages compared to white rice found in its nutritional composition and also consumes red rice is effective for reducing total cholesterol levels of type 2 DM patients. The purpose of this study is to describe the attitudes and purchasing decisions of consumers towards brown rice . Respondents in this study were 100 people. Data analysis was performed using descriptive statistical analysis. The results showed that respondents had a positive attitude towards red rice with an average respondent's answer on all attitude statements was 4.34 which means it was in the category of strongly agree and the respondents' buying decision was 3.93 which means it was in the agreed category

Modern Ways of Working: Comparing Results of Two Pilot Studies

This article provides a concise look into the theoretical basis and two small pilot studies which serve as the beginning of a further research collaboration, and have been done in 2018-2019 in service industry companies in Riga (Latvia) and Timisoara (Romania). The objective of these studies was to find the respondents’ knowledge about new ways of working (full or partial remote work, co-working spaces, etc.), as well as their personal fit with these types of work, among other questions. Results of these studies show that there is a significant difference between the theory, the respondent answers, and the actions of their organizations. Main recommendations: there is no single correct approach, it has to be aligned with the business strategy and the actual work specifics of various departments or positions in the company. Problems faced by the workforce must also be taken into account, instead of aiming to decrease office costs as much as possible by creating hot-desking or other similar open office layouts.

Augmented Reality in the Registration Flow for Enterance Eximination at State Polytechnic of Sriwijaya Based on Android

Augmented Reality is a technology that aims to combine digital content made by computers with the real world in real time. Augmented Reality can be applied in almost all areas of life. One of the applications is in the field of providing information. The publication of registration flow for entrance examination at State Polytechnic of Sriwijaya is still using paper media that makes it less interesting on the prospective applicants. Therefore it requires an application based on android to implement the information distribution of registration flow for entrance examination at State Polytechnic of Sriwijaya.This augmented reality application consists of two menus namely information menu and location menu. Information menu contains motion graphic video of registration flow for entrance examination at State Polytechnic of Sriwijaya and location menu contains 3d object of entrance examination at State Polytechnic registration buildings. The research method is divided into several stages, namely design, asset creation, implementation and testing. At the testing stage is divided into two, namely application testing by testing the functionality of the features provided by the application and testing of respondents to determine the effectiveness of registration flow at State Polytechnic of Sriwijaya compared to paper media seen in the respondent's answer of 88.7%.

Family Game Show-style Didactic for Teaching Nervous System Disorders during Emergency Medicine Training.

Emergency medicine residents and medical students. The field of emergency medicine requires learners to build a vast library of illness scripts to be accessible in a rapid manner. Illness scripts are refined and reinforced as senior physicians teach learners common associations between diagnoses, presentation, workup findings, and treatment modalities.1 In order to examine these associations, we developed a didactic session based on the popular television game show "Family Feud" to teach important neurologic conditions related to emergency medicine. This lecture was designed to be an interactive competition, leveraging group participation, competition, and expert opinion.Neurologic emergencies are very common, affecting millions of Americans yearly. It is important for emergency medicine physicians to quickly recognize these conditions and initiate treatment because delay can lead to devastating outcomes.2 The neurologic conditions covered in the lecture were chosen based on the 2016 EM model of clinical practice, sections 7.0: Head, ear, eye, nose, throat disorders, 10.0: Systemic infectious disorders, 12.0: Nervous system disorders, and 19.0: Procedures and skills integral to the practice of emergency medicine, as well as author experience. By the end of this didactic exercise the learner will: 1) name 13 important neurologic conditions related to emergency medicine: TPA (tissue plasminogen activator) contraindications/TPA eligibility, optic neuritis, botulism, giant cell (temporal) arteritis, viral encephalitis, neurocysticercosis, rabies, myasthenia gravis, neurosyphilis, status epilepticus, Bell's palsy, dementia vs. delirium, acute inflammatory demyelinating polyneuropathy (Guillain-Barré); 2) recognize five pattern words associated with each neurologic condition; 3) understand exam findings, diagnostic tests, and/or treatments for 13 important neurologic conditions. A survey was sent through a national emergency medicine education listserv (Council of Residency Directors in Emergency Medicine [CORD-EM]) asking educators to list common word or phrase associations that come to mind with a list of neurological diagnoses. A PowerPoint lecture was created in the form of the game, Family Feud, using the data from this national survey. The game Family Feud requires participant teams to guess answers to certain questions by attempting to guess the most popular answers of survey respondents. At our weekly residency conference, residents were divided into teams and offered the opportunity to compete in a game testing knowledge of nervous system disorders. Each neurology topic was then addressed by a mini-lecture to review pertinent concepts in the disease process. There was no formal assessment at the end of this lecture; however, learners actively participated throughout the lecture. Questions were discussed at the end of each round giving learners the opportunity to fully understand topics. Efficacy of the educational content was assessed based on learner feedback as well as observation of the learners during the exercise. Learners were engaged with the exercise and verbal feedback was uniformly positive. Learners were enthusiastic about the format and requested more sessions created in a similar game. Based on feedback as well as observation of the learners, the lecture was both an effective highyield neurology refresher and team-building exercise. Learners enjoyed the opportunity to compete as a team. Gamification seemed to improve student enjoyment, engagement, and attention, which has also been shown in the literature.3 Our residency program intends to implement similar lectures in the future. Neurology, TPA contraindications, TPA eligibility, upper motor neuron lesion, lower motor neuron lesion, optic neuritis, aphasia, botulism, ACA (anterior cerebral artery) stroke, giant cell (temporal) arteritis, Bell's palsy, viral encephalitis, Todd's paralysis, neurocysticercosis, tonic-clonic seizure, rabies, epidural hematoma, myasthenia gravis, spinal cord injury, neurosyphilis, Glasgow Coma Score (GCS), status epilepticus, Horner's syndrome, subarachnoid hemorrhage, dementia, delirium, Parkinson's disease, acute inflammatory demyelinating polyneuropathy (Guillain-Barré).

Good Governance Alokasi Dana Desa (ADD): Peran Perangkat dan Akuntabilitas Publik

This research was conducted related to the accountability of the management of the Village Fund Allocation (ADD) 2018 in Village of Tirtomartani, Kalasan District. The research objectives are 1) Measuring the Role of Village Apparatuses in realizing good governance in managing village financial funds, 2) to determine the accountability of ADD management can work effectively for all dimensions, namely Transparency, Accountability and Participation in each process and stage which includes the Planning Phase, Implementation and Reporting 3) to help resolve the problems in the management of ADD so that issues regarding the management of ADD can prove and explain the strategic plans and objectives or the goals that have been planned and established by village government organizations through the meeting mechanism of village development planning. The results of this research that the principle of transparency and participation had been implemented well through the mechanism of consultation and deliberation that involved all elements of village community institutions, indicated by the answers of respondents show 91% answered "yes". The principle of transparency is fulfilled by the existence of clear information about the schedule of implementation of activities, sources of funds that are easily accessed by the community, showed that respondents' answers“yes” were 85.6%, which meant that implementation the ADD APBDES was already accountable. Although ADD management has been accountable, it certainly cannot be separated from the role of village officials or village apparatus which is a key to the successful management of ADD APBDES. The results showed that the role of village apparatus in Tirtomartani village was 72%., indicated that village apparatus have played a role to create good governance of managing ADD. This research is expected to contribute in the form of Transfer of Knowledge for village government administrators in order to be optimalized in the management of ADD in the planning process, implementation (expenditure of funds) and reporting in accordance with the provisions of the central government.

CROSS-CULTURAL COMMUNICATION: CREATIVITY AND POLITENESS STRATEGIES ACROSS CULTURES. A COMPARISON OF LITHUANIAN AND AMERICAN CULTURES

The purpose of this study was to identify creative reactions and politeness schemes in two languages in cross-cultural communication – American English and Lithuanian – and then compare the means of expressing politeness strategies and creative reactions in the two mentioned languages. The method used in the study is a survey, evaluated by both qualitative and quantitative methods. The research illustrated that the two mentioned cultures do indeed express creative reactions as well as use the speech acts of gratitude and apology. It also showed that American female and American male groups tend to choose more polite and creative reactions, while Lithuanian female and Lithuanian male groups tend to use less polite and creative reactions more often. Americans (both genders) do not imply the feeling of gratitude or apology, they say it directly. The Lithuanians (both genders) expressed gratitude or apology in everyday situations not as often and not as directly. In other words, the Lithuanian culture tends to use positive politeness; and vice versa, the American culture tends to use negative politeness. Besides that, the research revealed that gender plays a significant role in the answers of the survey respondents. The female Americans and female Lithuanians seem to be more polite and express more creative reactions than their male counterparts. It was also revealed that the respondents of American nationality express gratitude or apology in a more polite and creative way and use more speech acts of gratitude or apology in both private and public spheres than the group of Lithuanian respondents.

Keputusan Pembelian Ulang Melalui Kepuasan Konsumen sebagai Variabel Intervening Ditinjau Dari Kualitas Produk Dan Kualitas Pelayanan Pada Pasar Triwindu Surakarta

The purpose of this study was to analyze whether the repurchase decision by product quality and service quality in Surakarta Triwindu Market. The population in this study is all consumers in Surakarta Triwindu Market.
 The sampling technique was accidental sampling, with 100 respondents. Data collection using a Likert scale questionnaire to measure respondent's answers. Path analysis to identify the relationship between product quality and service quality on repurchase decision s through customer satisfaction. The results showed that repurchase decision thought customer satisfaction were not significantly affected by product quality, while service quality on repurchase decisions through customer satisfaction significantly affected the Surakarta Triwindu Market
 Kerboard : Product quality, Service quality, Customer satisfaction, Repurchase decisions

Postoperative hand therapy management of zones V and VI extensor tendon repairs of the fingers: An international inquiry of current practice

Study DesignElectronic Web-based survey. IntroductionEvidence supports early motion over immobilization for postoperative extensor tendon repair management. Various early motion programs and orthoses are used, with no single approach recognized as superior. It remains unknown if and how early motion is used by hand therapists worldwide. Purpose of the StudyThe purpose of this study was to determine if there is a preferred approach and identify practice patterns for constituents of International Federation of Societies for Hand Therapy full-member countries. MethodsParticipation in this English-language survey required respondents to have postoperatively managed at least one extensor tendon repair within the previous year. Approaches surveyed included programs of immobilization, early passive (EPM), and early active (EAM) with motion delivered by resting hand, dynamic, palmar/interphalangeal joints (IPJs) free, or relative motion extension (RME) orthoses. Survey flow depended on the respondent's answer to their “most used” approach in the previous year. ResultsThere were 992 individual responses from 28 International Federation of Societies for Hand Therapy member countries including 887 eligible responses with an 81% completion rate. The order of most used program was EAM (83%), EPM (8%), and immobilization (7%). The two most used orthoses for delivery of EAM were RME (43%) and palmar/IPJs free (25%). The RME orthosis was preferred for earlier recovery of hand function and motion. Barriers to therapists wanting to use the RME/EAM approach related to preference of surgeon (70%) and clinic (24%). DiscussionIn practice, many therapists select from multiple approaches to manage zone V and VI extensor tendon repairs. Therapists believed TAM achieved with the RME/EAM approach was superior to the other approaches. Contrary to the literature, in practice, many therapists modify forearm-based palmar/IPJs free orthosis to exclude the wrist to manage this diagnosis. ConclusionsThe RME/EAM approach was identified as the favored approach. Practice patterns and evidence did not always align.

BEHAVIOR OF DIVERS AND RECOMMENDATIONS OF OTOLARYNGOLOGISTS CONCERNING DIVING: PILOT STUDY

The aim of the study is to estimate the possible risky behavior of Lithuanian divers and its relation to ear damage as well as identify the opinions of Lithuanian otolaryngologists concerning contraindications and recommendations in the diving field. Material and methods. The authors compiled two separate questionnaires for Lithuanian divers and otolaryngologists; in total, 84 questionnaires were completed. Statistical tests were used to detect the difference among answers of respondents who have distinct sociodemographic characteristics or different diving/consulting experience. Results. It was revealed that 47.5% of divers experienced difficulties while equalizing the air pressure. More than half of the divers (57.9%) ignored this embarrassment and continued diving. Ear pain was felt by 37.5% of the respondents during their diving session. Half of the divers consulted a doctor because of the pain, others did not pay attention and proceeded the diving. The third of the interviewed divers were diving though they had rhinitis. Most of them were diving without any medications. Only 13% of those who experienced dizziness consulted a doctor. Absolute contraindications to dive are a tympanic membrane perforation (90.9%), myringotomy tube inserted into a tympanic membrane (79.5%), and Eustachian tube dysfunction (61.4%); these disorders are most often reported by the interviewed otolaryngologists. In this survey, 61.3% of the otolaryngologists declared they would allow diving if there were no symptoms of vertigo in the past 3–6 months. The opinion of otolaryngologists on diving in the case of acute rhinitis, as well as on the returning to diving after the stapedoplasty, is different; 15% of the interviewed doctors would recommend stopping diving for a definite period. Despite the recommendations of doctors, 17.9% of divers continued to dive. Conclusions. This study shows that the behavior of divers regarding the hearing health is often quite risky. Lithuanian otolaryngologists are lacking consensus of opinion on contraindications for diving.

KAJIAN SEMANTIK PROTOTIPE TERHADAP ISTILAH “DESA WISATA”

Every person has a specific idea of a word, term, phrase, or discourse. The thought is heavily influenced by culture background and surroundings. This study uses the term “tourist village” to understand the thinking of society. The objectives of this study are to assess and describe the prototype semantics “tourist village” based on the notion of society. The study was conducted using a questionnaire that has been designed based on the hypothesis derived from field observations regarding the definition of “tourist village”. The questionnaire has given to 50 persons at random. The respondent's answer was counted, and the results were analyzed based on the predetermined variables. The research proves that prototype semantics “tourist village” as a linguistics study has four main variables, namely the beauty of nature, people skills, culture, and the arrival of people. The results of this study concluded that the prototype semantics “tourist village” according to the community is a village that has a natural beauty, people skills are adequate and special, unique culture, and there are people who want to know the arrival of distinctiveness that is owned in the village.

Knowledge, Perception and Attitude Regarding Generic Medicines among Iraqi Physicians.

The study aim was to explore the knowledge, perceptions, and attitudes of Iraqi physicians regarding generic and locally manufactured medicines. A total of 124 physicians were involved in this cross -sectional study. The convenience sample was collected from five public hospitals in Baghdad. A self-administered questionnaire was distributed and collected in-person. Fisher's Exact Test was used to measure the association between physician years of experience, gender and categorical (perception and knowledge) variables. Most respondent answers regarding the knowledge of generic medicines were incorrect. Only up to one-third of the participants knew that generic medicines are therapeutically equivalent to brand name medicines (26.6%), as safe as brand name medicines (34.7%) and required to meet similar safety standards as brand name medicines (12.1%). With respect to perception, many physicians had negative perceptions about generic medicines such as viewing generic medicines as lower quality (57.3%) and cause more side effects (41.1%) compared to brand name medicines. Regarding physician attitudes toward generic medicines, about two-thirds (64.5%) of the physicians were willing to prescribe low cost medicines; however, only about half (51.6%) of the physicians reported they offer generic medicines to their patients. Finally, 64.5% of the participants were not comfortable with pharmacist replacing prescribed brand with generic medicines. In general, Iraqi physicians have negative perceptions and attitudes about generic and locally manufactured medicines. Significant gaps were identified in the knowledge and perceptions among physicians regarding generic medicines especially in relation to efficacy and safety of generic medicines.

Современные источники националистического самосознания в молодежной среде: анализ имплицитных установок опроса «гармонизация межнациональных отношений и профилактика экстремистских проявлений в образовательной сфере и молодежной среде»

In today’s rapidly changing world, there is increased mobility of individuals and groups, which leads to an increase in density and an increase in the number of inter-ethnic interactions. The problem of reducing the conflict potential of these interactions comes to the fore. Through the use of the categories “Alien,” Other, “the article illustrates the current situation of inter-ethnic relations, allowing to understand the modern challenges related to them. The article considers and analyses a public opinion poll, and considers a questionnaire aimed at reconstructing a certain deterministic picture of the world. The survey was conducted in secondary and higher educational institutions of St. Petersburg and Leningrad Region within the framework of the program of research and advanced training of teachers “Harmonization of inter-ethnic relations and prevention of extremist manifestations in the educational sphere and youth.” With the help of methods of discursive analysis, linguistic expertise, sociological and philosophical critical thinking, possible options of interpretation of both questions and answers of respondents, which follow logic and policy of survey, incorporating the proposed vision and patterns of behavior, are considered. The questionnaire implicitly reconstructs the picture of the world, limited by the concept of “nationalism.” It is shown that tolerance is possible as a consequence of understanding the subjectivity and differences of the migrant and the Other, Alien.

Exploratory Findings of Prescribing Unlicensed and Off-Label Medicines Among Children and Neonates.

ObjectiveA cross-sectional study was carried out to evaluate the practice of unlicensed and off-label drug prescribing/dispensing in children and neonates by physicians and clinical pharmacists in the metropolitan city of Karachi.MethodsThe study was conducted for the duration of 5 months – November 2018 to March 2019 – in different clinics and tertiary care hospitals of Karachi, Pakistan. Respondents were interviewed by our researchers using 30 items questionnaire. Descriptive statistics were used to evaluate the answers of respondents to survey items. Pearson correlation and independent sample t-test were employed to recognize the association between the responses of participants and independent variables. P values less than 0.05 were considered statistically significant.ResultsA total of 421 questionnaires were completed by physicians and clinical pharmacists. The mean age of the study participants was 49.5 years. Around 98% of pharmacists and 93.5% of physicians were well conversant with the definition of unlicensed and off-label drugs. Around 68% of physicians and 77% of pharmacists reported that they were more concerned about the efficacy of such drugs as compared to that of licensed medicines in children. The most frequent off-label categories observed in the study were dose (65.21%) and indication (17.52%). A vast majority (>80%) thought that approving new drugs by regulatory authorities will drop the occurrence of medication errors due to incorrect dosing. The British National Formulary (BNF) for children was used as the best reliable source of information among respondents.ConclusionThe present study highlighted the common practice of unlicensed and off-label drug prescribing in pediatrics; however, respondents showed their concern towards decreasing such practice and are likely to welcome initiatives intended to assure medication safety in children.

Assessing the Involvement of Users During Development of Lower Limb Wearable Robotic Exoskeletons: A Survey Study.

ObjectiveTo explore user-centered design methods currently implemented during development of lower limb wearable robots and how they are utilized during different stages of product development.BackgroundCurrently, there appears to be a lack of standardized frameworks for evaluation methods and design requirements to implement effective user-centered design for safe and effective clinical or ergonomic system application.MethodResponses from a total of 191 experts working in the field of lower limb exoskeletons were analyzed in this exploratory survey. Descriptive statistics were used to present responses and measures of frequency, and chi-square tests were used to contrast the answers of respondents who identified as clinicians versus engineers.ResultsA vast majority of respondents involve users in their development, in particular at the initial and iterative stages, although some differences were found between disciplines. A variety of methods and metrics are used to capture feedback from users and test devices, and although valuable, some methods used may not be based on validated measures. Guidelines regarding tests on safety of exoskeletons also lack standardization.ConclusionThere seems to be a consensus among experts regarding the importance of a user-centered approach in exoskeleton development; however, standardized frameworks with regard to appropriate testing methods and design approaches are lacking. Such frameworks should consider an interdisciplinary focus on the needs and safety of the intended user during each iteration of the process.ApplicationThis exploratory study provides an overview of current practice among engineers and clinicians regarding the user-centered design of exoskeletons. Limitations and recommendations for future directions are identified.

Accuracy and Reliability of the Visual Assessment of Patellar Tracking

Background: Abnormal patellar tracking is described as a “J-sign” when the patella exhibits excessive lateral displacement during active knee extension. Purpose: To determine (1) the accuracy and reliability of the visual assessment of patellar tracking when viewed by surgeons with patellofemoral expertise and (2) whether surgeon experience (in years) correlates with the ability to accurately identify the presence and severity of patellar maltracking. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: Using a web-based assessment, 32 orthopaedic surgeon members of the International Patellofemoral Study Group determined the presence or absence of maltracking (≥2 quadrants of lateral translation) in 10 single-knee videos of patients with patellar instability during active knee extension (qualitative analysis). Surgeons then graded patellar tracking in 20 single-knee videos as follows: 0 (<1 patellar quadrant of lateral translation), 1 (1 to <2 quadrants), 2 (2 to <3 quadrants), or 3 (≥3 quadrants) (quantitative analysis). Responses were compared with a previously described grading system using patellar bisect offset measured with 4-dimensional computed tomography. We evaluated the association between number of years of surgeon experience and the ability to correctly identify and grade patellar tracking. A total of 22 surgeons repeated the survey 3 months later, and their answers were matched to the first survey, allowing for assessment of intraobserver reliability. Results: In the qualitative analysis, surgeons correctly identified videos as showing patellar maltracking 68% of the time (κ = 0.45). In the quantitative analysis, 53%, 51%, 48%, and 68% of surgeons correctly identified maltracking of grades 3, 2, 1, and 0, respectively (κ = 0.42). Surgeon experience did not correlate with ability to identify the presence (P = .59) or grade (P = .35) of patellar maltracking. Respondent answers from the second survey demonstrated inadequate intraobserver reliability (κ = 0.48). Conclusion: Using visual assessment alone, surgeons correctly identified patellar maltracking in approximately two-thirds of videos and correctly graded patellar maltracking in half. Inter- and intraobserver reliability were inadequate to support the use of visual assessment alone for detecting the presence or grade of patellar maltracking. Surgeon experience did not correlate with ability to identify the presence or grade of patellar maltracking.