Screening for Malingering Using the Standard Assessment of Concussion

This study aims to investigate noninvasive indices of neuromechanical coupling (NMC) and mechanical efficiency (MEff) of parasternal intercostal muscles. Gold standard assessment of diaphragm NMC requires using invasive techniques, limiting the utility of this procedure. Noninvasive NMC indices of parasternal intercostal muscles can be calculated using surface mechanomyography (sMMGpara) and electromyography (sEMGpara). However, the use of sMMGpara as an inspiratory muscle mechanical output measure, and the relationships between sMMGpara, sEMGpara, and simultaneous invasive and noninvasive pressure measurements have not previously been evaluated. sEMGpara, sMMGpara, and both invasive and noninvasive measurements of pressures were recorded in twelve healthy subjects during an inspiratory loading protocol. The ratios of sMMGpara to sEMGpara, which provided muscle-specific noninvasive NMC indices of parasternal intercostal muscles, showed nonsignificant changes with increasing load, since the relationships between sMMGpara and sEMGpara were linear (R2 = 0.85 (0.75–0.9)). The ratios of mouth pressure (Pmo) to sEMGpara and sMMGpara were also proposed as noninvasive indices of parasternal intercostal muscle NMC and MEff, respectively. These indices, similar to the analogous indices calculated using invasive transdiaphragmatic and esophageal pressures, showed nonsignificant changes during threshold loading, since the relationships between Pmo and both sEMGpara (R2 = 0.84 (0.77–0.93)) and sMMGpara (R2 = 0.89 (0.85–0.91)) were linear. The proposed noninvasive NMC and MEff indices of parasternal intercostal muscles may be of potential clinical value, particularly for the regular assessment of patients with disordered respiratory mechanics using noninvasive wearable and wireless devices.

Download Full-text

How to measure fluctuating impairments in people with MS: development of an ambulatory assessment version of the EQ-5D-5L in an exploratory study

Quality of Life Research ◽

10.1007/s11136-021-02802-8 ◽

2021 ◽

Author(s):

Christine Blome ◽

Jill Carlton ◽

Christoph Heesen ◽

Mathieu F. Janssen ◽

Andrew Lloyd ◽

...

Keyword(s):

Exploratory Study ◽

Iterative Process ◽

Face Validity ◽

Ambulatory Assessment ◽

Standard Assessment ◽

Before And After ◽

Standard Paper ◽

Subsequent Wave ◽

Patients Perspective ◽

Time Point

Abstract Background Health fluctuations even within a single day are typical in multiple sclerosis (MS), but are not captured by widely used questionnaires like the EQ-5D-5L. This exploratory study aimed to develop an ambulatory assessment (AA) version of the EQ-5D-5L (EQ-5D-AA) where patients rate their health on mobile phones multiple times per day over several days, and to assess its feasibility and face validity. Methods An initial EQ-5D-AA version was based on two patient focus groups. It was then tested and continuously developed in an iterative process: patients completed it over several days, followed by debriefing interviews. Findings were used to refine the EQ-5D-AA, with the resulting version being tested by the subsequent wave of patients until participants declared no need for changes anymore. Before and after the AA period, participants completed the standard paper-based EQ-5D-5L asking about ‘today’. Results Focus group participants reported that their impairments often fluctuated between and within days. They regarded an AA with three assessments per day over seven days most appropriate; assessment should be retrospective to the previous assessment, but not all items should be assessed at each time point. Four waves of AA testing were conducted. Thirteen out of the 17 participants preferred the AA over standard assessment as they regarded it more informative, but not too burdensome. Conclusion The newly developed one-week AA of the EQ-5D-5L captures within-day and day-to-day health fluctuations in people with MS. From the patients’ perspective, it is a feasible and face valid way to provide important information beyond what is captured by the standard EQ-5D-5L.

Download Full-text

POS1274 THERAPEUTIC MANAGEMENT OF RHEUMATOLOGISTS VERSUS OTORHINOLARYNGOLOGISTS OF CERVICOGENIC DIZZINESS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.2230 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 921.2-922

Author(s):

M. Yasmine ◽

K. Maatallah ◽

H. Ferjani ◽

W. Triki ◽

D. Ben Nsib ◽

...

Keyword(s):

Physical Therapy ◽

Treatment Approach ◽

Cross Sectional Study ◽

Treatment Modalities ◽

Sectional Study ◽

Cross Sectional ◽

Standard Assessment ◽

Number Of Patients ◽

Cervicogenic Dizziness ◽

No Gold Standard

Background:The treatment of patients presenting with cervicogenic dizziness (CGD) may be challenging. Indeed, there is no consensual treatment approach for CGD, nor is there no gold-standard assessment for diagnosis.Objectives:Our study aimed to assess the management of CGD by rheumatologists versus otorhinolaryngologists.Methods:We conducted a cross-sectional study including Tunisian doctors dealing with CGD. Rheumatologists (RTO) and otorhinolaryngologists (ORL) were invited to answer a questionnaire via google form about CGD daily management. Outcomes of interest were treatment modalities.Results:The study included 30 RTO and 32 ORL. Most of the doctors (RTO, vs ORL) were females (88.3%, vs 56.3%), aged between 35 and 45 (43.3%, vs 62.5%), and worked at a private practice (33.3%, vs 59.4%). The number of patients diagnosed with CGD by RTO was as follows: 1-2 per year (33.3%), 1-2 per month (18.8%), 1-2 per week (20%), less than one patient a year (10%) and none in 3.3% of cases. The number of patients diagnosed with CGD by ORL was as follows: 1-2 per year (50%), 1-2 per month (33.3%), 1-2 per week (6.2%), less than one patient a year (15.7%) and none (9.4%). Most patients presenting with CGD were females in both groups (93.1%, vs 82.8% respectively) with a mean age between 36 and 65 (79.3%, vs 82.1%). Most of the respondents declared treating patients with CGD (93.1%, vs 79.1%). Regarding treatment modalities, physical therapy was the most prescribed in both specialties (81.5% and 48.3%, respectively). Only RTO (18.5%) prescribed manual therapy. Concerning medical treatment, anti-inflammatory were the most prescribed drugs in both groups (92.6, and 34.5%, respectively). Sixty-seven percent of RTO prescribed anti-vertigo medication. Interestingly, it was the least prescribed drug by ORL (6.9%). Only RTO (59.3%) prescribed Muscle relaxants.Conclusion:Despite the disparities in the management of CGD, physical therapy remains the first prescribed treatment by Tunisian doctors. Further studies are needed to establish a consensus to treat CGD.Disclosure of Interests:None declared

Download Full-text

Stress and anxiety surrounding forthcoming Standard Assessment Tests in English schoolchildren

Pastoral Care in Education ◽

10.1080/02643944.2012.688063 ◽

2012 ◽

Vol 30 (4) ◽

pp. 289-302 ◽

Cited By ~ 15

Author(s):

Dave W. Putwain ◽

Liz Connors ◽

Kevin Woods ◽

Laura J. Nicholson

Keyword(s):

Assessment Tests ◽

Standard Assessment

Download Full-text

Psychological distress and streamlined BreastScreen follow‐up assessment versus standard assessment

The Medical Journal of Australia ◽

10.5694/mja13.10112 ◽

2013 ◽

Vol 199 (9) ◽

pp. 599-603 ◽

Cited By ~ 2

Author(s):

Kerry A Sherman ◽

Caleb J Winch ◽

Natacha Borecky ◽

John Boyages

Keyword(s):

Psychological Distress ◽

Standard Assessment

Download Full-text

Does predation by grey seals (Halichoerus grypus) affect Bothnian Sea herring stock estimates?

ICES Journal of Marine Science ◽

10.1093/icesjms/fss099 ◽

2012 ◽

Vol 69 (8) ◽

pp. 1448-1456 ◽

Cited By ~ 14

Author(s):

Anna Gårdmark ◽

Örjan Östman ◽

Anders Nielsen ◽

Karl Lundström ◽

Olle Karlsson ◽

...

Keyword(s):

Marine Mammals ◽

Halichoerus Grypus ◽

Grey Seal ◽

Older Individuals ◽

Standard Assessment ◽

Abundance Estimates ◽

Stock Biomass ◽

Key Species ◽

Spawning Stock ◽

Bothnian Sea

Abstract Gårdmark, A., Östman, Ö., Nielsen, A., Lundström K., Karlsson O., Pönni, J., and Aho, T. 2012. Does predation by grey seals (Halichoerus grypus) affect Bothnian Sea herring stock estimates? – ICES Journal of Marine Science, 69: . Mortality of small pelagic fish due to marine mammals is generally considered to be low compared with other sources of mortality. With recent recoveries of marine mammal predators worldwide, this may no longer hold. The grey seal (Halichoerus grypus) population in the Bothnian Sea has increased fivefold since 1985. Its main prey, herring (Clupea harrengus), is a key species for fisheries in the region. Yet, current stock assessments assume constant natural mortality, leading to a risk of biased stock estimates with increasing predation and misleading analyses of herring population dynamics. We estimated grey seal predation from diet data and reanalysed herring spawning stock biomass (SSB) during 1973–2009. Accounting for predation increased the herring SSB 16% (maximum 19%), but this was within the confidence intervals when ignoring predation. Although mortality in older individuals was inflated when accounting for seal predation, this did not change the conclusions about drivers of herring dynamics. Accounting for grey seal predation is important for abundance estimates of old herring, but currently not for SSB estimates, given the great uncertainties in the standard assessment. The grey seal impact on Bothnian Sea herring will need to be reassessed if stock age composition, grey seal feeding preferences, or total stock development change.

Download Full-text

Physico-chemical quality of drinking water in the Njoro sub-county in Kenya

Journal of Water Sanitation and Hygiene for Development ◽

10.2166/washdev.2018.001 ◽

2018 ◽

Vol 8 (3) ◽

pp. 497-507

Author(s):

Philip Ruciaka Kirianki ◽

Edward Muchiri ◽

Natasha Potgieter

Keyword(s):

Drinking Water ◽

Water Samples ◽

Water Source ◽

World Health ◽

Water Shortages ◽

Storage Container ◽

Standard Assessment ◽

Physico Chemical ◽

Study Support ◽

Health Organization

Abstract Njoro sub-county in Kenya suffers from constant water shortages causing the residents to rely on both improved and unimproved water sources in the area. The households in the sub-county also use different household storage containers to store drinking water in times when water is not readily available. This study was therefore undertaken to assess selective physico-chemical parameters of water used by the population for drinking purposes using standard assessment methods. A total of 372 water source samples and 162 storage container water samples were tested over a period of three months. Turbidity (0.70–273.85 NTU), iron (0.7–2.10 mg/L), fluoride (0.15–4.01 mg/L), manganese (0.01–0.37 mg/L), and nitrate (0.09–27.90 mg/L) levels in water samples were generally higher than the Kenya Bureau of Standards (KEBS) and/or the World Health Organization (WHO) water quality recommendations for safe drinkable water. The results from this study support the need for continuous monitoring and treating drinking water at the points of collection and of consumption to minimize the long-term health effects on communities consuming this water.

Download Full-text

Osteoporosis - a risk factor for cardiovascular diseases: A follow-up study

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh1502028t ◽

2015 ◽

Vol 143 (1-2) ◽

pp. 28-34 ◽

Cited By ~ 2

Author(s):

Ivan Tasic ◽

Marina Rasic-Popovic ◽

Sonja Stojanovic ◽

Bojana Stamenkovic ◽

Svetlana Kostic ◽

...

Keyword(s):

Bone Density ◽

Postmenopausal Women ◽

Bone Fractures ◽

Multivariate Logistic Regression Analysis ◽

The Elderly ◽

Group Iii ◽

Normal Bone ◽

Group I ◽

Standard Assessment

Introduction. Cardiovascular (CV) diseases and bone fractures due to osteoporosis are the leading causes of death in the elderly. Objective. The aim of this study was to demonstrate a correlation between the overall risk for CV events, and low bone density in postmenopausal women, and its impact on the incidence of serious CV events. Methods. Our prospective study involved 300 postmenopausal women. All the examinees were divided into three groups based on their measured bone density: Group I - 84 examinees with osteoporosis; Group II - 115 examinees with osteopenia; and Group III - 101 examinees with normal bone density. In all examinees the overall ten-year risk for a fatal CV event was calculated using the SCORE system tables. Results. After a 36-month follow-up, CV events occurred in 19 (6.3%) examinees. Significant differences in the incidence of CV events were demonstrated between the patients with osteoporosis, osteopenia, and normal bone density (?2=28.7; p<0.001), as well as between those with a high and low CV risk (?2=22.6; p<0.001). Multivariate logistic regression analysis showed that smoking (OR: 2.23; 95% CI: 1.02 to 6.19; p=0.035), and increase of overall CV score (OR: 1.36; 95% CI: 1.17 to 1.58; p<0.001) are associated with increased CV event risk, while the increase of T score value is associated with decreased risk of CV event (OR: 0.42; 95% CI: 0.25 to 0.73; p=0.002). Conclusion. Measurement of bone density with a standard assessment of the total CV risk could be useful for selecting women who need intensive prevention and treatment of atherosclerosis.

Download Full-text