scholarly journals Free-Living User Perspectives on Musculoskeletal Pain and Patient-Reported Mobility With Passive and Powered Prosthetic Ankle-Foot Components: A Pragmatic, Exploratory Cross-Sectional Study

2022 ◽  
Vol 2 ◽  
Author(s):  
Andreas Kannenberg ◽  
Arri R. Morris ◽  
Karl D. Hibler
Keyword(s):  
Musculoskeletal Pain ◽  
Knee Pain ◽  
Online Survey ◽  
Rating Scales ◽  
Living Environment ◽  
Rank Test ◽  
Recall Bias ◽  
Free Living ◽  
The Past ◽  
Patient Reported

IntroductionStudies with a powered prosthetic ankle-foot (PwrAF) found a reduction in sound knee loading compared to passive feet. Therefore, the aim of the present study was to determine whether anecdotal reports on reduced musculoskeletal pain and improved patient-reported mobility were isolated occurrences or reflect a common experience in PwrAF users.MethodsTwo hundred and fifty individuals with transtibial amputation (TTA) who had been fitted a PwrAF in the past were invited to an online survey on average sound knee, amputated side knee, and low-back pain assessed with numerical pain rating scales (NPRS), the PROMIS Pain Interference scale, and the PLUS-M for patient-reported mobility in the free-living environment. Subjects rated their current foot and recalled the ratings for their previous foot. Recalled scores were adjusted for recall bias by clinically meaningful amounts following published recommendations. Statistical comparisons were performed using Wilcoxon's signed rank test.ResultsForty-six subjects, all male, with unilateral TTA provided data suitable for analysis. Eighteen individuals (39%) were current PwrAF users, whereas 28 subjects (61%) had reverted to a passive foot. After adjustment for recall bias, current PwrAF users reported significantly less sound knee pain than they recalled for use of a passive foot (−0.5 NPRS, p = 0.036). Current PwrAF users who recalled sound knee pain ≥4 NPRS with a passive foot reported significant and clinically meaningful improvements in sound knee pain (−2.5 NPRS, p = 0.038) and amputated side knee pain (−3 NPRS, p = 0.042). Current PwrAF users also reported significant and clinically meaningful improvements in patient-reported mobility (+4.6 points PLUS-M, p = 0.016). Individuals who had abandoned the PwrAF did not recall any differences between the feet.DiscussionCurrent PwrAF users reported significant and clinically meaningful improvements in patient-reported prosthetic mobility as well as sound knee and amputated side knee pain compared to recalled mobility and pain with passive feet used previously. However, a substantial proportion of individuals who had been fitted such a foot in the past did not recall improvements and had reverted to passive feet. The identification of individuals with unilateral TTA who are likely to benefit from a PwrAF remains a clinical challenge and requires further research.

scholarly journals EXCURSION FROM HOME AND ECOLOGICAL PAIN IN OLDER ADULTS WITH KNEE PAIN

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S524-S524
Author(s):  
Mamoun T Mardini ◽  
Parisa Rashidi ◽  
Subhash Nerella ◽  
Dottington Fullwood ◽  
Duane Corbett ◽  
...  
Keyword(s):  
Older Adults ◽  
Pain Intensity ◽  
Knee Pain ◽  
Geodesic Distance ◽  
Patient Reported Outcome ◽  
Living Environment ◽  
Life Space ◽  
Patient Reported ◽  
The Impact ◽  
Daily Pain

Abstract Background: Pain is an essential factor in limiting life-space mobility. Ecological momentary assessment (EMA) is crucial to understanding pain intensity and frequency. This study evaluated a customized smartwatch app for daily ecological pain reporting and GPS (Global Positioning System) coordinates collection to understand the impact of pain on daily excursion from home in older adults who report knee pain. Methods: Participants (n=14, 73.2 +/- 5.4 yrs, 64% female) wore a smartwatch with a customized app called Patient Reported Outcome of Mood, Pain, and fatigue (PROMPT) for 6.5 (4.0) days. Participants were prompted in their free-living environment about their pain intensity (range 0-10) in the morning, afternoon and evening. Additionally, GPS data were collected at 15 min intervals throughout the day. Geodesic distance was used to calculate the distance from the home address. Daily pain values were binned into high and low levels to compare to maximum daily excursions. Results: Individuals with average daily pain > 2 traveled 4.1 fewer miles than those individuals reporting pain 2 exceeded a distance of 5 miles compared to 17.9% of those individuals reporting pain <= 2 (X2=6.89, p < 0.05). Conclusion: In older adults, higher level of knee pain is associated with a decline in life-space mobility. Using custom designed smartwatch applications provides new opportunity to investigate how pain impacts community mobility.

Weiterentwicklung der «Waldpolitik 2020» aus Sicht der Schweizer Waldstakeholder

2016 ◽  
Vol 167 (4) ◽  
pp. 221-228 ◽  
Author(s):  
Astrid Zabel ◽  
Eva Lieberherr
Keyword(s):  
Policy Process ◽  
Online Survey ◽  
Development Process ◽  
Sustainable Forest Management ◽  
Forest Policy ◽  
Legislative Process ◽  
Expert Interviews ◽  
The Past ◽  
Conflicting Interests ◽  
Forest Act

Advancement of the Swiss Forest Policy 2020 from stakeholders' perspectives In light of the ending of the Swiss “ Forest Policy 2020”, this article assesses the goals, challenges and concerns of Swiss forest stakeholders in relation to forest policy post 2020. The data were collected through expert interviews and an online survey. The results show that securing an economically sustainable forest management and economically viable silvicultural businesses are key concerns for many stakeholders. Apart from these issues, several further and sometimes conflicting interests were mentioned. The study concludes that a debate on an adjustment of the weights given to goals in the Swiss Forest Policy 2020 may be commendable. However, there does not appear to be need for a complete change of course in order to address the stakeholders' needs and concerns. In terms of policy process, most stakeholders positively evaluated the past planning and development process of the Swiss Forest Policy 2020, but also provided suggestions for improvements. Finally, a network analysis revealed that the Swiss Federal Agency for the Environment, the Swiss Forest Owners Association and the Conference of Cantonal Foresters played a central role in the amendment of the Swiss Federal Forest Act. The analysis also showed that more stakeholders find each other as important than actually work together in a legislative process.

Brain-eating Amoebae Infection: Challenges and Opportunities in Chemotherapy

2019 ◽  
Vol 19 (12) ◽  
pp. 980-987 ◽  
Author(s):  
Mohammad Ridwane Mungroo ◽  
Ayaz Anwar ◽  
Naveed Ahmed Khan ◽  
Ruqaiyyah Siddiqui
Keyword(s):  
Mortality Rate ◽  
Free Living ◽  
Outdoor Activities ◽  
The Past ◽  
Free Living Amoeba ◽  
Challenges And Opportunities ◽  
Life Threatening ◽  
The Central Nervous System ◽  
Living Nature ◽  
Treatment And Diagnosis

Pathogenic free-living amoeba are known to cause a devastating infection of the central nervous system and are often referred to as “brain-eating amoebae”. The mortality rate of more than 90% and free-living nature of these amoebae is a cause for concern. It is distressing that the mortality rate has remained the same over the past few decades, highlighting the lack of interest by the pharmaceutical industry. With the threat of global warming and increased outdoor activities of public, there is a need for renewed interest in identifying potential anti-amoebic compounds for successful prognosis. Here, we discuss the available chemotherapeutic options and opportunities for potential strategies in the treatment and diagnosis of these life-threatening infections.

Australian Orthodontists Utilization and Attitude Toward a Government Funded Cleft Scheme

2021 ◽  
pp. 105566562198912
Author(s):  
Morgan Wishney ◽  
Aziz Sahu-Khan ◽  
Peter Petocz ◽  
M. Ali Darendeliler ◽  
Alexandra K. Papadopoulou
Keyword(s):  
Cleft Palate ◽  
Online Survey ◽  
Cleft Lip ◽  
Training Programs ◽  
Capital City ◽  
Australian Society ◽  
Capital Cities ◽  
The Past ◽  
Orthodontic Training ◽  
University Training

Objectives: To (1) survey Australian orthodontists about their involvement with a government-funded scheme for patients with clefts, the Medicare Cleft Lip and Cleft Palate Scheme (MCLCPS) and (2) investigate their attitude toward treating patients with clefts and their training in this respect. Design: A 13-question online survey was distributed to members of the Australian Society of Orthodontists. The survey gathered information regarding respondent demographics, the number of MCLCPS-eligible patients seen in the past 12 months and usual billing practices. Results: A total of 96 complete responses were obtained. About 70% of respondents had treated MCLCPS-eligible patients in the past 12 months and 55% saw between 2 and 5 patients during this time. The likelihood of treating patients with clefts increased by a factor of 4.8 (95% CI: 1.2-18.9) if practicing outside of a capital city and 1.5 times for each decade increase in orthodontist’s age (95% CI: 1.0-2.2). The MCLCPS was utilized by 81% of orthodontists with 26% of these respondents accepting rebate only. Most orthodontists felt their university training could have better prepared them to treat patients with clefts. A minority of orthodontists felt that a rebate increase would make them more likely to treat these patients. Conclusions: Australian orthodontists who treat patients with clefts tend to be older and work outside of capital cities. The decision to treat these patients tends to not be financially motived. Specialty orthodontic training programs could improve the preparedness of their graduates to treat patients with clefts.

scholarly journals Musculoskeletal Pain in Gymnasts: A Retrospective Analysis on a Cohort of Professional Athletes

2021 ◽  
Vol 18 (10) ◽  
pp. 5460
Author(s):  
Giacomo Farì ◽  
Francesco Fischetti ◽  
Alessandra Zonno ◽  
Francesco Marra ◽  
Alessia Maglie ◽  
...  
Keyword(s):  
Shoulder Pain ◽  
Musculoskeletal Pain ◽  
Online Survey ◽  
Left Knee ◽  
Wrist Pain ◽  
Professional Athletes ◽  
Sitting Position ◽  
Left Wrist ◽  
Sport Practice ◽  
Potential Risk Factors

Gymnastics athletes are exposed to a high risk of injury, but also of developing musculoskeletal pain. These data are still little investigated in the available scientific literature. An online survey was distributed to 79 professional athletes who practiced artistic and rhythmic gymnastics. The survey collected demographic and anthropometric data, information about the sport practice, the training sessions, the prevalence of musculoskeletal pain gymnastics-related, and lifestyle habits. Musculoskeletal pain had a high prevalence, involving 65 of 79 athletes (82.3%). A significant correlation was found between musculoskeletal pain and the duration of sports practice, both for general pain (p = 0.041) and for specific districts: right wrist pain (p = 0.031), left wrist pain (p = 0.028), right shoulder (p = 0.039), left hip (p = 0.031), right thigh (p = 0.031), and left knee (p = 0.005). Another statistical association was found between right wrist pain and BMI (p = 0.001), and hip pain and BMI (p = 0.030). Hours spent in a sitting position were also correlated with the incidence of pain (p = 0.045). Wrist pain and right shoulder pain had a statistically significant association with the age of the athletes (right wrist pain: p = 0.038; left wrist pain: p = 0.004; right shoulder pain: p = 0.035). The more the gymnasts practice this sport, the more likely they are to develop musculoskeletal pain. Increased age and a higher BMI, as well as daily prolonged sitting position, seem to be potential risk factors for the onset of musculoskeletal pain. Future studies could plan training strategies aimed at preventing musculoskeletal pain associated with gymnastics, in order to promote its further spread.

scholarly journals Significant increase in quantity and quality of knee arthroplasty related research in KSSTA over the past 15 years

2021 ◽  
Author(s):  
Stephanie Kirschbaum ◽  
Thilo Kakzhad ◽  
Fabian Granrath ◽  
Andrzej Jasina ◽  
Jakub Oronowicz ◽  
...  
Keyword(s):  
Knee Arthroplasty ◽  
Special Topic ◽  
Computer Assisted ◽  
Time Interval ◽  
Search Term ◽  
Level Of Evidence ◽  
The Past ◽  
Patient Reported ◽  
Over Time ◽  
Number Of Authors

Abstract Purpose This study aimed to evaluate both publication and authorship characteristics in Knee Surgery, Sports Traumatology, Arthroscopy journal (KSSTA) regarding knee arthroplasty over the past 15 years. Methods PubMed was searched for articles published in KSSTA between January 1, 2006, and December 31st, 2020, utilising the search term ‘knee arthroplasty’. 1288 articles met the inclusion criteria. The articles were evaluated using the following criteria: type of article, type of study, main topic and special topic, use of patient-reported outcome scores, number of references and citations, level of evidence (LOE), number of authors, gender of the first author and continent of origin. Three time intervals were compared: 2006–2010, 2011–2015 and 2016–2020. Results Between 2016 and 2020, publications peaked at 670 articles (52%) compared with 465 (36%) published between 2011 and 2016 and 153 articles (12%) between 2006 and 2010. While percentage of reviews (2006–2010: 0% vs. 2011–2015: 5% vs. 2016–2020: 5%) and meta-analyses (1% vs. 6% vs. 5%) increased, fewer case reports were published (13% vs. 3% vs. 1%) (p < 0.001). Interest in navigation and computer-assisted surgery decreased, whereas interest in perioperative management, robotic and individualized surgery increased over time (p < 0.001). There was an increasing number of references [26 (2–73) vs. 30 (2–158) vs. 31 (1–143), p < 0.001] while number of citations decreased [30 (0–188) vs. 22 (0–264) vs. 6 (0–106), p < 0.001]. LOE showed no significant changes (p = 0.439). The number of authors increased between each time interval (p < 0.001), while the percentage of female authors was comparable between first and last interval (p = 0.252). Europe published significantly fewer articles over time (56% vs. 47% vs. 52%), whereas the number of articles from Asia increased (35% vs. 45% vs. 37%, p = 0.005). Conclusion Increasing interest in the field of knee arthroplasty-related surgery arose within the last 15 years in KSSTA. The investigated topics showed a significant trend towards the latest techniques at each time interval. With rising number of authors, the part of female first authors also increased—but not significantly. Furthermore, publishing characteristics showed an increasing number of publications from Asia and a slightly decreasing number in Europe. Level of evidence IV.

scholarly journals Evaluating Metrics Applied to the Medical Science Liaison (MSL) Role: A Survey-Based Study of Canadian MSL Leaders

2021 ◽  
Author(s):  
Munaza Saleem ◽  
Lisa Cesario ◽  
Lisa Wilcox ◽  
Marsha Haynes ◽  
Simon Collin ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Professional ◽  
Online Survey ◽  
Medical Science ◽  
Specialty Care ◽  
Product Lifecycle ◽  
The Past ◽  
Data Analyses ◽  
Quantitative Metrics ◽  
Frequency Of Use

Abstract Introduction Metrics utilized within the Medical Science Liaison (MSL) role are plentiful and traditionally quantitative. We sought to understand the current use and value of metrics applied to the MSL role, including the use of qualitative metrics. Methods We developed a list of 70 MSL leaders working in Canada, spanning 29 companies. Invitations were emailed Jun 16, 2020 and the 25-question online survey was open for 3 weeks. Questions were designed to assess demographics as well as how and why metrics are applied to the MSL role. Data analyses were descriptive. Results Responses were received from 44 leaders (63%). Of the 42 eligible, 45% had ≤ 2 years of experience as MSL leaders and 86% supported specialty care products over many phases of the product lifecycle. A majority (69%) agreed or strongly agreed that metrics are critical to understanding whether an MSL is delivering value, and 98% had used metrics in the past year. The most common reason to use metrics was ‘to show value/impact of MSLs to leadership’ (66%). The most frequently used metric was ‘number of health-care professional (HCP) interactions’, despite this being seen as having moderate value. Quantitative metrics were used more often than qualitative, although qualitative were more often highly valued. Conclusion The data collected show a lack of agreement between the frequency of use for some metrics and their value in demonstrating the contribution of an MSL. Overall, MSL leaders in our study felt qualitative metrics were a better means of showing the true impact of MSLs.

scholarly journals B.05 Hemi-laryngopharyngeal spasm (HELPS) syndrome: The discovery, cure, and characterization of a new neurological condition

2017 ◽  
Vol 44 (S2) ◽  
pp. S11-S11
Author(s):  
C Honey ◽  
M Morrison
Keyword(s):  
Surgical Care ◽  
Review Of The Literature ◽  
The Past ◽  
First Case ◽  
Patient Reported ◽  
Operative Outcome ◽  
Small Cohort ◽  
The Common ◽  
Similar Motor

Background: We published the world’s first case of hemi-laryngpharyngeal spasm (HELPS) syndrome cured by microvascular decompression (MVD) of the Xth cranial nerve in 2016. We now present a small cohort of patients (n=3) successfully treated with surgery in order to better delineate the common characteristics of this syndrome, diagnostic tests of choice, nuances of their surgical care and outcomes of their treatment. Methods: The history and physical examination of three patients with HELPS syndrome are presented. Pre-operative laryngoscopy, neuroimaging, response to botox and intra-operative videos are detailed. Post-operative outcome and complications are presented. Results: Each patient reported similar motor (choking) and sensory (coughing) features in their history. Episodic choking relentlessly progressed over the years until it occurred while sleeping and with frightening severity prompting tracheostomy in one patient and intubation in another. A “tickling” sensation deep in the throat triggered episodic coughing that worsened over the years until it occurred while sleeping and with frightening severity (syncope and incontinence). Conclusions: A review of the literature suggests that patients with similar symptoms, often called episodic laryngospasm in the past, have been treated with psychotherapy or antacids. With the recognition that a clearly defined subset of these patients have HELPS syndrome, we can offer them the potential of a neurosurgical cure.

Do Lumbar Decompression and Fusion Patients Recall Their Preoperative Status? A Cohort Study of Recall Bias in Patient-Reported Outcomes

2016 ◽  
Vol 16 (10) ◽  
pp. S370 ◽  
Author(s):  
Ilyas Aleem ◽  
Jonathan S. Duncan ◽  
Amin Mohamed Ahmed ◽  
Mohammad Zarrabian ◽  
Jason C. Eck ◽  
...  
Keyword(s):  
Cohort Study ◽  
Patient Reported Outcomes ◽  
Recall Bias ◽  
Lumbar Decompression ◽  
Patient Reported ◽  
Preoperative Status

Towards Early Detection and Burden Estimation of Atrial Fibrillation in an Ambulatory Free-living Environment

2021 ◽  
Vol 5 (2) ◽  
pp. 1-19
Author(s):  
Hanbin Zhang ◽  
Li Zhu ◽  
Viswam Nathan ◽  
Jilong Kuang ◽  
Jacob Kim ◽  
...  
Keyword(s):  
Neural Network ◽  
Atrial Fibrillation ◽  
Early Detection ◽  
Daily Living ◽  
Research Study ◽  
Heart Rhythm ◽  
Living Environment ◽  
User Engagement ◽  
Free Living ◽  
Time Frequency

Early detection and accurate burden estimation of atrial fibrillation (AFib) can provide the foundation for effective physician treatment. New approaches to accomplish this have attracted tremendous attention in recent years. In this paper, we develop a novel passive smartwatch-based system to detect AFib episodes and estimate the AFib burden in an ambulatory free-living environment without user engagement. Our system leverages a built-in PPG sensor to collect heart rhythm without user engagement. Then, a data preprocessor module includes time-frequency (TF) analysis to augment features in both the time and frequency domain. Finally, a lightweight multi-view convolutional neural network consisting of 19 layers achieves the AFib detection. To validate our system, we carry out a research study that enrolls 53 participants across three months, where we collect and annotate more than 27,622 hours of data. Our system achieves an average of 91.6% accuracy, 93.0% specificity, and 90.8% sensitivity without dropping any data. Moreover, our system takes 0.51 million parameters and costs 5.18 ms per inference. These results reveal that our proposed system can provide a clinical assessment of AFib in daily living.

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