Acoustic characterization of Thiel liver for magnetic resonance-guided focused ultrasound treatment

Background: The purpose of this work was to measure the essential acoustic parameters, i.e., acoustic impedance, reflection coefficient, attenuation coefficient, of Thiel embalmed human and animal liver. The Thiel embalmed tissue can be a promising, pre-clinical model to study liver treatment with Magnetic Resonance-guided Focused Ultrasound (MRgFUS).

Material and methods: Using a single-element transducer and the contact pulse-echo method, the acoustic parameters, i.e., acoustic impedance, reflection coefficient and attenuation coefficient of Thiel embalmed human and animal liver were measured.

Results: The Thiel embalmed livers had higher impedance, similar reflection and lower attenuation compared to the fresh tissue.

Conclusions: Embalming liver with Thiel fluid affects its acoustic properties. During MRgFUS sonication of a Thiel organ, more focused ultrasound (FUS) will be backscattered by the organ, and higher acoustic powers are required to reach coagulation levels (temperatures >56?°C).     

Long-lasting improvements in health-related quality of life among women with chronic pain,following multidisciplinary rehabilitation

Purpose: To determine whether observed health-related quality-of-life improvements after four-week traditional multidisciplinary pain management program and additional neuroscience education and mindfulness-based cognitive therapy for chronic pain are sustained at six-month follow-up.

Method: This observational longitudinal follow-up study, with complete follow-up of 75 women, 61.5% of initial traditional approach group (treated 2001–2005) and 56 (62.2%) receiving the new approach (treated 2006–2009). Pain intensity and quality of life were measured at baseline and six months after interventions. Analysis of variance (ANOVA) and paired samples t-tests were used for statistical analysis.

Results: Both groups showed sustained improvements in pain intensity (traditional approach?=??10.6 [p?<?0.001]; new approach?=??14.5 [p?p?p?p?=?0.066]), whereas all other domains among both groups were sustained. Significant decline was observed from discharge to six month among both groups with the exception of the sleep domain among the traditional approach group, pain intensity among the new approach and financial status among both groups. No baseline differences were revealed between responders and nonresponders.

Conclusions: Multidisciplinary interventions for women with chronic pain conditions improved quality of life and pain intensity with lasting improvements observed half a year after treatment completion.

• Implications for rehabilitation

• Intensive multidisciplinary biopsychosocial rehabilitation is essential for chronic pain conditions.

• This follow-up study shows sustained improvement in health-related quality of life and pain intensity six months after such rehabilitation was completed.

• Emphasizing mindfulness-based cognitive therapy and neuroscience patient education may contribute to less decline in pain intensity from discharge to six-month follow-up compared with a more traditional approach.

     

Muscle power is an important measure to detect deficits in muscle function in hip osteoarthritis: a cross-sectional study

Purpose: To investigate between-leg differences in hip and thigh muscle strength and leg extensor power in patients with unilateral hip osteoarthritis. Further, to compare between-leg differences in knee extensor strength and leg extensor power between patients and healthy peers.

Methods: Seventy-two patients (60–87 years) with radiographic and symptomatic hip osteoarthritis not awaiting hip replacement and 35 healthy peers (63–82 years) were included. Hip and thigh muscle strength and leg extensor power were measured in patients and knee extensor strength and leg extensor power in healthy.

Results: The symptomatic extremity in patients was significantly (p?t-test) weaker compared with the non-symptomatic extremity for five hip muscles (8–17%), knee extensors (11%) and leg extensor power (19%). Healthy older adults had asymmetry in knee extensor strength (6%, p?Conclusions: Patients had generalized weakening of the affected lower extremity and numerically the largest asymmetry was evident for leg extensor power. In contrast, healthy peers had no asymmetry in leg extensor power. These results indicate that exercise interventions focusing on improving leg extensor power of the symptomatic lower extremity and reducing asymmetry may be beneficial for patients with hip osteoarthritis.

• Implications for Rehabilitation

• Even in patients with mild symptoms not awaiting hip replacement a generalized muscle weakening of the symptomatic lower extremity seems to be present.

• Between-leg differences in leg extensor power (force?×?velocity) appears to be relatively large (19%) in patients with unilateral hip osteoarthritis in contrast to healthy peers who show no asymmetry.

• Compared to muscle strength the relationship between functional performance and leg extensor power seems to be stronger, and more strongly related to power of the symptomatic lower extremity.

• Our results indicate that exercise interventions focusing on improving leg extensor power of the symptomatic lower extremity and reducing asymmetry may be beneficial for patients with mild symptoms not awaiting hip replacement.

     

Determining metabolic equivalent values of physical activities for persons with paraplegia

Purpose.?The compendium of physical activity (CPA) may not be appropriate for persons with paraplegia (PP) because of their possible low resting metabolic rate (RMR), or 1 MET, and a lack of physical activities (PAs) engaged by PP in the CPA. A CPA supplement, therefore, is needed. The purpose of this study was to examine the feasibility of constructing a short supplement for PP with two specific aims: to determine whether PP need an alternative 1-MET value and if selected PA can be classified into corresponding categories based on their ‘engagement’ and ‘energy expenditure (EE)’ characteristics.

Method.?Thirty-one PP (161.26?cm?±?22.99?cm, 60.52?kg?±?15.32?kg, and 24.16?±?6.25 years) were recruited. RMR and 10 PA with different intensities were measured using indirect calorimetry. The z- and t-tests were employed to examine MET difference between the measured values and those of CPA (α?=?0.05).

Results.?One-MET for PP (3.1?mL/kg/min) was lower than that of the CPA (3.5?mL/kg/min). Although some MET values were found to be similar to those in the CPA, others were statistically significantly different.

Conclusions.?To be able to measure PA-related EE of a disability subpopulation using the CPA accurately, a supplement that accounts for the impact of different types of activities and the EE characteristics of the subpopulation must be developed.     

Measurement properties of the WheelCon for powered wheelchair users

Purpose: To evaluate the measurement properties of the Wheelchair Use Confidence Scale for power wheelchair users (WheelCon-P).

Design: One-month test–retest design, using data from a longitudinal study of power wheelchair use.

Participants: Volunteer sample of 73 community dwelling, older adult experienced power wheelchair users who had a mean age of 60.5?±?7.1 years.

Methods: Participants completed the WheelCon-P twice to assess retest reliability. Concurrent validity was assessed by evaluating hypothesized relationships between the WheelCon-P and relevant variables.

Results: The baseline mean (standard deviation) WheelCon-P score was 78.8?±?14.5. Cronbach’s α was 0.92. The one-month test–retest intraclass correlation coefficient was 0.85 (CI 0.77–0.90). Correlations ranging from r?=?0.26 (social support) to r?=?0.49 (wheelchair skills) were found between the WheelCon-P and the validation outcome measures.

Conclusion: The WheelCon-P has high internal consistency, strong retest reliability and evidence supporting its validity. Although further work is needed, the WheelCon-P may serve as a useful clinical and research tool for measuring power wheelchair confidence.

• Implications for rehabilitation

• The WheelCon-P is a reliable and valid outcome measure for assessing wheelchair confidence.

• This tool can be used to identify individuals with low power wheelchair confidence who require a confidence-enhancing intervention.

     

Heterosexual women rate perceived anabolic steroid-using men as less attractive for long-term romantic relationships

ABSTRACT

Background: Physical attractiveness is a major motive for anabolic-androgenic steroid (AAS) use. Since majority of AAS users are men, we investigated heterosexual women’s ratings of the physical, sexual and romantic attractiveness of AAS-using and non-using men.

Methods: A sample of 112 AAS-non-using heterosexual women (age range: 15–81, M = 29.61 years) was randomized to two independent conditions: food (n = 50) and AAS (n = 62). After exposure to a vignette (varied in AAS use or food consumption) and the target image of a moderately muscular man (same across conditions), participants in both conditions rated their respective target on physical, short-term sexual, and long-term romantic attractiveness. We compared ratings of the two targets using an independent t-test.

Results: Compared to the non-using target, the AAS-using target received lower ratings (t = ?2.61, p < .05, Cohen’s d = 0.50) on long-term romantic attractiveness.

Conclusion: Heterosexual women rate perceived AAS-using men as less attractive for long-term romantic relationships. Preventive and harm reduction interventions may benefit from highlighting this finding.     

Feasibility study of pre-clinical Thiel embalmed human cadaver for MR-guided focused ultrasound of the spine

Background Magnetic Resonance-guided Focused Ultrasound Surgery (MRgFUS) is a non-invasive treatment option based on high acoustic absorption and minimal thermal conductivity of the bone to destroy nerves and reduce pain. There is lack of a preclinical validation tool with correct human anatomy. This work introduces usage of an ex-vivo Thiel embalmed human tissue model for preclinical verification of MRgFUS on intervertebral discs or bone metastases within the spinal body. Material and methods Thiel embalmed human cadaver was subjected to FUS sonication of the vertebra (with energies 250J, 420J, 600J) and the intervertebral disc (with energies 310J, 610J, 950J) of the lumbar spine for 20s of sonication under MR guidance. Results For the vertebra, maximum temperatures were recorded as 38?°C, 58.3?°C, 69?°C. The intervertebral disc reached maximum temperatures of 23.7?°C, 54?°C, 83?°C. The temperature measurements showed that the spinal canal and adjacent organs were not heated > 0.1?°C. Conclusions A heating pattern that can induce thermal ablation was achieved in the vertebral body and the intervertebral disc. Adjacent structures and nerves were not heated in lethal levels. Thus, the Thiel embalmed human cadaver can be a safe and efficient model for preclinical study of application of MRgFUS on the upper lumbar spine.     

Investigating the Effects of an Otago-Based Program among Individuals Living with Dementia

Abstract

Aim: To examine the impact of an Otago-based exercise program (OEP) on physical function in patients living with mild cognitive impairment (MCI) or dementia receiving home heath physical therapy.

Methods: 34 patients (mean age 88.3?years; 62% female; mean Mini-Cog 1.76) completed the following assessments: Four-Stage Balance test, Timed Up & Go, 30-Second Chair Stand test, and Tinetti Gait and Balance. Assessments were completed at baseline and an average of 4.79 (2.29) visits later, with a mean of 1.74 (0.79) months between assessments. The OEP-based exercises were individually tailored and progressed based on performance as recommended by the program protocol.

Results: A paired samples t-test revealed significant differences in scores for the Four-Stage Balance Test (p?<?0.001), the Timed Up & Go (p?=?0.002), and the Tinetti Gait and Balance (p?=?0.002).

Conclusion: The OEP can potentially be used for individuals living with cognitive impairments to improve performance outcomes such as balance and functional mobility.     

“Strong and steady”: a community-based strength and balance exercise group for children with cerebral palsy

Abstract

Purpose: This study investigated the effect of an eight-week community-based strength and balance exercise group for children with cerebral palsy (CP). Method: Ten children with CP participated in the study (8–15 years; six male; GMFCS I?=?6, II?=?4; five diplegia; five hemiplegia). Muscle strength was assessed using dynamometry and functional strength tests (seated throw, distance jump, vertical jump). Balance was assessed using the Bruninks–Oseretsky Test of Motor Proficiency, the Movement Assessment Battery for Children (MABC), lateral and forward reach tests and the Timed-up and Go. Results: Muscle strength improved in dominant side elbow flexors, hip abductors, ankle dorsiflexors and ankle plantarflexors (p?=?0.018–0.042). Functional strength improved in seated throw (t?=?2.7; p?=?0.024), distance jump (t?= ?2.8; p?=?0.025) and lateral step-up (p?<?0.05). Balance improved on the MABC (t?=?2.4; p?=?0.040), lateral (p?<?0.05) and forward reach (p?<?0.05). Conclusion: This feasibility study translated research into sustainable practice, showing that a community-based, low dose, group exercise program can improve the balance and strength of children with CP within current funding capacity.

• Implications for Rehabilitation

• It has been known that strength and balance training in the clinical research setting with specialized equipment is effective for children with CP, but this study demonstrates the translation of research into clinical practice in a low-cost, low-dose group program.

• Significant gains in both muscle strength and balance can be achieved in an eight-week community-based gym group using simple equipment.

     

Differences in outcomes between the JoyBar control and standard wheelchair joystick control on two maneuverability tasks: a pilot study

Purpose: To determine if older adult, novice wheelchair users who drive a power wheelchair with a JoyBar control complete maneuverability tasks in less time and with less error than those who drive a power wheelchair with a standard joystick control.

Materials and methods: A parallel randomized controlled trial design conducted at a medical rehabilitation and research centre with ambulatory older adults aged 60 and above (n?=?27). The intervention was the JoyBar alternative wheelchair control. The primary outcome measure was total time to complete each of the two maneuverability tasks. The secondary outcome measure was total number of errors during each of the maneuverability tasks.

Results: An independent, two sampled t-test was conducted and revealed that the JoyBar group took a greater amount of time to complete both maneuverability tasks than the control group (p?p?Conclusions: Maneuverability of a powered wheelchair by novice wheelchair users was not improved through the use of the JoyBar when compared to a standard wheelchair joystick, as measured by rates of error and time to complete maneuverability tasks.

• Implications for rehabilitation

• Clients who are new to powered wheelchair use may perform maneuverability tasks faster, with equivalent accuracy, using a standard joystick versus the JoyBar.

• Clients who use a JoyBar may require adjustments to the programming of their wheelchair to ensure optimal performance.

• Additional training may be required to achieve proficiency in maneuverability tasks with a JoyBar versus a standard joystick.

     

Emergency management of chlorine gas exposure – a systematic review

Introduction: Chlorine exposure can lead to pulmonary obstruction, reactive airway dysfunction syndrome, acute respiratory distress syndrome and, rarely, death.

Objective: We performed a systematic review of published animal and human data regarding the management of chlorine exposure.

Methods: Three databases were searched from 2007 to 2017 using the following keywords “(“chlorine gas” OR “chlorine-induced” OR” chlorine-exposed”) AND (“therapy” OR “treatment” OR “post-exposure”)”. Forty-five relevant papers were found: 22 animal studies, 6 reviews, 19 case reports and 1 human randomized controlled study.

General management: Once the casualty has been removed from the source of exposure and adequately decontaminated, chlorine-exposed patients should receive supportive care.

Humidified oxygen: If dyspnea and hypoxemia are present, humidified oxygen should be administered.

Inhaled bronchodilators: The use of nebulized or inhaled bronchodilators to counteract bronchoconstriction is standard therapy, and the combination of ipratropium bromide with beta₂-agonists effectively reversed bronchoconstriction, airway irritation and increased airway resistance in experimental studies.

Inhaled sodium bicarbonate: In a randomized controlled trial, humidified oxygen, intravenous prednisolone and inhaled salbutamol were compared with nebulized sodium bicarbonate. The only additional benefit of sodium bicarbonate was to increase the forced expiratory volume in one second, 2 and 4?h after administration.

Corticosteroids: Dexamethasone 100?mg/kg intraperitoneally (IP) reduced lung edema when given within 1?h of chlorine inhalation and when administered within 6?h significantly decreased (p?Antioxidants: An ascorbic acid/deferoxamine combination (equivalent to 100?mg/kg and 15?mg/kg, respectively) was administered intramuscularly 1?h after chlorine exposure, then every 12?h up to 60?h, then as an aerosol, and produced a significant reduction (p?p?Sodium nitrite: Sodium nitrite 10?mg/kg intramuscularly (IM), 30?min post-chlorine exposure in mice and rabbits significantly reduced (p?Dimethylthiourea: Dimethylthiourea 100?mg/kg IP significantly decreased (p?AEOL 10150: Administration of AEOL10150 5?mg/kg IP at 1?h and 9?h post-chlorine exposure reduced significantly the neutrophil (p?p?Transient receptor potential vanilloid 4 (TRPV4): IM or IP TRPV4 reduced significantly (p?Reparixin and triptolide: In experimental studies, triptolide 100–1000 µg/kg IP 1?h post-exposure caused a significant decrease (p?Rolipram: Nanoemulsion formulated rolipram administered intramuscularly returned airway resistance to baseline. Rolipram (40%)/poly(lactic-co-glycolic acid) (60%) 0.36?mg/mouse given intramuscularly 1?h post-exposure significantly reduced (p?t?+?6?h.

Prophylactic antibiotics: Studies in patients have failed to demonstrate benefit.

Sevoflurane: Sevoflurane has been used in one intubated patient in addition to beta₂-agonists. Although the peak inspiratory pressure was decreased after 60?min, the role of sevofluorine is not known.

Conclusions: Various therapies seem promising based on animal studies or case reports. However, these recommendations are based on low-level quality data. A systematic list of outcomes to monitor and improve may help to design optimal therapeutic protocols to manage chlorine-exposed patients.     

Supporting the growth of peer-professional workforces in healthcare settings: an evaluation of a targeted training approach for volunteer leaders of the STEPS Program

Abstract

Purpose: To examine the effectiveness of a targeted training approach to foster and support a peer-professional workforce in the delivery of a community rehabilitation program for adults with acquired brain injury (ABI) and their families. Method: A prospective longitudinal design was used to evaluate the effectiveness of a targeted two-day training forum for peer (n?=?25) and professional (n?=?15) leaders of the Skills to Enable People and Communities Program. Leaders completed a set of questionnaires (General Self-Efficacy Scale – GSES, Rosenberg Self-Esteem Scale, Volunteer Motivation Inventory – VMI and Community Involvement Scale – CIS) both prior to and immediately following the forum. Data analysis entailed paired sample t-test to explore changes in scores over time, and independent sample t-tests for comparisons between the two participant groups. Results: The results indicated a significant increase in scores over time for the GSES (p?=?0.047). Improvements in leaders’ volunteer motivations and community involvement were also observed between the two time intervals. The between group comparisons highlighted that the peer leader group scored significantly higher than the professional leader group on the CIS and several domains of the VMI at both time intervals. Conclusion: The study provides an enhanced understanding of the utility of innovative workforce solutions for community rehabilitation after ABI; and further highlights the benefits of targeted training approaches to support the development of such workforce configurations.

• Implications for Rehabilitation

• Innovative workforce solutions that incorporate peer-professional partnerships should be considered in planning for future health services.

• Service implementation needs to address the unique training and support needs of such a workforce to ensure high standards of service delivery and to enhance long-term sustainability.

• Good practice is to include an evaluation of a targeted training approach to foster leader development.

     

Participation in daily life activities and its relationship to strength and functional measures in boys with Duchenne muscular dystrophy

Abstract

Purpose: While most studies of Duchenne muscular dystrophy (DMD) have focused on physical impairment, there is a need to explore how impairment impacts real-life experiences in order to provide intervention strategies focused on participation. Objectives were: (1) to investigate the domains of participation in a sample of boys with DMD; (2) to compare a younger (<10 years) and older (≥10 years) group of boys with DMD with regard to participation; (3) to investigate strength and timed functional tests in a sample of boys with DMD; (4) to compare a younger (<10 years) and older (≥10 years) group of boys with DMD with regard to strength and timed functional tests; and (5) to explore associations between participation and strength and timed functional tests for our DMD cohorts. Methods: This cross-sectional study included 60 boys with DMD (mean 9.3 years?±?0.3). Boys completed strength testing, timed functional tests, the Children’s Assessment of Participation and Enjoyment and the ACTIVLIM. Independent samples t-tests were used to test for differences in all measures between our younger and older cohorts; Spearman’s (rank) correlation was used to assess relationships between participation and strength and time functional tests. Results: Significant differences were found between our younger and older boys with DMD in the areas of recreational (p?<?0.01), social (p?<?0.001), and skill-based activities (p?<?0.05), as well as with whom and where the activities were performed (p?<?0.05 and 0.001, respectively). Older boys with DMD report lower levels of participation in these areas, as well as less engagement in activities with individuals other than family members and less participation outside of the home. Lower levels of strength and slower rates of functional performance correlate with participation in fewer physical activities for our younger cohort and fewer physical and social activities for our older cohort. Conclusions: Strength and function relate to the variability and type of activities in which boys with DMD participate. A key finding is the significant decline in social activities and community-based engagement as the boys with DMD age. The ultimate goal of an intervention is for our children to be as actively engaged in life as they desire. This requires addressing participation when measuring outcomes in order to more fully understand limitations and provide appropriate strategies for continued participation for boys and their families.

• Implications for Rehabilitation

• Duchenne muscular dystrophy is a devastating progressive neuromuscular disorder that leads to significant strength and functional limitations, which affect physical and social participation for these boys.

• The ability to move beyond clinically-based outcomes and assess and monitor a child’s daily activities through participation measures may provide information for therapeutic interventions.

• Rehabilitation specialists have a role as advocates for social and community engagement for children with physical limitations.

• Providing families with information on community-based opportunities, and the strategies and environmental modifications available may increase social participation for our youth growing up with a neuromuscular disorder.

     

Effects of simulated neural mobilization on fluid movement in cadaveric peripheral nerve sections: implications for the treatment of neuropathic pain and dysfunction

Abstract

Background and purpose:

Neural mobilization techniques are used clinically to treat neuropathic pain and dysfunction. While selected studies report efficacy of these techniques, the mechanisms of benefit are speculative. The purpose of this study was to evaluate the effects of in vitro simulated stretch/relax neural mobilization cycles on fluid dispersion within sections of unembalmed cadaveric peripheral nerve tissue.

Methods:

Bilateral sciatic nerve sections were harvested from six cadavers. Matched pairs of nerve sections were secured in a tissue tester and injected with a plasma/Toluidine Blue dye solution. Once the initial dye spread stabilized, the experimental nerve sections underwent 25 stretch/relaxation cycles (e.g. simulated neural mobilization) produced by a mechanical tissue tester. Post-test dye spread measurements were compared to pre-test measurements as well as control findings (no simulated mobilization). Data were analyzed using paired t-tests.

Results:

Individual dye spread measurements were reliable [ICC(3,1)?=?0·99]. The post-test intraneural fluid movement (dye spread) in the experimental section increased significantly with simulated neural mobilization compared to pre-test measurements (3·2±2·1 mm; P?=?0·015) and control measurements (3·3±2·7 mm; P?=?0·013).

Conclusion:

Repetitive simulated neural mobilization, incorporating stretch/relax cycles, of excised cadaveric peripheral nerve tissue produced an increase in intraneural fluid dispersion. Neural mobilization may alter nerve tissue environment, promoting improved function and nerve health, by dispersing tissue fluid and diminishing intraneural swelling and/or pressure.     

Development of a wheelchair maintenance training programme and questionnaire for clinicians and wheelchair users

Purpose of state: The aims of this study were to develop a Wheelchair Maintenance Training Programme (WMTP) as a tool for clinicians to teach wheelchair users (and caregivers when applicable) in a group setting to perform basic maintenance at home in the USA and to develop a Wheelchair Maintenance Training Questionnaire (WMT-Q) to evaluate wheelchair maintenance knowledge in clinicians, manual and power wheelchair users.

Methods: The WMTP and WMT-Q were developed through an iterative process.

Results: A convenience sample of clinicians (n?=?17), manual wheelchair (n ∞ 5), power wheelchair users (n?=?4) and caregivers (n?=?4) provided feedback on the training programme. A convenience sample of clinicians (n?=?38), manual wheelchair (n?=?25), and power wheelchair users (n?=?30) answered the WMT-Q throughout different phases of development. The subscores of the WMT-Q achieved a reliability that ranged between ICC(3,1)?=?0.48 to ICC(3,1)?=?0.89. The WMTP and WMT-Q were implemented with 15 clinicians who received in-person training in the USA using the materials developed and showed a significant increase in all except one of the WMT-Q subscores after the WMTP (p?<?0.007).

Conclusion: The WMTP will continue to be revised as it is further implemented. The WMT-Q is an acceptable instrument to measure pre- and post-training maintenance knowledge.

• Implications for Rehabilitation

• The Wheelchair Maintenance Training Program can be used to educate rehabilitation clinicians and technicians to improve wheelchair service and delivery to end users.

• This training complements the World Health Organization basic wheelchair service curriculum, which only includes training of the clinicians, but does not include detailed information to train wheelchair users and caregivers.

• This training program offers a time efficient method for providing education to end users in a group setting that may mitigate adverse consequences resulting from wheelchair breakdown.

• This training program has significant potential for impact among wheelchair users in areas where access to repair services is limited.

     

Reference-less MR thermometry on pre-clinical thiel human cadaver for liver surgery with MRgFUS

Purpose: Reference-less MR thermometry can be a promising technique for temperature mapping during liver treatment with Magnetic Resonance-guided Focused Ultrasound (MRgFUS), as it is more robust to breathing motion than Proton Resonance Frequency MR thermometry. However, there is a lack of a pre-clinical model for repeatable testing of reference-less thermometry. The purpose of this work was to verify the explanted Thiel embalmed human liver and whole Thiel embalmed human cadaver for application of a custom made reference-less thermometry algorithm during MRgFUS sonication.

Material and methods: Phase maps were generated during sonication as an input to the algorithm. A square Region-of-Interest (ROI) was designed around the heated area. The ROI was interpolated using a two-dimensional polynomial to the surrounding phase map to calculate the background phase.

Results: Using the phase information from the images, the temperature rise was measured. Validation of the methodology showed accordance of temperatures with actual temperatures.

Conclusions: The explanted liver and the whole cadaver constitute a promising and feasible model to study reference-less techniques for thermometry during MRgFUS, before clinical trials.     

Psychometric properties of Persian version of the Caregiver Burden Scale in Iranian caregivers of patients with spinal cord injury

Purpose: To investigate the psychometric properties of the Persian version of Caregiver Burden Scale (CBS) in caregivers of patients with spinal cord injury.

Methods: This is a cross-sectional study. After a forward–backward translation, the CBS was administered to 110 caregivers of patients with spinal cord injury (men?=?60, women?=?50). Factor structure was evaluated by confirmatory factor analysis. The Internal consistency and test–retest reliability of the CBS were examined using Cronbach’s α and the intraclass correlation coefficient, respectively. Construct validity was assessed by examining the relationship among CBS and the World Health Organization Quality of Life, and the Beck Depression Inventory.

Results: The results of confirmatory factor analysis provided support for a five-factor model of CBS. All subscales of CBS revealed acceptable internal consistency (0.698–0.755), except for environment subscale (0.559). The CBS showed adequate test–retest reliability for its subscales (0.745–0.900). All subscales of CBS significantly correlated with both Beck Depression Inventory and World Health Organization Quality of Life, confirming construct validity.

Conclusions: The Persian version of the CBS is a valid and reliable measure for assessing burden of care in caregivers of patients with spinal cord injury.

• Implications for Rehabilitation

• Spinal cord injury leads to depression, high levels of stress and diminished quality of life due to the high physical, emotional, and social burdens in caregivers.

• Persian version of the Caregiver Burden Scale is a valid and reliable tool for assessing burden in Iranian caregivers of patients with spinal cord injury.

     

A comparison of two-coloured filter systems for treating visual reading difficulties

Abstract

Purpose: Visual disturbances that make it difficult to read text are often termed “visual stress”. Coloured filters in spectacles may help some children overcome reading problems that are often caused by visual stress. It has been suggested that for optimal effect each child requires an individually prescribed colour for each eye, as determined in systems such as the “Harris Foundation” coloured filters. Alternatively, it has been argued that only blue or yellow filters, as used in the “Dyslexia Research Trust” (DRT) filter system, are necessary to affect the underlying physiology. Method: A randomised, double blind trial with 73 delayed readers, was undertaken to compare changes in reading and spelling as well as irregular and non-word reading skills after 3 months of wearing either the Harris or the DRT filters. Results: Reading improved significantly after wearing either type of filter (t?=??8.4, p?<?0.01), with 40% of the children improving their reading age by 6 months or more during the 3 month trial. However, spelling ability (t?=?2.1, p?=?0.05) and non-word reading (f?=?4.7, p?<?0.05) improved significantly more with the DRT than with the Harris filters. Conclusion: Education and rehabilitation professionals should therefore, consider coloured filters as an effective intervention for delayed readers experiencing visual stress.

• Implications for Rehabilitation

• Any disability that impacts on a child’s capacity to read has serious implications for academic development as well as the ability to participate independently in activities of daily living.

• One reading disability, generally termed “visual stress”, is related to visual disturbances that make it difficult to read text.

• This research demonstrates the beneficial use of coloured filters for promoting visual reading capacity for children with visual stress.

• Professionals who are involved in the needs of children with reading delay, may like to consider the benefits that coloured filters can afford children with visual reading problems.