Construct Validity of Functional Capacity Evaluation Lifting Tests in Construction Workers on Sick Leave as a Result of Musculoskeletal Disorders

Gouttebarge V, Wind H, Kuijer PP, Sluiter JK, Frings-Dresen MH. Construct validity of functional capacity evaluation lifting tests in construction workers on sick leave as a result of musculoskeletal disorders.

Objectives

To assess the construct (discriminative and convergent) validity of 5 Ergo-Kit (EK) functional capacity evaluation (FCE) lifting tests in construction workers on sick leave as a result of musculoskeletal disorders (MSDs).

Design

Cross sectional within-subject design.

Setting

Occupational health service for the construction industry.

Participants

Male construction workers (N=72) on 6-week sick leave as a result of MSDs.

Interventions

Not applicable.

Main Outcome Measure

After being assessed on 5 EK FCE lifting tests, participants were asked to complete the Von Korff questionnaire on pain intensity and disability as a result of MSDs and the instrument for disability risk assessing the risk for work disability. Discriminative validity was evaluated by comparing the results of the EK FCE lifting test scores between the 2 groups of participants based on the instrument for disability risk scores (high risk for work disability compared with low risk for work disability). Convergent validity was evaluated by assessing the associations between the results of the EK FCE lifting tests and Von Korff questionnaire self-reported pain intensity and disability as a result of MSDs.

Results

The hypothesized differences between both instrument for disability risk groups on the 5 EK FCE lifting tests were found in the expected direction but were not statistically significant (1 test exhibited a trend). Pearson correlation coefficients showed a poor convergent validity between the scores of the Von Korff questionnaire and the EK FCE lifting tests (-.29≤r≤.05).

Conclusions

Poor construct validity of the 5 EK lifting tests was found: discriminative validity was not statistically established, and convergent validity with self-reported pain intensity and disability was poor.     

The collaborative track option for BSN education: the best of both worlds

As the healthcare needs of patients in acute and community settings become increasingly complex, the demand for nurses with baccalaureate and higher degrees will increase. The collaborative efforts of faculty from 1 university and 4 community colleges created a model for increasing the number of BSN graduates in 4 years. The authors describe this collaborative track model that efficiently uses the strengths and resources of both community colleges and a university for preparing baccalaureate degree nurses.     

Treatments for chronic pain associated with spinal cord injuries: many are tried,few are helpful

OBJECTIVE: The objective was to investigate, in two community samples of people with spinal cord injuries, the frequency of use of different pain treatments and the perceived helpfulness of these treatments. DESIGN AND SETTING: A postal survey was conducted in the community. PARTICIPANTS: The participants were 471 persons aged 18 years or older who had spinal cord injuries and pain. There were 2 separate samples (n = 308 and n = 163). OUTCOME MEASURES: The pain treatments used, the helpfulness of these treatments, and the Chronic Pain Grade questionnaire answers were assessed. RESULTS: Respondents reported multiple pain treatments (range of 0-14 and median of 4 in sample 1; range of 0-16 and median of 4 in sample 2). The most commonly reported treatments were oral medications and physical therapy. Medication types most commonly reported were nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen, and opioids. The treatments rated as most helpful were opioid medications, physical therapy, and diazepam therapy, and those rated as least helpful were spinal cord stimulation, counseling or psychotherapy, administration of acetaminophen, and administration of amitriptyline. Alternative treatments reported as most helpful were massage therapy and use of marijuana. Acupuncture was tried by many but was rated as only moderately helpful. CONCLUSIONS: This survey of two large samples of community-dwelling individuals with spinal cord injury-related chronic pain indicates that multiple pain treatments are tried but only a few are rated as more than somewhat helpful. Furthermore, the treatments that are most commonly reported are not always those that are rated as most helpful. The findings point to a number of potentially fruitful directions for future research.     

A trial of an activating intervention for chronic back pain in primary care and physical therapy settings

In primary care and physical therapy settings, we evaluated an intervention for chronic back pain patients which incorporated fear reducing and activating techniques. Primary care patients seen for back pain in primary care were screened to identify persons with significant activity limitations 8-10 weeks after their visit. Eligible and willing patients were randomized (N=240). A brief, individualized program to reduce fear and increase activity levels was delivered by a psychologist and physical therapists. Over a 2 year follow-up period, intervention patients reported greater reductions in pain-related fear (P<0.01), average pain (P<0.01) and activity limitations due to back pain (P<0.01) relative to control patients. The percent with greater than a one-third reduction in Roland Disability Questionnaire scores at 6 months was 42% among Intervention patients and 24% among control patients (P<0.01). Over the 2 year follow-up, fewer intervention patients reported 30 or more days unable to carry out usual activities in the prior 3 months (P<0.01). The adjusted mean difference in activity limitation days was 4.5 days at 6 months, 2.8 days at 12 months, and 6.9 days at 24 months. No differences were observed in the percent unemployed or the percent receiving worker's compensation or disability benefits, but these outcomes were relatively uncommon. We conclude that an intervention integrating fear reducing and activating interventions into care for chronic back pain patients produced sustained reductions in patient fears, common activity limitations related to back pain, and days missed from usual activities due to back pain.     

Recommended minimal emergency equipment and resources for schools: national consensus group report.

Providing an environment that is responsive to emergency health needs of students is essential to creating a safe setting for children in schools. The question of what minimal essential emergency equipment and resources should be available in schools brings with it many and varied opinions, issues, and concerns. Through funding from the Emergency Medical Services for Children (EMSC), the National Association of School Nurses (NASN) was charged with the task of convening a consensus group to formulate a recommended list of minimal essential emergency equipment and resources that should be present in all schools. This article provides an overview of the issues surrounding minimal emergency equipment needs for schools, presents recommended minimal emergency equipment and resources, and recommendations for further actions.     

Subcortical auditory structures in the mongolian gerbil: I. Golgi architecture

By means of the Golgi–Cox and Nissl methods we investigated the cyto‐ and fiberarchitecture as well as the morphology of neurons in the subcortical auditory structures of the Mongolian gerbil (Meriones unguiculatus), a frequently used animal model in auditory neuroscience. We describe the divisions and subdivisions of the auditory thalamus including the medial geniculate body, suprageniculate nucleus, and reticular thalamic nucleus, as well as of the inferior colliculi, nuclei of the lateral lemniscus, superior olivary complex, and cochlear nuclear complex. In this study, we 1) confirm previous results about the organization of the gerbil's subcortical auditory pathway using other anatomical staining methods (e.g., Budinger et al. [2000] Eur J Neurosci 12:2452–2474); 2) add substantially to the knowledge about the laminar and cellular organization of the gerbil's subcortical auditory structures, in particular about the orientation of their fibrodendritic laminae and about the morphology of their most distinctive neuron types; and 3) demonstrate that the cellular organization of these structures, as seen by the Golgi technique, corresponds generally to that of other mammalian species, in particular to that of rodents. J. Comp. Neurol., 521:1289–1321, 2013. © 2012 Wiley Periodicals, Inc.     

Abnormal functioning of the semantic network in schizophrenia patients with thought disorganization. An exemplar production task

Numerous studies have indicated that thought disorganization in schizophrenia is associated with an enhanced semantic priming effect. This suggests abnormal functioning of the semantic network in these patients, with disinhibited spreading of semantic activation. We investigated whether thought disorganization is also associated with atypical responses in the production of semantic category exemplars. An exemplar production task was administered to 43 patients with schizophrenia and 24 healthy controls. The names of 16 semantic categories were provided, and the participants were requested to produce an exemplar for each category. The typicality of the response was rated according to norms. Higher ratings of thought disorganization were associated with the production of more atypical exemplars. In addition, the patients with high thought disorganization scores were significantly more atypical in their responses than were the healthy controls. In contrast, the patients with low thought disorganization scores were equivalent to the healthy controls. Higher ratings of affective flattening were associated with the production of less atypical exemplars. The results corroborate, within a different paradigm than semantic priming, the theory that thought disorganization is associated with faster and more distant connections within the semantic network. This effect is counteracted by affective flattening.