How do people with knee pain from osteoarthritis respond to a brief video delivering empowering education about the condition and its management?

ObjectiveTo evaluate responses by people with knee osteoarthritis to a brief educational video about their condition that aimed to empower and motivate effective self-management. The video content addressed psychosocial contributors to pain and barriers to behaviour change.MethodsA mixed methods design, including a survey and semi-structured interviews, was used to collect data from 118 people (46–83 years, 78% female) with knee osteoarthritis.ResultsQuantitative data analysis showed the video was rated positively on 0–6 scales for enjoyability (mean 5.0), helpfulness (4.9), relevance (5.0) and believability (5.4). The majority would recommend the video (89%), learned new information (78%) and/or reported intentions to change behaviour (78%). A minority disliked aspects of the video (23%). The thematic analyses identified three main themes: Reactions to the video, including emotions; Learning from the video, including new knowledge and empowerment, but also unmet information needs or disagreement; and Intentions, including behaviour changes, cognitive changes and help seeking.ConclusionEducation about knee osteoarthritis with a focus on empowerment is well received by people with the condition, although some discordant views emerged.Practice implicationsThe educational video about knee osteoarthritis can be recommended to promote effective self-management and counteract potential drawbacks associated with biomedical-based education.     

Involuntary 5F-ADB-related intoxication following e-cigarette use

International Journal of Legal Medicine - The detection of synthetic cannabinoid (SC) intoxication cases is challenging, even more when the involved SC identification is requested in a forensic...     

Simplified evaluation of CONsciousness disorders (SECONDs) in individuals with severe brain injury: A validation study

BackgroundThe Coma Recovery Scale-Revised (CRS-R) is the gold standard to assess severely brain-injured patients with prolonged disorders of consciousness (DoC). However, the amount of time needed to complete this examination may limit its use in clinical settings. Objective. We aimed to validate a new faster tool to assess consciousness in individuals with DoC.MethodsThis prospective validation study introduces the Simplified Evaluation of CONsciousness Disorders (SECONDs), a tool composed of 8 items: arousal, localization to pain, visual fixation, visual pursuit, oriented behaviors, command-following, and communication (both intentional and functional). A total of 57 individuals with DoC were assessed on 2 consecutive days by 3 blinded examiners: one CRS-R and one SECONDs were performed on 1 day, whereas 2 SECONDs were performed on the other day. A Mann-Whitney U test was used to compare the duration of administration of the SECONDs versus the CRS-R, and weighted Fleiss’ kappa coefficients were used to assess inter-/intra-rater reliability as well as concurrent validity.ResultsIn the 57 participants, the SECONDs was about 2.5 times faster to administer than the CRS-R. The comparison of the CRS-R versus the SECONDs on the same day or the best of the 3 SECONDs led to “substantial” or “almost perfect” agreement (kappa coefficients ranging from 0.78 to 0.85). Intra-/inter-rater reliability also showed almost perfect agreement (kappa coefficients from 0.85 to 0.91 and 0.82 to 0.85, respectively).ConclusionsThe SECONDs appears to be a fast, reliable and easy-to-use scale to diagnose DoC and may be a good alternative to other scales in clinical settings where time constraints preclude a more thorough assessment.     

Is pelvic floor muscle strength and thickness associated with pelvic organ prolapse in Nepali women? – A cross-sectional study

BackgroundPelvic floor muscle function has been shown to be inversely associated with pelvic organ prolapse in Western women, however differences have been documented between ethnic groups.ObjectiveTo determine if pelvic floor muscle strength and thickness and hiatal area are associated with pelvic organ prolapse in Nepali women.MethodsThis cross-sectional study included non-pregnant Nepali women ≥18 years attending an outpatient gynecology clinic in Kathmandu, Nepal. A clinical examination included the pelvic organ prolapse quantification (POP-Q)- system examination and Modified Oxford Scale. Puborectalis muscle thickness and hiatal area were assessed using 3D/4D translabial ultrasound. Statistical analysis included Pearson's correlation and multiple regression (p < 0.05).ResultsOf the 123 women; 14 (11%) had POP-Q stage 0 prolapse, 29 (24%) stage I, 69 (56%) stage II, 8 (7%) stage III, and 3 (2%) stage IV. Mean ± SD Modified Oxford Scale was 3.37 ± 0.48 and muscle thickness was 1.14 ± 0.21 cm, hiatal area at rest was 14.67 ± 3.11 cm² and on contraction was 11.29 ± 2.51 cm². No associations were found between pelvic floor muscle strength or thickness and POP-Q stages 0–IV. There was a positive correlation found between hiatal area at rest and pelvic organ prolapse stage (r = 0.34, p < 0.001)and hiatal area on contraction and prolapse stage (r = 0.30, p < 0.001) and a negative correlation between pelvic floor muscle strength and hiatal area on contraction (r = ?0.36, p < 0.001).ConclusionIn contrast to previous findings, pelvic floor muscle strength and thickness are not associated with pelvic organ prolapse in this sample of Nepali women. It is important to consider these findings when developing pelvic organ prolapse treatment and management strategies in this population.     

Corticospinal tract asymmetry and handedness in right- and left-handers by diffusion tensor tractography

Purpose

Cerebral hemispheres represent both structural and functional asymmetry, which differs among right- and left-handers. The left hemisphere is specialised for language and task execution of the right hand in right-handers. We studied the corticospinal tract in right- and left-handers by diffusion tensor imaging and tractography. The present study aimed at revealing a morphological difference resulting from a region of interest (ROI) obtained by functional MRI (fMRI).

Methods

Twenty-five healthy participants (right-handed: 15, left-handed: 10) were enrolled in our assessment of morphological, functional and diffusion tensor MRI. Assessment of brain fibre reconstruction (tractography) was done using a deterministic algorithm. Fractional anisotropy (FA) and mean diffusivity (MD) were studied on the tractography traces of the reference slices.

Results

We observed a significant difference in number of leftward fibres based on laterality. The significant difference in regard to FA and MD was based on the slices obtained at different levels and the laterality index. We found left-hand asymmetry and right-hand asymmetry, respectively, for the MD and FA.

Conclusions

Our study showed the presence of hemispheric asymmetry based on laterality index in right- and left-handers. These results are inconsistent with some studies and consistent with others. The reported difference in hemispheric asymmetry could be related to dexterity (manual skill).