Differences In Subjective Measures Research Articles

Description of the Baseline Audiologic Characteristics of the Participants Enrolled in the Aging and Cognitive Health Evaluation in Elders Study.

The Aging and Cognitive Health Evaluation in Elders (ACHIEVE) study is a randomized clinical trial designed to determine the effects of a best-practice hearing intervention versus a successful aging health education control intervention on cognitive decline among community-dwelling older adults with untreated mild-to-moderate hearing loss. We describe the baseline audiologic characteristics of the ACHIEVE participants. Participants aged 70-84 years (N = 977; Mage = 76.8) were enrolled at four U.S. sites through two recruitment routes: (a) an ongoing longitudinal study and (b) de novo through the community. Participants underwent diagnostic evaluation including otoscopy, tympanometry, pure-tone and speech audiometry, speech-in-noise testing, and provided self-reported hearing abilities. Baseline characteristics are reported as frequencies (percentages) for categorical variables or medians (interquartiles, Q1-Q3) for continuous variables. Between-groups comparisons were conducted using chi-square tests for categorical variables or Kruskal-Wallis test for continuous variables. Spearman correlations assessed relationships between measured hearing function and self-reported hearing handicap. The median four-frequency pure-tone average of the better ear was 39 dB HL, and the median speech-in-noise performance was a 6-dB SNR loss, indicating mild speech-in-noise difficulty. No clinically meaningful differences were found across sites. Significant differences in subjective measures were found for recruitment route. Expected correlations between hearing measurements and self-reported handicap were found. The extensive baseline audiologic characteristics reported here will inform future analyses examining associations between hearing loss and cognitive decline. The final ACHIEVE data set will be publicly available for use among the scientific community. https://doi.org/10.23641/asha.24756948.

Outcomes of conventional versus virtual surgical planning of orthognathic surgery using surgery-first approach for class III asymmetry.

To determine if patient outcome variables differ between conventional and virtual surgical planning of orthognathic surgery for class III asymmetry. This retrospective case-control study examined 95 patients with class III asymmetry who had been consecutively treated with at least a Le Fort I osteotomy and a bilateral sagittal split osteotomy with a surgery-first approach. Two groups were examined: 51 patients treated with conventional surgical planning and 44 with virtual surgical planning. After treatment, quantitative assessment was determined with measurements of midline symmetry, contour symmetry, and overall facial symmetry using standardized frontal photographs. Subject assessments were analyzed with questionnaires regarding self-perception of overall appearance, satisfaction with appearance, and quality of life. Conventional and virtual surgical planning resulted in significant improvements in outcomes for all patients. However, facial midline and overall facial symmetry were significantly greater for the virtual compared with the conventional group. There were no significant differences in subjective measures of appearance, satisfaction with appearance, and quality of life for patients treated with conventional or virtual surgical planning; measures were high for both groups. Conventional and virtual surgical planning of surgery-first bimaxillary orthognathic surgery resulted in quantitative and qualitative improvements in facial symmetry. Although patient satisfaction was similar for both approaches, virtual surgical planning was superior to conventional surgical planning for the improvement of midline and overall asymmetry. Improvements with virtual surgical planning in facial midline, facial contour, and overall facial symmetry are as good as or better than conventional surgical planning.

Impact of Hydration Status on Electromyography and Ratings of Perceived Exertion During the Vertical Jump

Background: The vertical jumping task is commonly used to assess lower-body power output in athletic populations, in addition to being commonly used to during investigations of hydration and anaerobic performance. Changes in neuromuscular function during a hypohydrated state have been proposed as a potential mechanism to decreases in anaerobic performance. Objectives: The primary purpose of this investigation was to examine the impact of hydration state on electromyography during the vertical jumping task. Methods: Twenty recreationally trained males were tested in three hydration conditions (hypohydrated, euhydrated, and control). Testing included maximal voluntary contractions of the vastus lateralis, vastus medialis, semitendinosus and medial gastrocnemius. Participants performed three maximal countermovement and squat jumps respectively for a total of six jumps in each condition. Both mean muscle activity and percentage of maximal voluntary contraction were calculated across the propulsive phase of each jump. Additionally, measures of RPE and the use of a mood rating scale were used as subjective measures. Results: No differences were seen in mean muscle activity and percentage of MVC in either of the jumping conditions (p > 0.05). Significant differences were seen with higher ratings of perceived exertion as well as lower levels of mood ratings after the hypohydrated condition (p = 0.02 and p = 0.048 respectively). Conclusions: Decrements seen in vertical jump performance during a hypohydrated state appear to be caused from changes other than neuromuscular function and muscle activity. Differences in subjective measures may provide insight into changes in motivational levels and potentially impacting performance.

The Effects of Balance Training on Balance Performance and Functional Outcome Measures Following Total Knee Arthroplasty: A Systematic Review and Meta-Analysis.

Several studies have examined the effects of balance training in elderly individuals following total knee arthroplasty (TKA), although findings appear to be equivocal. This systematic review and meta-analysis examined the effects of balance training on walking capacity, balance-specific performance and other functional outcome measures in elderly individuals following TKA. Data sources: Pubmed, PEDro, Cinahl, SportDiscus, Scopus. Eligibility criteria: Data were aggregated following the population-intervention-comparison-outcome (PICO) principles. Eligibility criteria included: (1) randomised controlled trials; (2) studies with comparative groups; (3) training interventions were incorporated post-TKA; and (4) outcome measures included walking capacity, balance-specific performance measures, subjective measures of physical function and pain and knee range-of-motion. Elderly individuals (65 + years) who underwent total knee arthroplasty. Balance interventions that consisted of balance exercises, which were compared to control interventions that did not involve balance exercises, or to a lesser extent. Participants also undertook usual physiotherapy care in conjunction with either the balance and/or control intervention. The intervention duration ranged from 4 to 32weeks with outcome measures reported immediately following the intervention. Of these, four studies also reported follow-up measures ranging from 6 to 12months post-interventions. Study appraisal: PEDro scale. Quantitative analysis was conducted by generating forest plots to report on standardised mean differences (SMD; i.e. effect size), test statistics for statistical significance (i.e. Z values) and inter-trial heterogeneity by inspecting I2. A meta-regression was also conducted to determine whether training duration predicted the magnitude of SMD. Balance training exhibited significantly greater improvement in walking capacity (SMD = 0.57; Z = 6.30; P < 0.001; I2 = 35%), balance-specific performance measures (SMD = 1.19; Z = 7.33; P < 0.001; I2 = 0%) and subjective measures of physical function (SMD = 0.46; Z = 4.19; P < 0.001; I2 = 0%) compared to conventional training immediately post-intervention. However, there were no differences in subjective measures of pain (SMD = 0.77; Z = 1.63; P > 0.05; I2 = 95%) and knee range-of-motion (SMD = 0.05; Z = 0.39; P > 0.05; I2 = 1%) between interventions. At the 6- to 12-month follow-up period, improvement in combined measures of walking capacity and balance performance (SMD = 041; Z = 3.55; P < 0.001; I2 = 0%) were significantly greater for balance training compared to conventional training, although no differences were observed for subjective measures of physical function and pain (SMD = 0.26; Z = 2.09; P > 0.05; I2 = 0%). Finally, the training duration significantly predicted subjective measures of pain and physical function (r2 = 0.85; standardised β = 0.92; P < 0.001), although this was not observed for walking capacity and balance-specific performance measures (r2 = 0.02; standardised β = 0.13; P = 0.48). A number of outcome measures indicated high inter-trial heterogeneity and only articles published in English were included. Balance training improved walking capacity, balance-specific performance and functional outcome measures for elderly individuals following TKA. These findings may improve clinical decision-making for appropriate post-TKA exercise prescription to minimise falls risks and optimise physical function.

Physiological Evaluation of Cooling Devices in Conjunction With Personal Protective Ensembles Recommended for Use in West Africa.

Cooling devices (CDs) worn under personal protective equipment (PPE) can alleviate some of the heat stress faced by health care workers responding to the Ebola outbreak in West Africa. Six healthy, young individuals were tested while wearing 4 different CDs or no cooling (control) under PPE in an environmental chamber (32°C/92% relative humidity) while walking (3 METs, 2.5 mph, 0% grade) on a treadmill for 60 minutes. Exercise was preceded by a 15-minute stabilization period and a 15-minute donning period. The control condition resulted in a significantly higher rectal temperature (Tre) at the end of the exercise than did all CD conditions (CD1, P=0.004; CD2, P=0.01; CD3, P=0.000; CD4, P=0.000) with CD1 and CD2 resulting in a higher Tre than CD3 and CD4 (P<0.05). The control condition resulted in a higher heart rate (HR) at the end of exercise than did the CD3 (P=0.01) and CD4 (P=0.009) conditions, whereas the HR of the CD1 and CD2 conditions was higher than that of the CD3 and CD4 conditions (P<0.05). Weight loss in the control condition was higher than in the CD3 (P=0.003) and CD4 (P=0.01) conditions. Significant differences in subjective measurements of thermal stress were found across conditions and time. Use of CDs can be advantageous in decreasing the negative physiological and subjective responses to the heat stress encountered by health care workers wearing PPE in hot and humid environments. (Disaster Med Public Health Preparedness. 2017;11:573-579).

Accounting for vulnerable populations in rural hazard mitigation plans: Results of a survey of emergency managers

Rural areas of the United States are uniquely vulnerable to the impacts of natural disasters. One possible way to mitigate vulnerability to disasters in rural communities is to have a high-quality hazard mitigation plan in place. To understand the resources available for hazard mitigation planning and determine how well hazard mitigation plans in rural counties meet the needs of vulnerable populations, we surveyed the lead planning or emergency management official responsible for hazard mitigation plans in 96 rural counties in eight states in the Southeastern United States. In most counties, emergency management was responsible for implementing the county's hazard mitigation plan and the majority of counties had experienced a presidentially declared disaster in the last 5 years. Our research findings demonstrated that there were differences in subjective measures of vulnerability (as reported by survey respondents) and objective measures of vulnerability (as determined by US Census data). In addition, although few counties surveyed included outreach to vulnerable groups as a part of their hazard mitigation planning process, a majority felt that their hazard mitigation plan addressed the needs of vulnerable populations "well" or "very well." These differences could result in increased vulnerabilities in rural areas, particularly for certain vulnerable groups.

Betalain-Rich Concentrate Supplementation Improves Exercise Performance in Competitive Runners.

This study aimed to determine the effects of a betalain-rich concentrate (BRC) of red beets, containing antioxidant and anti-inflammatory properties, on performance and exercise-related muscle damage. Thirteen (25.3 ± 5.4 years) competitive male runners completed two double-blind, cross-over, randomized trials (BRC and control) separated by seven days. Each trial was preceded by six days of supplementation with 100 mg of BRC or control. On the seventh day, exercise trials commenced 150 min after supplementation with 50 mg BRC or control and consisted of 30 min of treadmill running (77 ± 4% VO2max) followed by a 5-km time trial (TT). During exercise at the same intensity, BRC resulted in a 3% lower heart rate, a 15% lower rate of perceived exertion (RPE) and a 14% lower blood lactate concentration compared to the control (p = 0.05). Five-kilometer TT duration (23.0 ± 4.2 versus 23.6 ± 4.0 min) was faster in 10 of the 13 subjects, and RPE was lower (p < 0.05) with the BRC treatment compared to the control. Lactate dehydrogenase, a marker of muscle damage, increased less from baseline to immediately and 30 min after the 5-km TT with the BRC treatment, despite no differences in subjective measures of muscle soreness and fatigue. In summary, BRC supplementation improved 5-km performance time in male competitive runners.

Gender Differences in Subjective and Objective Measures for Patients with Lumbar Degenerative Disc Disease

Background: It has been observed that gender differences exist for the perception of pain. However, the genetic, biochemical, and developmental reasons behind this phenomenon remain unclear. This work aims to elucidate gender differences in subjective and objective measures of pain, functional disability, and health-related quality of life (hrQoL) in patients with lumbar degenerative disc disease (DDD). Methods: In a prospective two-center study, back and leg pain (using the visual analogue scale [VAS]), functional disability scores (Oswestry Disability Index [ODI] and Roland–Morris Disability Index [RMDI]), and hrQoL evaluation (using the EuroQol 5D (Eq. 5D) and Short-Form (SF-12)) were recorded for 253 consecutive patients scheduled for lumbar spine surgery (study group). In addition, objective functional disability was measured using the timed-up-and-go (TUG) test. The same examinations were applied to a healthy cohort of n = 110 subjects (control group). Results: One-hundred thirty-seven patients (46 females) had a microdiscectomy, 80 (42 females) a decompression, and 36 (19 females) a fusion procedure. Female patients were slightly older than male patients (61.0 vs. 56.6 years, p = 0.0306). All other baseline demographic data (body mass index [BMI], smoking status, ASA score, and Charlson comorbidity index [CCI]) were similar in both female and male patients (p > 0.0931). The mean TUG test time was 12.9 seconds in female and 10.1 seconds in male patients (p = 0.0004). Mean VAS back and leg pain was 4.5 and 5.3 in female patients compared with 3.5 and 4.5 in male patients (p = 0.0021 and 0.0246). The ODI was higher in female patients (51.2 vs. 46.3, p = 0.0042) and, correspondingly, the SF-12 PCS lower in female patients (28.8 vs. 31.3, p = 0.0060). All other subjective preoperative measures (RMDI, Eq. 5D, VAS and Eq. 5D Index, and SF-12 MCS) did not differ between female and male patients. In the healthy control group, female subjects took a mean of 1.1 seconds longer than males (6.5 vs. 5.4 seconds, p < 0.0001). There was no difference in the subjective measures between female and male controls subjects. Conclusions: We found significant gender differences in subjective and objective measures of pain intensity, functional disability, and hrQoL in patients with lumbar DDD. Female patients reported higher pain, higher disability, and more reduced hrQoL as compared with male patients. Correspondingly, the TUG test was significantly longer in female patients/controls.

Do patients with active RA have differences in disease activity and perceptions if anti-TNF naïve versus anti-TNF experienced? Baseline results of the optimization of adalimumab trial

SummaryBackgroundThe chance of a good response in RA is attenuated in previous anti-TNF users who start new anti-TNF therapy compared to biologic naïve patients. In active RA, those with previous anti-TNF exposure compared to anti-TNF naïve may have different baseline disease activity and patient perceptions when starting a new anti-TNF treatment that could explain the observed response differences.Material/MethodsThe aim of this study was a post hoc analysis of baseline characteristics of patients enrolled in the Optimization of Adalimumab study that was a treat to target vs. routine care study in patients initiating adalimumab. As per the protocol, a maximum of 20% anti-TNF experienced patients were enrolled in the 300 patient trial. Twelve (4.0%) were excluded who previously used other biologics. Baseline characteristics including age, gender, tender and swollen joint counts, disease activity (DAS28), function (HAQ-DI), patient global assessment, patient satisfaction with current treatment, and inflammatory markers (CRP, ESR), were compared between previously anti-TNF experienced [etanercept or infliximab (EXP)], and anti-TNF naïve patients (NAÏVE).ResultsThe mean (SD) age was 54.8 (13.3) years; 81.0% were female, and 237 (79.0%) were anti-TNF naïve while 51 (17.0%) patients were anti-TNF experienced (29 with etanercept, 16 with infliximab, and 6 for both). The mean (SD) baseline in EXP versus NAÏVE groups respectively was: CRP=21.7(32.9) vs. 17.5(20.7); ESR=28.7(22.5) vs. 29.8(20.4); SJC=10.5(6.0) vs. 10.7(5.6); TJC=12.8(7.1) vs. 12.3(7.3); and DAS28=6.0(1.2) vs. 5.8(1.1). None of the between-group differences were statistically significant, however, the HAQ-DI in EXP was 1.7(0.6) compared to 1.5(0.7) for the NAÏVE (P=0.021). Additionally, EXP patients had a higher patient global score [71.3(26.1) vs. 61.9(26.2), P=0.021].ConclusionsAlthough anti-TNF naïve and experienced patients who initiated adalimumab were similar, with respect to several baseline characteristics, significant differences in subjective measures were observed, which may indicate more severe patient measures (function and global disease activity) in anti-TNF experienced patients.

Effect of 15 Days of Betaine Ingestion on Concentric and Eccentric Force Outputs During Isokinetic Exercise

The purpose of this study was to examine the efficacy of 15 days of betaine supplementation on peak concentric (CON) and eccentric (ECC) force during isokinetic exercise in active college-aged men. Eleven men volunteered for this study (21.7 ± 5.1 years; height: 178.5 ± 6.4 cm; body mass: 79.8 ± 10.3 kg). Subjects were randomly assigned to either a supplement (BET) or placebo (PL) group. Supplementation occurred for 15 days. Subjects reported to the Human Performance Laboratory on 5 occasions during this period, separated by 72 hours, for a testing and exercise session on an isokinetic chest press device. After each exercise protocol, subjects rated their fatigue and muscle soreness on a 15-cm visual analog scale. Subjects then consumed no daily BET for 4 weeks but maintained familiarity with the exercise device once per week. After the washout period, subjects resumed the BET protocol using the opposite drink and repeated the same 15-day protocol. No differences were noted in maximum CON force output between pre (335.9 ± 78.3 and 321.6 ± 63.6 N) and post (330.3 ± 74.8 and 330.2 ± 71.6 N) workouts in both BET and PL, respectively. In addition, no differences were noted in maximum ECC force output between pre (352.0 ± 90.6 and 324.4 ± 85.2 N) and post (353.2 ± 98.2 and 366.9 ± 128.5 N) workouts in BET and PL, respectively. No differences in subjective measures of soreness and fatigue were seen, but a significant reduction in Δ fatigue was observed in BET compared to PL. In conclusion, 15 days of betaine supplementation did not increase peak CON or ECC force outputs during an isokinetic chest press but did appear to reduce subjective measures of fatigue to the exercise protocol.

Quality of life in patients with schizophrenia in five European countries: the EPSILON study.

To compare subjective quality of life (QOL) and objective QOL indicators in patients with schizophrenia from five European sites: Amsterdam, Copenhagen, London, Santander and Verona. A representative sample of 404 patients with schizophrenia, in contact with mental health services, was randomly selected and evaluated with the Lancashire Quality of Life Profile (EU). The level of satisfaction in certain domains, religion, family and social relations appears to be associated with local style of living and culture while work, finances, and safety were more independent from local variations. In addition to the severity of symptoms, frequency of contacts with family, friendship and age appear as predictors of QOL, all of them influenced by the characteristics of the surroundings. The centres participating in the study presented differences in subjective measures of QOL, objective indicators and also in service provision and styles of living.