Descriptive Scale Research Articles

Predicting communicative effectiveness in the international workplace: Support for TOEIC® Speaking test scores from linguistic laypersons

In this study we examined the extent to which TOEIC® Speaking test scores relate to evaluations by professionals in the international workplace, the target language use domain of TOEIC tests. Linguistic laypersons in 10 countries were invited to participate in an online research survey. The survey incorporated a stratified sample of test-taker ( N = 99) responses to three representative tasks from the TOEIC Speaking test (reading a text aloud, responding to questions, expressing an opinion) that were cast as workplace role-play tasks. After completing each role-play task, participants used brief, descriptive six-point rating scales to rate the communicative effectiveness (comprehensibility, task fulfillment, elaboration, and coherence) of each of several speakers. Communicative effectiveness ratings from linguistic laypersons were strongly correlated with TOEIC Speaking test scaled scores ( r = 0.84). In addition, regression analysis was used to plot the relationship between layperson and test-based evaluations of speaking proficiency. Results suggested that test takers’ performances can be expected to be perceived as effective at score ranges typically associated with important decisions. The results are discussed in terms of their implications for claims about the generalizability of TOEIC Speaking test score interpretations in relation to the evaluations of linguistic laypersons in the international workplace.

Modality-specific facilitation of noninjurious sharp mechanical pain by topical capsaicin.

We had previously shown that a "blunt blade" stimulator can mimic the noninjurious strain phase of incisional pain, but not its sustained duration. Here, we tested whether acute sensitization of the skin with topical capsaicin can add the sustained phase to this noninvasive surrogate model of intraoperative pain. Altogether, 110 healthy volunteers (55 male and 55 female; 26 ± 5 years) participated in several experiments using the "blunt blade" (0.25 × 4 mm) on normal skin (n = 36) and on skin pretreated by a high-concentration capsaicin patch (8%, Qutenza; n = 36). These data were compared with an experimental incision (n = 40) using quantitative and qualitative pain ratings by numerical rating scale and SES Pain Perception Scale descriptors. Capsaicin sensitization increased blade-induced pain magnitude and duration significantly (both P < 0.05), but it failed to fully match the sustained duration of incisional pain. In normal skin, the SES pattern of pain qualities elicited by the blade matched incision in pain magnitude and pattern of pain descriptors. In capsaicin-treated skin, the blade acquired a significant facilitation only of the perceived heat pain component (P < 0.001), but not of mechanical pain components. Thus, capsaicin morphed the descriptor pattern of the blade to become more capsaicin-like, which is probably explained best by peripheral sensitization of the TRPV1 receptor. Quantitative sensory testing in capsaicin-sensitized skin revealed hyperalgesia to heat and pressure stimuli, and loss of cold and cold pain sensitivity. These findings support our hypothesis that the blade models the early tissue-strain-related mechanical pain phase of surgical incisions.

Diffusion Geometry Derived Keypoints and Local Descriptors for 3D Deformable Shape Analysis

Geometric analysis of three-dimensional (3D) surfaces with local deformations is a challenging task, required by mobile devices. In this paper, we propose a new local feature-based method derived from diffusion geometry, including a keypoint detector named persistence-based Heat Kernel Signature (pHKS), and a feature descriptor named Heat Propagation Strips (HeaPS). The pHKS detector first constructs a scalar field using the heat kernel signature function. The scalar field is generated at a small scale to capture fine geometric information of the local surface. Persistent homology is then computed to extract all the local maxima from the scalar field, and to provide a measure of persistence. Points with a high persistence are selected as pHKS keypoints. In order to describe a keypoint, an intrinsic support region is generated by the diffusion area. This support region is more robust than its geodesic distance counterpart, and provides a local surface with adaptive scale for subsequent feature description. The HeaPS descriptor is then developed by encoding the information contained in both the spatial and temporal domains of the heat kernel. We conducted several experiments to evaluate the effectiveness of the proposed method. On the TOSCA Dataset, the HeaPS descriptor achieved a high performance in terms of descriptiveness. The feature detector and descriptor were then tested on the SHREC 2010 Feature Detection and Description Dataset, and produced results that were better than the state-of-the-art methods. Finally, their application to shape retrieval was evaluated. The proposed pHKS detector and HeaPS descriptor achieved a notable improvement on the SHREC 2014 Human Dataset.

Spousal support underlying self-determined physical activity in adults with multiple sclerosis

Aim Identifying motivational factors that facilitate physical activity engagement in adults with multiple sclerosis (MS) is important given beneficial health outcomes. The purpose of this study was to examine the relationship between physical activity of adults with MS and perceived spousal behaviors underlying self-determination. Methods One-hundred and twelve individuals with MS completed the Patient Determined Disease Steps, Physical Exercise Self-Efficacy Scale, Spousal Support for Physical Activity Scale, and Godin Leisure-Time Exercise Questionnaire. Descriptive statistics, scale reliabilities, and bivariate correlations were obtained. To examine the influence of perceived spousal behavior on total metabolic equivalents, a regression analysis was conducted. Results All subscales were found to be highly reliable. Strong and significant associations between each of the variables and physical activity existed except for that of expectations, social control, and self-efficacy. Physical activity was best predicted by spousal behaviors supporting the self-determination constructs of relatedness, competence, and autonomy (R = 0.49, R 2=0.24, F 8,93=2.27, p < 0.05), with spousal support contributing 14.8% to total self-determined physical activity. Conclusions Given the significant role of the spouse in fostering intrinsic motivation for physical activity in adults with MS, delivering more partner-oriented and targeted interventions that build relationship, competence and autonomy appear warranted. Implications for Rehabilitation Physical activity offers significant physical and psychological benefit to adults with multiple sclerosis (MS) and can contribute to greater marital satisfaction. Self-determined physical activity of individuals with MS can be facilitated by spouses who support their partner’s needs for relatedness, competency, and autonomy. Delivering more partner-oriented and targeted interventions that develop self-determination have the potential to increase physical activity and improve quality of life in those with MS.

The new CEFR descriptors for the assessment of written mediation: Exploring their applicability in a local context in an effort towards multilingual testing

Focusing on the process of written mediation, this paper deals with the newly developed descriptor scales presented in the CEFR Companion Volume with New Descriptors (CEFR/CV) (Council of Europe (CoE) 2018). It investigates the views of both language education experts and teachers in Greece regarding these new descriptors in an effort to explore the extent to which they can be exploited in a local context. The questions this study addresses are: Which descriptors can be useful in the Greek educational context, and to what extent? The research project was organised into two phases. In Phase 1, 18 language experts (mainly from the two major state universities in Athens and Thessaloniki) completed online questionnaires containing the 90 new CEFR written mediation descriptors and they judged the clarity of these descriptors in terms of language, their usefulness for assessment purposes, and their relevance for the Greek context. Phase 2 involved 94 language teachers in Greece who were invited to judge the degree to which the same 90 CEFR descriptors correspond to the proficiency level for which they had initially been designed. Based on empirical evidence, the present paper stresses the urgent need for language testers to consider (cross-lingual) written mediation as a fundamental ability which needs to be both taught as well as tested, and discusses the possibility of transforming the monoglossic paradigm in assessment.

Validation of the UNESP-Botucatu pig composite acute pain scale (UPAPS).

The creation of species-specific valid tools for pain assessment is essential to recognize pain and determine the requirement and efficacy of analgesic treatments. This study aimed to assess behaviour and investigate the validity and reliability of an acute pain scale in pigs undergoing orchiectomy. Forty-five pigs aged 38±3 days were castrated under local anaesthesia. Behaviour was video-recorded 30 minutes before and intermittently up to 24 hours after castration. Edited footage (before surgery, after surgery before and after rescue analgesia, and 24 hours postoperatively) was analysed twice (one month apart) by one observer who was present during video-recording (in-person researcher) and three blinded observers. Statistical analysis was performed using R software and differences were considered significant when p<0.05. Intra and inter-observer agreement, based on intra-class correlation coefficient, was good or very good between most observers (>0.60), except between observers 1 and 3 (moderate agreement 0.57). The scale was unidimensional according to principal component analysis. The scale showed acceptable item-total Spearman correlation, excellent predictive and concurrent criterion validity (Spearman correlation ≥ 0.85 between the proposed scale versus visual analogue, numerical rating, and simple descriptive scales), internal consistency (Cronbach's α coefficient >0.80 for all items), responsiveness (the pain scores of all items of the scale increased after castration and decreased after intervention analgesia according to Friedman test), and specificity (> 95%). Sensitivity was good or excellent for most of the items. The optimal cut-off point for rescue analgesia was ≥ 6 of 18. Discriminatory ability was excellent for all observers according to the area under the curve (>0.95). The proposed scale is a reliable and valid instrument and may be used clinically and experimentally to assess postoperative acute pain in pigs. The well-defined cut-off point supports the evaluator´s decision to provide or not analgesia.

Trabajo y rendimiento académico en estudiantes de Educación Básica Alternativa altoandina

Objetivo. Describir las características del trabajo en el rendimiento académico de los estudiantes del CEBA María Inmaculada. Métodos. Estudio de tipo básico, nivel descriptivo y técnicas mixtas, diseño de investigación: explicativo secuencial (DEXPLIS). La muestra estuvo constituida por 31 estudiantes que trabajan de 14 a 18 años. La metodología estadística usada fue descriptiva y se emplearonpruebas de chi cuadrado. Resultados. Se encontró que las características laborales de los estudiantes son muy duras en su mayoría, resaltando horarios laborales superiores a 8 horas diarias, trabajos diurnos de subsistencia. En relación al rendimiento académico se reportó que el 64 % presentó calificaciones admisibles de logros, previsto según la escala nacional de aprendizaje (ECA) normada por el Ministerio de Educación del Perú; ajustada a las escalas literal, descriptiva y categórica. El resto de estudiantes está en proceso de aprendizaje, pero ninguno con deficiencias o reprobación académica. También se determinó que la legitimidad del contrato, la jornada de trabajo, la retribución mensual, el periodo de pago, la autorización de los padres para trabajar y la autonomía del trabajo no se relacionan significativamente con el rendimiento académico (p &amp;gt; 0, 05). Conclusión. A pesar de tener condiciones de trabajo muy básicas y defectuosas con faltas graves a las políticas laborales, los resultados muestran que los estudiantes tienen buen desempeño académico; denotando por ello una capacidad de autosuperación inmutable enriquecedora para su formación, pero conminándonos a proteger sus derechos mediante normas y condiciones que regulen el trabajo adolescente por parte de los gobiernos locales y nacionales.

Clinical effects of two doses of butorphanol with detomidine for intravenous premedication of healthy warmblood horses

ObjectiveTo compare the effects of two different doses of butorphanol combined with detomidine administered intravenously (IV) on quality of sedation, degree of ataxia and anaesthetic induction in horses. Study designRandomized, blinded, clinical study. AnimalsA total of 40 client-owned healthy warmblood horses scheduled for elective surgery under general anaesthesia. MethodsHorses were randomly allocated to be administered 8 μg kg–1 detomidine IV plus either 20 or 50 μg kg–1 butorphanol IV, with the principal investigator blinded to group allocation. Head height was measured before drug injection and 2 minutes thereafter. Data were compared using unpaired t test. Horses were filmed and scored using Simple Descriptive Scales for sedation (2 and 15 minutes after IV injection), ataxia (at walk, immediately after the 2 minute time point) and quality of swing-door induction following diazepam and ketamine administration. Data are shown as median (and range where appropriate). Scores were compared using chi-square tests (p < 0.05). ResultsThere were 14 and 17 horses in high-dose (HD) and low-dose (LD) groups respectively. Data from nine horses were excluded. Mean head height reduction did not differ between groups (p = 0.86), nor did sedation scores at 2 minutes (median = 3 in both groups; p = 0.09) or 15 minutes (median = 2 in both groups; p = 0.63). There was no significant difference in the requirement for additional detomidine (p = 0.73) or in induction quality between groups (p = 0.99), but initial ataxia was significantly greater in the HD group 2 (1–3) versus 2.5 (1–3) in the LD group (p = 0.017). Conclusions and clinical relevance:In healthy warmblood horses, simultaneous administration of 50 rather than 20 μg kg–1 butorphanol with 8 μg kg–1 detomidine does not provide greater sedation or affect induction, but it causes more pronounced ataxia shortly after IV injection.

Touch and Massage on Labor Pain Intensity During First Stage of Active Phase

Introduction: Labor pain is a challenging issue for nurses designing intervention protocols. Touch and massage therapy is one of non-pharmacology approaches that they could do during labor process. The study was conducted to assess the effectiveness in reducing pain intensity scale on the labor during first stage of active phase. Methods: A quasi-experimental approach was conducted and a purposive sampling technique was used to recruit 56 women who expected to have normal childbirth at a public hospital in Jakarta, Indonesia. They randomly assigned to either received touch and massage intervention (experiment) or not (control). The labor pain intensity was using Verbal Description Scale (VDS) with descriptive statistics, paired, and independent t-test. Results: The result showed that touch and massage therapy had a significant impact on the experimental group (tcalI 2.839, p&lt;0.05). A significant difference also showed among the experimental dan control group during pre-test (tcalI 1.817, p&gt;0.05) and post-test (tcalI 10.77, p&lt;0.05). The study found that a combination of touch and massage therapy was effective to reduce labor pain during active stage. Conclusions: Touch and massage therapy can reduce labor pain intensity, and at the same time serve as closeness and encouragement during the first stage of active phase. It is a cost-effective nursing intervention and can positively influence the quality of women’s birth experiences.

The Effect Bonapace Method Reduces Labor Pain Of Active Phase I To Intranatal Care

Sampling technique used is Accidental Sampling. The independent variable is Bonapace Method, the instrument used is a checklist. Dependent variable is the reduction of labor pain in the active phase I, an instrument used to measure the level of pre and post pain with an observation sheet with a pain scale between 0 to 10 and an interview using the Verbal Descriptive Scale (VDS), rating scale, value 0 = no pain , 1-3 = mild pain, 4-6 = moderate pain, 7-9 = severe pain, 10 = very severe pain. Analysis of data using the Wilcoxon Sign Rank. The results of the data analysis stated sig (p) = 0,000 where α = 0.05, p &lt;α, it means that there is an effect of the Bonapace Method on the reduction of labor pain in the active phase of the First Maternity where the Correlation or effect using the Wilcoxon Correlation = -0,382

Is There Variability in Scoring of Student Surgical OSCE Performance Based on Examiner Experience and Expertise?

To investigate the influence of clinical experience and content expertise on global assessment scores in a Surgical Objective Structured Clinical Exam (OSCE) for senior medical undergraduate students. Scripted videos of simulated student performance in an OSCE at two standards (clear pass and borderline) were awarded a global score on each of two rating scales by a range of clinical assessors. Results were analysed by examiner experience and content expertise. The study was designed in a large Medical School in Ireland. Examiners were consultant and training grade doctors from three university teaching hospitals. 147 assessors participated. Of these, 75 (51%) were surgeons and 25 (17%) had sub-speciality surgical expertise directly relevant to the OSCE station. 41 were consultants. Responsible academic scoring set the benchmark. By multivariable linear regression analysis, neither clinical experience (consultant status) nor relevant content expertise in surgery was independently predictive of assessor grading for either clear pass or borderline student performance. No educational factor (previous examining experience/training, self-rated confidence in assessment or frame of reference) was significant. Assessor gender (male) was associated with award of a fail grade for borderline performance. Trainees were reliable graders of borderline performance but more lenient than the gold standard for clear pass. We report greater agreement with the gold standard score using the global descriptive scale, with strong agreement for all assessors in the borderline case. Neither assessor clinical experience nor content expertise is independently predictive of grade awarded in an OSCE. Where non-experts or trainees assess, we find evidence for use of a descriptive global score to maximise agreement with expert gold standard, particularly for borderline performance. These results inform the fair and reliable participation of a range of examiners across subspecialty stations in the surgical OSCE format.

Pain Management in Patients with Peripheral Arterial Disease

Introduction-Aim: A chronic disease with increasing frequency, peripheral arterial disease occurs due to atherosclerosis. Fontaine and Rutherford classifications are common staging methods in peripheral arterial disease. Resting pain caused by ischemia (Fontaine 3-4) adversely affect the patient's life and their treatment is as important as the treatment of the disease. Accurate assessment of pain also provides the right approach. The Visual Analogue Scale and verbal descriptive pain scale are among the various scales used in pain measurement. We aim to contribute to the literature by evaluating our patients who were treated with pain due to peripheral arterial disease in our hospital. Materials and Methods: Patients with peripheral arterial disease who were treated for pain between January 2014 and September 2018 were investigated retrospectively. Those with resting pain due to ischemia (Fontaine stage 3-4) were included in the study, while Fontaine stage 1-2 patients without pain were excluded. The data were obtained from the patient files and hospital registry. Results: The mean age of the 15 patients who had pain treatment for peripheral arterial disease was 69.13 ± 8.11 years. The patients included 7 females and 8 males. Six stage 3 and nine stage 4 patients were identified based on Fontaine classification. According to the verbal descriptive pain scale, 5 had mild, 7 had moderate and 3 had severe pain. One patient underwent epidural catheter placement for administration of patient-controlled analgesia while 14 patients received pharmacological treatment. Conclusion: Accurate assessment is important for appropriate pain treatment in peripheral arterial disease. Communication with the patient is important in this regard. Risks that may occur in the treatment of pain should be undertaken with a multidisciplinary approach.

Investigating Level and Reasons of Insurance Deductions of Hospitalization Bills in AL Zahra Academic and Medical Center of Isfahan in 2017

Background: Insurances are the most important financial sources of hospitals but sometimes insurance companies deduct amounts as deductions from the sum of requested amounts after investigating financial documents sent to hospitals monthly. The current study aims at determining the level and reasons for insurance bill deductions in AL Zahra Hospital in Isfahan. Methods: This applied study is descriptive-cross sectional in method and has been conducted retrospectively. The statistical population of this study contained file information of hospitalized patients who have been referred to Isfahan AL Zahra Hospital in 2016. The sample size determined by Cochran Formula and 400 files has been investigated. Random sampling employed. The information has been extracted from patients through a checklist whose reliability and validity has been confirmed by insurance experts and management specialists. Qualitative methods of interview used to identify the most important reasons for increasing the deduction sums and statistical indices and descriptive scales (frequency, percent etc) have been analyzed. Results: The most and the least percent of insurance deductions are related to Armed Forces Insurance (36.8 %) and Social Security Insurance Organization (3.64 %) respectively. Also, the most deductions of hospitalized files were related to visiting deductions of hospitalized patients’ doctor and drug and consumables deduction, other services, surgeon and anesthetist commission, experiments and pathology, radiology and sonography are in next rates and the least deductions is related to doctors 2k visit cost, hoteling, and surgery room. Conclusion: According to high percent of insurance deductions and investigation of its reasons, it has been revealed that hospitalized files related to visit by resident year 1 and 2 and absence of resident physician in center and the academic status of hospital that managers have to clarify this issue and use residents year 3 and 4, attending and resident physicians to reduce difference between hospitals and insurance companies and consider documentation as one of main elements of their agenda. So training all individuals who are influential on patients’ bills such as doctors and nurses is essential.

Development of the Dietitian Integrated Evaluation Tool for Gluten-free Diets (DIET-GFD).

Celiac disease (CD) treatment involves a gluten-free diet (GFD). There is no standardized tool for dietitians to objectively grade GFD adherence. This study aimed to develop a standardized tool for dietitians to evaluate and communicate GFD adherence. Participants were recruited from the Manitoba Celiac Disease Cohort. Using a consensus process, an expert panel of gastroenterologists, dietitians, clinical health psychologists, and persons with CD developed the Dietitian Integrated Evaluation Tool for Gluten-free Diets (DIET-GFD). Two dietitians performed duplicate assessments of 27 newly diagnosed participants who had been advised to follow a GFD. The global adherence scale was further revised after panel discussions of the cases where there was uncertainty or discordance on dietitian ratings. Subsequently, the scoring system was evaluated using duplicate assessments of an additional 37 participants with CD. Interrater agreement was assessed using square-weight Cohen's kappa. The DIET-GFD includes features related to frequency and quantity of gluten ingestion based on self-reporting and food frequency evaluation, shopping and dining habits, how and where food is prepared and consumed, eating behaviors, and label reading skills. The DIET-GFD global assessment is reported using a 10-point ordinal descriptive scale, ranging from 1 (takes few precautions and regularly eats gluten) to 10 (no gluten in kitchen and rarely eats food prepared outside the home). The kappa of DIET-GFD global assessment was 0.845, which indicates excellent agreement. DIET-GFD is a useful tool for dietitians to evaluate GFD adherence. Further studies are needed to confirm that the score from the DIET-GFD is reliable across various settings.

Assessment of Income Generation from Non-timber Forest Products in Awka-North Local Government Area of Anambra State, Nigeria

Non-Timber Forest Products are important sources of income that can supplement farming and/or other activities to the rural dwellers. In spite of this, its potential to improve the standard of living and generate income to rural dwellers has not been known in Awka-North Local Government Area. The study was carried out from January to August, 2017. The study identified the variety of non-timber forest products (NTFPs) available to rural households, the level of income generated by households from these available Non-timber forest products and constraints to Non-timber forest products collection in the study area. Three towns; Achalla, Amansea and Mgbakwu were selected using multi-stage random sampling technique. A total of 100 copies of structured questionnaires were administered to obtain information from respondents who engaged in NTFPs based activities in the selected towns. Data collected were analyzed using descriptive statistics and 5-point Likert Type Scale. The study revealed that fish, snail, bush meat, spices, firewood, fruits, seeds and nuts, vegetables and honey are the Non-timber forest products available to the rural dwellers. Monthly income of ₦61,000 and above was generated by the rural dwellers who engaged in NTFPs sales. Lack of marketing, bush burning, deforestation, NTFPs scarcity, over exploitation, transportation, bad road network, distance from forest, market price of other products and unfavourable government policies are the constraints confronting the respondents in the collection of Non-timber forest products in the study area.

Measuring mathematics competence in international and national large scale assessments: Linking PISA and the national educational panel study in Germany

This study examines a linkage between the international mathematics scale of the Programme for International Student Assessment (PISA 2012) and the mathematics assessment taken from the German National Educational Panel Study (NEPS). The linking was realized by a separate linking study that uses a single group design. The sample consists of n = 1,270 9th graders from 78 German secondary schools. The equipercentile linking leads to close descriptive scale characteristics (means, standard deviation, and skewness) between the original PISA mathematics scale and the PISA score equivalents. The linking was stable over the four subgroups (gender, migration background, books at home, and school type). Altogether, the results indicate that assigning students to PISA proficiency levels given their NEPS mathematics test score, the PISA score equivalents produce a similar distribution of students reaching the PISA proficiency levels at a group level.

Comparison of xylazine and detomidine in combination with midazolam/ketamine for field castration in Quarter Horses.

The ideal field anaesthetic protocol for castration will offer an adequate duration and depth of anaesthesia using a single injection without compromising safety or recovery quality. The objective of this study was to compare intravenous (IV) xylazine and detomidine as sedatives in combination with midazolam and ketamine for induction of anaesthesia in horses undergoing field castration. Randomised, blinded, clinical study. Fifty-seven male Quarter Horses were randomly assigned to receive xylazine (group X) (1.1mg/kg bwt) or detomidine (group D) (0.03mg/kg bwt) as premedication with midazolam (0.05mg/kg bwt) and ketamine (2.2mg/kg bwt) anaesthesia. Using simple descriptive scales, quality of sedation, induction, surgical conditions and recovery were scored by blinded observers. Induction, surgery, recovery time and time from induction to standing were recorded. There were a greater number of horses with lower sedation score in group D when compared with horses in group X at 5minutes after the first dose of sedation (11.1%, 66.7% and 2.2% of horses from group D with sedation scores of 1, 2 and 3, vs 0%, 52% and 48% from group X, respectively, P=.05). A significant (P<.01) difference was found between surgical condition scores for group D (63%, 14.8%, 11.1% and 11.1% with surgery scores of 1, 2, 3 and 4, respectively) and group X (28%, 4%, 28% and 40%). Horses in Group D were less likely to require maintenance doses of ketamine (P=.05) with only 26% (7 of 27 horses) in this group requiring additional doses compared to 68% (17 of 25 horses) in group X. Recovery time in minutes (Group D: 24.74±14.80, Group X: 13.08±8.00; P<.01) and induction to standing time in minutes (Group D: 42.2±13.8, Group X: 29.8±8.2; P<.01) were significantly longer for horses in group D compared with group X. Multiple surgeons and multiple blinded observers. Detomidine as compared with xylazine as premedication results in good quality sedation and surgical conditions and prolonged surgical plane of anaesthesia, without significant differences in induction or recovery quality.

A randomized placebo-controlled trial of desipramine, cognitive behavioral therapy, and active placebo therapy for low back pain.

This clinical trial evaluated the independent and combined effects of a tricyclic antidepressant (desipramine) and cognitive behavioral therapy (CBT) for chronic back pain relative to an active placebo treatment. Participants (n = 142) were patients experiencing daily chronic back pain at an intensity of ≥4/10 who were randomized to a single-center, double-blind, 12-week, 4-arm, parallel groups controlled clinical trial of (1) low concentration desipramine titrated to reach a serum concentration level of 15 to 65 ng/mL; (2) CBT and active placebo medication (benztropine mesylate, 0.125 mg); (3) low concentration desipramine and CBT; and (4) active benztropine placebo medication. Participants completed the Differential Description Scale and Roland Morris Disability Questionnaires before and after treatment as validated measures of outcomes in back pain intensity and disability, respectively. Participants within each condition showed significant reductions from pre-treatment to post-treatment in pain intensity (mean changes ranged from = -2.58 to 3.87, Cohen's d's = 0.46-0.84) and improvements in pain disability (mean changes = -3.04 to 4.29, Cohen's d's = 0.54-0.88). However, intent-to-treat analyses at post-treatment showed no significant differences between any condition, with small effect sizes ranging from 0.06 to 0.27. The results from this clinical trial did not support the hypothesis that desipramine, CBT, or their combination would be statistically superior to an active medicine placebo for reducing chronic back pain intensity or disability. Key limitations included recruiting 71% of the planned sample size and use of multiple inclusion/exclusion criteria that may limit generalizability to broader populations of patients with chronic back pain.

Prolonged Sitting Causes Lower Back Pain For Nursing Students In Yogyakarta, Indonesia

Individuals who spend most of their time sitting for long periods are at risk of experiencing low back pain. Pain complaints are the most common injuries in the work environment, both as administrator and in academia. The purpose of this study was to determine the relationship between the lengths of sitting during lectures with complaints of low back pain. This research is a quantitative analytic cross-sectional design conducted on 62 nursing students. Sitting time and pain complaints were measured using a questionnaire, physical examination (laseque test) and descriptive scale verbal pain assessment instrument (VDS). Data analysis used Fisher exact test with α: 5%. The results showed that the number of respondents who experienced low back pain complaints was 44 (71.0%) with a sitting time of ≥5 hours is 51 (82.3%) with a value of p = 0.025. The conclusion of this research is the length of sitting during lectures is at risk of causing low back pain

The myth and truth of a comprehensive stroke scale

Background and purposeThe National Institutes of Health Stroke Scale (NIHSS) has been found to be biased toward the left hemispheric and motoric functions providing minimal assessment to the right hemispheric language and cognitive functions. The need to complement the role of the NIHSS is necessary in accurate and rapid assessment of AIS patients and better management. We hypothesized that combining the NIHSS with a quantitative analysis of Spoken Picture Description scale of Comprehensive Aphasia Test (SPD-CAT) could provide valuable data regarding side, site, and size of stroke.Subjects and methodsEighty-six AIS patients presented within 48 h of onset of stroke were enrolled from Stroke Units of Ain-Shams University Hospitals (ASUHS). Clinical Assessment with NIHSS and SPD-CAT were correlated with the radiological MRI Brain lesions of stroke regarding (site, side, size/volume and lesion volume percent to the whole brain volume “LV% WBV”).ResultsTotal and subscale scores of NIHSS and SPD-CAT have a highly statistically significant correlation with the ischemic “LV% WBV.” Quantitative analysis (content units) of SPD-CAT may help in prediction of the lobar site of the stroke with higher significance in the tempro-parietal and brainstem regions. Right hemispheric strokes have clinically and statistically significant scores on SPD-CAT in comparison to NIHSS scores. Also, the left to right ratio of content units of information carrying words (ICWs) in SPD-CAT gives a significant difference between right and left hemispheric strokes. Recording and analysis time of SPD-CAT makes it easy and rapidly applicable in emergency room (ER) and stroke units.ConclusionCombining the quantitative analysis of NIHSS and SPD-CAT can better predict the side, size, and site of AIS within reasonable time table and without urgent MRI for AIS assessment and management.