Reliability and responsiveness of measures of pain in people with osteoarthritis of the knee: a psychometric evaluation

PURPOSE: To examine the fit between data from the Short Form McGill Pain Questionnaire (SF-MPQ-2) and the Rasch model, and to explore the reliability and internal responsiveness of measures of pain in people with knee osteoarthritis. METHODS: Participants with knee osteoarthritis completed the SF-MPQ-2, Intermittent and Constant Osteoarthritis Pain questionnaire (ICOAP) and painDETECT. Participants were sent the same questionnaires 3 and 6 months later. RESULTS: Fit to the Rasch model was not achieved for the SF-MPQ-2 Total scale. The Continuous subscale yielded adequate fit statistics after splitting item 10 on uniform DIF for gender, and removing item 9. The Intermittent subscale fit the Rasch model after rescoring items. The Neuropathic subscale had relatively good fit to the model. Test-retest reliability was satisfactory for most scales using both original and Rasch scoring ranging from fair to substantial. Effect sizes ranged from 0.13 to 1.79 indicating good internal responsiveness for most scales. CONCLUSIONS: These findings support the use of ICOAP subscales as reliable and responsive measure of pain in people with knee osteoarthritis. The MPQ-SF-2 subscales found to be acceptable alternatives. Implications for Rehabilitation The McGill Pain Questionnaire short version 2 is not a unidimensional scale in people with knee osteoarthritis, whereas three of the subscales are unidimensional. The McGill Pain Questionnaire short version 2 Affective subscale does not have good measurement properties for people with knee osteoarthritis. The McGill Pain Questionnaire short version 2 and the Intermittent and Constant Osteoarthritis Pain scales can be used to assess change over time. The painDETECT performs better as a screening measure than as an outcome measure

Optical Methods for Imaging Ionic Activities

Optical fluorescence is characteristic of molecules and their environment, and dyes can be made whose fluorescence is altered by reversible binding to specific ions. By introducing these into the cytosol, fluorescence microscopy can be used to form dynamic images of ionic activities in living cells under experimental manipulation. Optical fluorescence spectra are broad-band, and if specific ion binding alters the wavelength of maximal excitation or emission, quantitative measurements can be made from the ratio of images taken at two different wavelengths, eliminating errors due to spatial variations in dye concentration and optical path-length. This method is analogous to continuum normalisation in X-ray microanalysis, and is implemented using a sensitive video camera and computer processing of digitised images. Fluorescent indicators exist for calcium, magnesium, hydrogen, sodium, zinc and chloride ions. Most imaging work has been on calcium, which is important in many cell signalling processes, and several calcium indicators are available with different spectral properties. Spatial resolution is limited to a few μm by out-of-focus blur, but repeated images can be captured with a time resolution as low as 200 msec, and by using dyes with high binding affinity, detection limits can be lower than by X-ray methods. There is a large and fast-growing literature of applications to many plant and animal cell-types

Personal experience of osteoarthritis and pain questionnaires: mapping items to themes

Purpose. The aim of this study was to examine the correspondence between qualitative and quantitative methods of coding experience of pain reported by participants with osteoarthritis (OA) of the knee. Method. A mapping grid was produced to record the correspondence between subthemes that emerged from thematic analysis of interviews with 24 participants with knee OA, and from questionnaire items which were used in a study of 192 knee OA participants. Items were rated according to their degree of correspondence between subthemes and questionnaire items and an overall correspondence score was produced for each subtheme and questionnaire measure. Results. The subthemes that corresponded well with the questionnaire items were those that related to socio-emotional functioning, the overall experience of pain and the impact of pain on physical functioning. The questionnaire items did not relate to participants' knowledge about their condition and their experience of the medical system. Conclusions. The study indicated that many aspects of pain experience reported by patients in qualitative interviews are also assessed by commonly used questionnaire outcome measures for people with pain. However, although participants reported that knowledge about their condition and their experience of the medical system were important aspects of the overall pain experience, these are rarely used as outcome measures. Questionnaires that address these additional aspects ofthe pain experience could be useful to further evaluate the experience of pain and may help to address importance concerns raised by patients with OA of the knee

Evaluation of a group acceptance commitment therapy intervention for people with knee or hip osteoarthritis: a pilot randomized controlled trial

Objectives: The aim was to evaluate an Acceptance Commitment Therapy (ACT) intervention for people with knee or hip osteoarthritis; a related aim was to compare treatment effects from Rasch-transformed and standard scales. Methods: Participants were recruited from a research database and outpatient rheumatology and orthopaedic clinics at two hospitals. Eligible participants were randomly allocated to either intervention or usual care. Intervention comprised six-sessions of group ACT. Outcomes were assessed two and four months after randomisation. Rasch-transformed and standard self-report measures were compared. Qualitative interviews also explored the acceptability of the intervention. Results: Of 8 people assessed for eligibility, 31 (36%) were randomised. The main reason for non-randomisation was that participants received surgery. Of the 16 participants randomised to intervention, 64% completed ≥50% of the scheduled group sessions. Follow-up data was complete for 84% participants at two months and 68% at four months. Outcome analysis demonstrated important differences between the Rasch-transformed and standard scales. There were significant differences between the groups in pain. Qualitative interviews with 7 participants suggested the intervention was acceptable. Conclusions: ACT for osteoarthritis is likely to be an acceptable treatment option for people with osteoarthritis. Progress to a definitive trial is warranted. Rasch-transformed outcome scales are preferable in clinical trials where possible

Coronal Shock Waves, EUV waves, and their Relation to CMEs. II. Modeling MHD Shock Wave Propagation Along the Solar Surface, Using Nonlinear Geometrical Acoustics

We model the propagation of a coronal shock wave, using nonlinear geometrical acoustics. The method is based on the Wentzel-Kramers-Brillouin (WKB) approach and takes into account the main properties of nonlinear waves: i) dependence of the wave front velocity on the wave amplitude, ii) nonlinear dissipation of the wave energy, and iii) progressive increase in the duration of solitary shock waves. We address the method in detail and present results of the modeling of the propagation of shock-associated extreme-ultraviolet (EUV) waves as well as Moreton waves along the solar surface in the simplest solar corona model. The calculations reveal deceleration and lengthening of the waves. In contrast, waves considered in the linear approximation keep their length unchanged and slightly accelerate.Comment: 15 pages, 7 figures, accepted for publication in Solar Physic

Coronal Shock Waves, EUV waves, and Their Relation to CMEs. I. Reconciliation of "EIT waves", Type II Radio Bursts, and Leading Edges of CMEs

We show examples of excitation of coronal waves by flare-related abrupt eruptions of magnetic rope structures. The waves presumably rapidly steepened into shocks and freely propagated afterwards like decelerating blast waves that showed up as Moreton waves and EUV waves. We propose a simple quantitative description for such shock waves to reconcile their observed propagation with drift rates of metric type II bursts and kinematics of leading edges of coronal mass ejections (CMEs). Taking account of different plasma density falloffs for propagation of a wave up and along the solar surface, we demonstrate a close correspondence between drift rates of type II bursts and speeds of EUV waves, Moreton waves, and CMEs observed in a few known events.Comment: 30 pages, 15 figures. Solar Physics, published online. The final publication is available at http://www.springerlink.co

Aphelenchoides sp. destroying mushroom mycelium

RESP-357

Large-scale Bright Fronts in the Solar Corona: A Review of "EIT waves"

``EIT waves" are large-scale coronal bright fronts (CBFs) that were first observed in 195 \AA\ images obtained using the Extreme-ultraviolet Imaging Telescope (EIT) onboard the \emph{Solar and Heliospheric Observatory (SOHO)}. Commonly called ``EIT waves", CBFs typically appear as diffuse fronts that propagate pseudo-radially across the solar disk at velocities of 100--700 km s$^{-1}$ with front widths of 50-100 Mm. As their speed is greater than the quiet coronal sound speed ($c_s\leq$200 km s$^{-1}$) and comparable to the local Alfv\'{e}n speed ($v_A\leq$1000 km s$^{-1}$), they were initially interpreted as fast-mode magnetoacoustic waves ($v_{f}=(c_s^2 + v_A^2)^{1/2}$). Their propagation is now known to be modified by regions where the magnetosonic sound speed varies, such as active regions and coronal holes, but there is also evidence for stationary CBFs at coronal hole boundaries. The latter has led to the suggestion that they may be a manifestation of a processes such as Joule heating or magnetic reconnection, rather than a wave-related phenomena. While the general morphological and kinematic properties of CBFs and their association with coronal mass ejections have now been well described, there are many questions regarding their excitation and propagation. In particular, the theoretical interpretation of these enigmatic events as magnetohydrodynamic waves or due to changes in magnetic topology remains the topic of much debate.Comment: 34 pages, 19 figure

The effect of the environment on the P1/P2 period ratio for kink oscillations of coronal loops

The P1/P2 period ratio of transversal loop oscillations is currently used for the diagnostics of longitudinal structuring of coronal loops as its deviation from 2 is intrinsically connected to the density scale-height along coronal loops and/or the sub-resolution structure of the magnetic field. The same technique can be applied not only to coronal structures, but also to other oscillating magnetic structures. The oscillations in magnetic structures are described by differential equations whose coefficients depend on the longitudinal structure of the plasma. Using a variational principle written for the transversal component of the velocity vector, developed earlier by McEwan et al. (2008), we investigate how the different temperature of the environment compared to the temperature of the magnetic structure will influence the P1/P2 ratio for typical coronal and prominence conditions. The possible changes are translated into quantities that are used in the process of remote plasma diagnostics in the solar atmosphere