TENDINopathy Severity Assessment - Achilles (TENDINS-A):Development and Content Validity Assessment of a New Patient-Reported Outcome Measure for Achilles Tendinopathy

OBJECTIVE: To develop a new patient-reported outcome measure (PROM) assessing TENDINopathy Severity of the Achilles (TENDINS-Achilles) and evaluate its content validity. DESIGN: Mixed-methods, modified Delphi. METHODS: We performed 1 round of semistructured one-on-one interview responses with professionals and patients, for initial item generation. This was followed by 1 round of survey responses for professionals and a final round of semistructured one-on-one interviews with patients. The work culminated in a PROM to quantify Achilles tendinopathy severity under the core health domain of disability. Participants identified 3 subdomains contributing to the severity of disability of Achilles tendinopathy: pain, symptoms, and functional capacity. RESULTS: All 8 patient participants invited to participate were enrolled. Forty professional participants (50% women, six different continents) were invited to participate and 30 were enrolled (75% response rate). Therefore, a total of 30 professionals and 8 patients were included within this study. Following 3 rounds of qualitative or quantitative feedback, this study has established the content validity of TENDINS-A (good relevance, comprehensibility, and comprehensiveness) as a new PROM to assess the severity of Achilles tendinopathy, which assesses aspects of pain, symptoms, and functional capacity. CONCLUSION: TENDINS-A has established content validity and is appropriate for use with clinical and research populations. We recommend users interpret TENDINS-A results cautiously, until further testing evaluates the most appropriate scoring scale, reliability, construct validity, criterion validity, and responsiveness of TENDINS-A. Until these psychometric properties are established, we suggest using TENDINS-A alongside existing tools. J Orthop Sports Phys Ther 2023;53(11):1-16. Epub: 24 August 2023. doi:10.2519/jospt.2023.11964.</p

Uninterested youth? Young people's attitudes towards party politics in Britain

Following the outcome of the 2001 and 2005 General Elections, when the numbers of abstainers outweighed the numbers of Labour voters on both occasions, much attention has focused upon the state of British democracy and how to enthuse the electorate, especially young people. While the government is exploring ways to make the whole process of voting easier, it may be failing to tackle the real problem - that youth appear to find the business of politics uninviting and irrelevant. This paper examines data derived from a nationwide survey of over 700 young people in order to shed light on what lies at the heart of young people's apparent disengagement from formal politics in Britain - political apathy or a sense of political alienation. The findings reveal that they support the democratic process, but are sceptical of the way the British political system is organised and led, and are turned off by politicians and the political parties. However, there is no uniform youth orientation to politics, and the data indicate that views differ according to social class, educational history, and also gender. However both ethnicity and region of the country in which young people live seem to have little influence in structuring political attitudes and behaviour

Differential training loads and individual fitness responses to pre-season in professional rugby union players

We aimed to compare differentiated training loads (TL) between fitness responders and non-responders to an eight-week pre-season training period in a squad of thirty-five professional rugby union players. Differential TL were calculated by multiplying player’s perceptions of breathlessness (sRPE-B) and leg muscle exertion (sRPE-L) with training duration for each completed session. Performance-based fitness measures included the Yo-Yo Intermittent Recovery Test Level 1 (YYIRTL1), 10-, 20-, and 30-m linear sprint times, countermovement jump height (CMJ) and predicted one-repetition maximum back squat (P1RM Squat). The proportion of responders (≥ 75% chance that the observed change in fitness was > typical error and smallest worthwhile change) were 37%, 50%, 52%, 82% and 70% for YYIRTL1, 20/30-m, 10-m, CMJ and P1RM Squat, respectively. Weekly sRPE-B-TL was very likely higher in YYIRTL1 responders (mean difference = 18%; ±90% confidence limits 11%), likely lower in 20/30-m (19%; ±20%) and 10-m (18%; ±17%) responders, and likely higher in CMJ responders (15%; ±16%). All other comparisons were unclear. Weekly sRPE-B discriminate between rugby union players who respond to pre-season training when compared with players who do not. Our findings support the collection of differential ratings of perceived exertion and the use of individual response analysis in team-sport athletes

ICON 2019: International Scientific Tendinopathy Symposium Consensus: Clinical Terminology

© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.Background Persistent tendon pain that impairs function has inconsistent medical terms that can influence choice of treatment.1 When a person is told they have tendinopathy by clinician A or tendinitis by clinician B, they might feel confused or be alarmed at receiving what they might perceive as two different diagnoses. This may lead to loss of confidence in their health professional and likely adds to uncertainty if they were to search for information about their condition. Clear and uniform terminology also assists inter-professional communication. Inconsistency in terminology for painful tendon disorders is a problem at numerous anatomical sites. Historically, the term ‘tendinitis’ was first used to describe tendon pain, thickening and impaired function (online supplementary figure S1). The term ‘tendinosis’ has also been used in a small number of publications, some of which were very influential.2 3 Subsequently, ‘tendinopathy’ emerged as the most common term for persistent tendon pain.4 5 To our knowledge, experts (clinicians and researchers) or patients have never engaged in a formal process to discuss the terminology we use. We believe that health professionals have not yet agreed on the appropriate terminology for painful tendon conditions.Peer reviewedFinal Accepted Versio

Understanding the health and wellbeing challenges of the food banking system: A qualitative study of food bank users, providers and referrers in London.

In the UK, food poverty has been associated with conditions such as obesity, malnutrition, hypertension, iron deficiency, and impaired liver function. Food banks, the primary response to food poverty on the ground, typically rely on community referral and distribution systems that involve health and social care professionals and local authority public health teams. The perspectives of these key stakeholders remain underexplored. This paper reports on a qualitative study of the health and wellbeing challenges of food poverty and food banking in London. An ethnographic investigation of food bank staff and users was carried out alongside a series of healthcare stakeholder interviews. A total of 42 participants were interviewed. A Critical Grounded Theory (CGT) analysis revealed that contemporary lived experiences of food poverty are embedded within and symptomatic of extreme marginalisation, which in turn impacts upon health. Specifically, food poverty was conceptualised by participants to: firstly, be a barrier to providing adequate care and nutrition for young children; secondly, be exacerbated by lack of access to adequate fresh food, food storage and cooking facilities; and thirdly, amplify existing health and social problems. Further investigation of the local government structures and professional roles that both rely upon and serve to further embed the food banking system is necessary in order to understand the politics of changing welfare landscapes

Contested space: The contradictory political dynamics of food banking in the UK

This paper offers a critical reappraisal of the politics of food banking in the UK. Existing work has raised concerns about the institutionalisation of food banks, with charitable assistance apparently – even if inadvertently – undermining collectivist welfare and deflecting attention from fundamental injustices in the food system. This paper presents original ethnographic work that examines the neglected politics articulated within food banks themselves. Conceptualising food banks as potential spaces of encounter where predominantly middle-class volunteers come into contact with ‘poor others’ (Lawson and Elwood, 2013), we illustrate the ways food banks may both reinforce but also rework and generate new, ethical and political attitudes, beliefs and identities. We also draw attention to the limits of these progressive possibilities and examine the ways in which some food banks continue to operate within a set of highly restrictive, and stigmatising, welfare technologies. By highlighting the contradictory dynamics at work in food bank organisations, and among food bank volunteers and clients, we suggest the political role of food banks warrants neither uncritical celebration nor outright dismissal. Rather, food banks represent a highly ambiguous political space still in the making and open to contestatio

Data Quality in Citizen Science

This chapter discusses the broad and complex topic of data quality in citizen science – a contested arena because different projects and stakeholders aspire to different levels of data accuracy. In this chapter, we consider how we ensure the validity and reliability of data generated by citizen scientists and citizen science projects. We show that this is an essential methodological question that has emerged within a highly contested field in recent years. Data quality means different things to different stakeholders. This is no surprise as quality is always a broad spectrum, and nearly 200 terms are in use to describe it, regardless of the approach. We seek to deliver a high-level overview of the main themes and issues in data quality in citizen science, mechanisms to ensure and improve quality, and some conclusions on best practice and ways forwards. We encourage citizen science projects to share insights on their data practice failures. Finally, we show how data quality assurance gives credibility, reputation, and sustainability to citizen science projects

Patellar tendinosis as an adaptive process: a new hypothesis

Background: Patellar tendinosis (PT), or "jumper's knee" is a common condition in athletes participating in jumping sports, and is characterised by proximal patellar tendon pain and focal tenderness to palpation. Hypoechoic lesions observed in the proximal patellar tendon associated with the tendinosis are typically described as being a result of degenerative change or "failed healing". We propose a new model for the development of the hypoechoic lesion observed in PT, in which the aetiology is an adaptive response to differential forces within the tendon. Methods: We assessed the clinical, histopathological, and biomechanical literature surrounding the patellar tendon and integrated this with research into the response of tendons to differential forces. Results and conclusions: We propose that the hypoechoic lesion commonly described in PT is the result of adaptation or partial adaptation of the proximal patellar tendon to a compressive load. We postulate that the biomechanics of the patellar–patellar tendon interface creates this compressive environment. Secondary failure of the surrounding tensile adapted tendon tissue may result in tissue overload and failure, with resultant stimulation of nociceptors. We believe that this "adaptive model" of patellar tendinosis is consistent with the clinical and histological findings