Interrogation of fibre Bragg gratings through a fibre optic rotary joint on a geotechnical centrifuge

The monitoring of an array of fibre Bragg gratings (FBGs) strain sensors was performed through a single channel, single mode fibre optic rotary joint (FORJ) mounted on a geotechnical centrifuge. The array of three FBGs was attached to an aluminum plate that was anchored at the ends and placed on the model platform of the centrifuge. Acceleration forces of up to 50g were applied and the reflection signal of the monitored FBGs recorded dynamically using a 2.5kHz FBG interrogator placed outside the centrifuge. The use of a FORJ allowed the monitoring of the FBGs without submitting the FBG interrogator to the high g-forces experienced in the centrifuge. © (2016) COPYRIGHT Society of Photo-Optical Instrumentation Engineers (SPIE). Downloading of the abstract is permitted for personal use only

Quantitative sensory testing in painful hand osteoarthritis demonstrates features of peripheral sensitisation.

Hand osteoarthritis (HOA) is a prevalent condition for which treatments are based on analgesia and physical therapies. Our primary objective was to evaluate pain perception in participants with HOA by assessing the characteristics of nodal involvement, pain threshold in each hand joint, and radiological severity. We hypothesised that inflammation in hand osteoarthritis joints enhances sensitivity and firing of peripheral nociceptors, thereby causing chronic pain. Participants with proximal and distal interphalangeal (PIP and DIP) joint HOA and non-OA controls were recruited. Clinical parameters of joint involvement were measured including clinical nodes, VAS (visual analogue score) for pain (0-100 mm scale), HAQ (health assessment questionnaire), and Kellgren-Lawrence scores for radiological severity and pain threshold measurement were performed. The mean VAS in HOA participants was 59.3 mm ± 8.19 compared with 4.0 mm ± 1.89 in the control group (P < 0.0001). Quantitative sensory testing (QST) demonstrated lower pain thresholds in DIP/PIP joints and other subgroups in the OA group including the thumb, metacarpophalangeal (MCPs), joints, and wrists (P < 0.008) but not in controls (P = 0.348). Our data demonstrate that HOA subjects are sensitised to pain due to increased firing of peripheral nociceptors. Future work to evaluate mechanisms of peripheral sensitisation warrants further investigation

The health profile of football/soccer players in Northern Ireland – a review of the uefa pre-participation medical screening procedure

Background It is compulsory that domestic football/soccer teams in UEFA competitions organise players’ pre-participation medicals. Although screening guidelines have been established, these remain controversial. The findings of medical examinations can have lasting consequences for athletes and doctors. No previous studies have reported UEFA pre-participation screening results in semi-professional footballers. This study aims to further knowledge regarding ‘normal’ data in this population. Method Retrospective audit and analysis of records of pre-season medicals for all male first-team players at one semi-professional Northern Ireland Premiership team between 2009-2012. Medicals were conducted by the club doctor following the UEFA proforma. Height, weight, blood pressure (BP), full blood count (FBC), dipstick urinalysis and resting electrocardiogram (ECG) were conducted by an independent nurse. Only one ECG must be documented during a player’s career; other tests are repeated yearly. Results 89 medicals from 47 players (6 goalkeepers, 11 defenders, 22 midfielders and 8 attackers; mean age 25.0 years (SD 4.86)) were reviewed. Mean height of the players was 179.3 cm (SD 5.90) with a mean weight of 77.6 kg (SD 10.5). Of 89 urine dipsticks, 7 were positive for protein; all 7 were normal on repeat testing following 48 hours of rest. Of 40 ECGs (mean ventricular rate 61.2 bpm (SD 11.6)), one was referred to cardiology (right bundle branch block; prolonged Q-T interval). No players were excluded from participation. Conclusions This study provides important information about ‘normal’ values in a population of semi-professional footballers. Urinalysis showing protein is not uncommon but is likely to be normal on repeat testing

Concussion assessment in cycling: a systematic review and call to action

Purpose:Concussion is a recognised risk in road cycling and can have serious health consequences1, especially when mismanaged. Epidemiological studies estimate that concussions account for 4-13% of all cycling injuries2-4and that the incidence of concussions is increasing5. The high-profile case of Toms Skujins in the 2017 Tour of California, who was initially allowed to continue riding despite demonstrating obvious ataxia following a crash, highlighted the lack of a concussion assessment protocol in road cycling. Aim: a systematic review of the literature on concussion assessmentin cycling.Methods:literature describing concussion assessment in cycling was identified by searching MEDLINE, EMBASE, PsycINFO & Web of Science. Two reviewers independently screened titles andabstracts for eligibility. Figure 1 demonstrates the flow diagram of reviewed and included studies. A qualitative analysis was undertaken of included studies.Results:From 94 studies identified, 2 were included for review. Gordon et al. 20136describe the presentation of a single case of paediatric concussion following a cycling crash and highlights the utility of evaluation using the Sport Concussion Assessment Tool7(SCAT5) as well as the importance of a stepwise return-to-play protocol. Greve & Modabber 20128discuss a number of traumatic brain injuries that occurred during the 2011 road cycling season and, as a minimum, calls for riders to be withdrawn from riding following loss of consciousness or amnesia. Discussion:Road cycling poses a unique challenge for the assessment of concussion and we have found there is little published evidence to advise effective means of in-race assessment. Following a potentially concussive impact, the decision to allow a rider to continue or not, must be made quickly and in sub-optimal conditions. Indeed it is not possible to temporarily withdraw a rider for a ‘sideline assessment’. Moreover medical personnel are often unable to observe the rider directly and rely on radio communication for assessment. The recent Berlin Consensus Statement on Concussion in Sport9states that “Adequate facilities should be provided for the appropriate medical assessment both on and off the field for all injured athletes. In some sports, this may require rule changes to allow an appropriate off-field medical assessment to occur without affecting the flow of the game or unduly penalising the injured player’s team.” Action must be taken to increase adherenceto the Berlin Consensus statement within cycling. Whilst the UCI Cycling Regulations10discuss multi-modal assessment in suspected concussion and the need for immediate withdrawal from competition/training if concussion is suspected, no internationally-agreed assessment protocol for concussion in road cycling has been published. The UCI regulations advise the use of SCAT5 for concussion assessment but this tool is impractical to use in-competition and would require modifications for use in road cycling, particularly for in-competition assessments. Abramson et al. of USA Cycling/MedicineofCycling.com have produced a concussions in cycling consensus statement11but with limited race-specific assessment instructions and the statement has not been published in a peer-reviewed journal.Conclusion:We would like to call on the UCI to hold a consensus meeting to establish an evidence-based concussion assessment protocol and return-to-riding protocol for road cycling. These protocols would need to be multi-lingual and should consider the role of both medical and non-medical personnel, e.g. neutral mechanics, who may be the first responder following a crash

What Musculoskeletal (MSK) Conditions are Referred from Routine General Practice (GP) and what Impact does this have on Developing Innovative Care Models for Patients with MSK Conditions in Primary Care?

Introduction: The current ethos within the United Kingdom (UK) health system is to encourage community management of health problems, increasing primary care workload. Yet General Practice (GP) is currently in ‘crisis’ with significant workload pressures. GP Federations have been developed to allow more collaborative working between GP practices and help develop new innovative models of care to better manage the GP workload pressures. Musculoskeletal(MSK) conditions constitute approximately 20% of General Practice(GP) consultations and therefore the Belfast GP Federation aimed to assess the demand for MSK conditions to allow development of new primary care-based treatment pathways for these conditions. The aim of this paper is therefore to assess the demand for orthopaedic, rheumatology and chronic MSK painful conditions by assessing the referrals from 2 GP practices and the referrals to one orthopaedic Integrated Clinical Assessment and Treatment services (ICATs) clinic for these conditions and then propose innovative models of care to manage this demand within the community. Methods: Secondary care referral rates for two urban GP surgeries in the Belfast area were assessed in April, 2016 to orthopaedics, rheumatology and chronic pain clinics. The referrals to an orthopaedic ICATs clinics, staffed by one GPwSI in MSK, in May 2016 were also reviewed. The orthopaedic ICATs team receive referrals from GPs regarding musculoskeletal conditions and this particular service is based in the Southern Trust area of Northern Ireland. Results: Overall from the 2 GP surgeries there was 59 orthopaedic referrals, 11 to rheumatology and 3 to the chronic pain clinic. The commonest joint referred to the orthopaedic clinic was knee (15 referrals, 25.4%) and the commonest reason to refer to rheumatology was to exclude an inflammatory arthritis (6 referrals, 54.5%). There was then 25 referrals to ICATs, with the commonest reason for referral being neck (6 referrals, 24%) and back (4 referrals, 16%). The commonest treatment options employed within the ICAT service included joint injections (8 patients, 32%) with referral to in-house physiotherapy (8 patients, 32%). Conclusions: UK GP is currently under significant workload pressures and musculoskeletal conditions, including orthopaedic, rheumatology and chronic painful conditions, make up a significant proportion of this workload. The main musculoskeletal areas which GPs are referring to secondary care include knee and spinal conditions. To help better manage this workload within primary care we propose developing a new community-based monthly musculoskeletal clinic based within local GP surgeries, supported by a MSK educational programme open to all GPs in the area. Outcomes which will be monitored from this quality improvement work will include secondary care referrals and maintaining high patient satisfaction as well as improving GP confidence in managing MSK conditions

The timing of maternal depressive symptoms and child cognitive development: a longitudinal study.

Background: Maternal depression is known to be associated with impairments in child cognitive development, although the effect of timing of exposure to maternal depression is unclear. Methods: Data collected for the Avon Longitudinal Study of Parents and Children, a longitudinal study beginning in pregnancy, included self-report measures of maternal depression the Edinburgh Postnatal Depression Scale, completed on 6 occasions up to 3 years of age, and IQ of the index child (WISC) measured at aged 8 years. We used these data to assign women to 8 groups according to whether depression occurred in the antenatal, postnatal, preschool period, any combination of these times, or not at all. We compared a model comprising all patterns of depression (saturated model) with models nested within this to test whether there is a relationship between depression and child cognitive development and, if so, whether there is a sensitive period. We then investigated the relationship with child IQ for each model, following adjustment for confounders. Results: Six thousand seven hundred and thirty-five of 13,615 children from singleton births (49.5%, of eligible core sample) attended a research clinic at 8 years and completed a WISC with a score ≥ 70. A total of 5,029 mothers of these children had completed mood assessments over the 3 time periods. In unadjusted analyses, all three sensitive period models were as good as the saturated model, as was an accumulation model. Of the sensitive period models, only that for antenatal exposure was a consistently better fit than the accumulation model. After multiple imputation for missing data (to n = 6,735), there was no effect of postnatal depression on child IQ independent of depression at other times [-0.19 IQ points, 95% confidence interval (CI) -1.5 to 1.1 points]. There was an effect of antenatal depression (-3.19 IQ points, 95% CI: -4.33 to -2.06) which attenuated following adjustment (-0.64 IQ points, 95% CI: -1.68 to 0.40). Conclusions: The postnatal period is not a sensitive one for the effect of maternal depression on child cognitive development. © 2011 The Authors. Journal of Child Psychology and Psychiatry

From feedback-as-information to feedback-as-process: a linguistic analysis of the feedback literature

Feedback is a term used so frequently that it is commonly taken that there is a shared view about what it means. However, in recent years, the notion of feedback as simply the provision of information to students about their work has been substantially challenged and learning-centred views have been articulated. This paper employs a corpus linguistics approach to analyse the use of the term ‘feedback’ in research articles published in key higher education journals on the topic over two five-year periods: 2009–2013 and 2015–2019. Analysis focused on the most common noun modifiers of ‘feedback’ and nouns modified by ‘feedback’, verbs with ‘feedback’ as the object, possessors of ‘feedback’, and prepositions representing an action or concept on or with ‘feedback’. Whilst the analysis demonstrated that transmission-focused conceptions dominate publications on feedback, linguistic signifiers of a shift over time in representation of feedback away from a transmission-focus towards a learning-focus were evident within each grammatical relation category. The data indicate that the term ‘feedback’ is used by different authors to refer to very different representations of the concept, and the paper proposes that greater clarity in the representation of feedback is needed

Correlates of sport participation in adults with long-standing illness or disability

Background Little is known about why people with a long-standing illness/disability are less likely to participate in sport than others. This study aimed to identify for the first time sport participation levels and their correlates among Northern Ireland (NI) adults who report a long-standing illness/disability. Method Using data collected in the Continuous Household Survey, an annual survey of a random sample of the NI population, during 2007–2011, we examined responses for the total sample, those with a long-term illness/disability and those with no long-term health issues. We conducted univariate binary regression analysis for the whole sample and for those with a long-standing illness or disability, using sport participation as the dependent variable, and then carried significant variables into a multivariate analysis. Results The sample included 13 683 adults; 3550 (26%) reported a long-term illness or disability. Multivariate analysis showed that, for the total sample and for those with a long-standing illness or disability, sport participation correlated positively with being male, aged <56 years, having a household car/van, health being ‘fairly good’/‘good’ in the previous year, doing work and living in an urban location. Also, for those with a long-standing illness or disability, being single and less socioeconomically deprived correlated positively with sport participation. Conclusions The findings suggest that more focused efforts may promote sport participation for people with a long-standing illness or disability who are female, older, not working, living rurally, married/cohabiting, socioeconomically deprived and report having had poor health in the past year. Our findings should inform public health policy and help in developing initiatives to support sport participation and reduce health inequalities