Aural Rehabilitation of Older Adults with or at risk for Cognitive Decline: Development of Recommendations and Supplemental Resources Based on Evidence from the Literature

The purpose of this research project was to determine if there might be a need to supplement hearing healthcare service delivery for older adults with or at risk of cognitive decline. Through database searches, evidence was collected from the literature to determine recommended resources within the professional field of audiology and surrounding healthcare professions. Based on the literature, appropriate resources for retention of medical information in this population were recommended. Resources were then created based on the literature recommendations for hearing aid fittings and follow-ups when working with older adult patients with or at risk of cognitive decline. The resources included written supplemental materials with visual pictures in the form of hand-outs and video supplemental materials available to patients on YouTube. The resources were created to provide older adult patients with hearing loss and with or at risk of cognitive decline with additional support in the hearing aid rehabilitation process

Aural rehabilitation of older adults with or at risk for cognitive decline: Development of recommendations and supplemental resources based on evidence from the literature.

The purpose of this research project was to determine if there might be a need to supplement hearing healthcare service delivery for older adults with or at risk of cognitive decline. Through database searches, evidence was collected from the literature to determine recommended resources within the professional field of audiology and surrounding healthcare professions. Based on the literature, appropriate resources for retention of medical information in this population were recommended. Resources were then created based on the literature recommendations for hearing aid fittings and follow-ups when working with older adult patients with or at risk of cognitive decline. The resources included written supplemental materials with visual pictures in the form of hand-outs and video supplemental materials available to patients on YouTube. The resources were created to provide older adult patients with hearing loss and with or at risk of cognitive decline with additional support in the hearing aid rehabilitation process

Changes in Head, Withers, and Pelvis Movement Asymmetry in Lame Horses as a Function of Diagnostic Anesthesia Outcome, Surface and Direction

Evaluation of diagnostic anesthesia during equine lameness examination requires comparison of com-plex movement patterns and can be influenced by expectation bias. There is limited research about how changes in movement asymmetries after successful analgesia are affected by different exercise condi-tions. Movement asymmetry of head, withers and pelvis was quantified in N = 31 horses undergoing forelimb or hindlimb diagnostic anesthesia. Evaluation on a straight line and a circle was performed with subjective diagnostic anesthesia outcome and quantitative changes recorded. Mixed linear models ( P < .05) analyzed the differences in movement asymmetry before/after diagnostic anesthesia -random fac-tor: horse, fixed factors: surface (soft, hard), direction (straight, inside, outside, inside-outside average), diagnostic anesthesia outcome (negative, partially positive, positive) and two-way interactions. Forelimb diagnostic anesthesia influenced primary movement asymmetry (all head and withers parameters) and compensatory movement asymmetry (two pelvic parameters) either individually ( P <=.009) or in interac-tion with surface ( P <=.03). Hindlimb diagnostic anesthesia influenced primary movement asymmetry (all pelvic parameters) and compensatory movement asymmetry (two head and two withers parameters) ei-ther individually ( P <=.04) or in interaction with surface ( P <=.01;) or direction ( P <=.006). Direction was also significant individually for two pelvic parameters ( P <=.04). Changes in primary movement asymmetries after partially positive or positive outcomes indicated improvement in the blocked limb. Compensatory changes were mostly in agreement with the 'law of sides'. The changes were more pronounced on the hard surface for hindlimb lameness and on the soft surface for forelimb lameness. Withers asymmetry showed distinct patterns for forelimb and hindlimb lameness potentially aiding clinical decision-making.(c) 2022 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY license ( http://creativecommons.org/licenses/by/4.0/

Intra-synovial Ropivacaine and Morphine for Pain Relief after Total Knee Arthroplasty -A Prospective, Randomized, Double Blind Study-

PURPOSE: Several analgesic techniques are available for pain management after a major operation. MATERIALS AND METHODS: From December 2005 to February 2006, a prospective, double-blind study was performed involving 90 patients who had undergone a total knee arthroplasty. Patients were randomly divided into three equal groups (n=30). Demographic data, including age, height, weight, knee score, visual analogue scale (VAS), and range of flexion were evaluated preoperatively. Before wound closure, patients were given intra-synovial injections of the following solutions: patients in group I received 40mL of 300mg ropivacaine with 1:200,000 epinephrine and 5mg morphine; patients in Group II received 40mL of 300mg ropivacaine with epinephrine; and patients in Group III received 50mL normal saline as a control. All patients received an epidural patient-controlled analgesia (PCA) for 24 postoperative hours. Analgesic efficacy was evaluated using the VAS at intervals of 2, 4, 6, 12, 24, 32, 40, and 48 hours postoperatively. During this period, the side effects, the dosage of rescue analgesia required, and the range of knee flexion were recorded for each group. RESULTS: There were no significant differences among the three groups with regards to the VAS and the required dose of rescue analgesia (p > 0.05). None of the groups demonstrated significant differences in the range of knee flexion and the incidence of postoperative nausea and emesis (p > 0.05). CONCLUSION: Therefore, we found that ropivacaine, alone or with morphine, injected into the synovial tissue, along with an epidural PCA has no additional benefits in pain control after a total knee arthroplasty.ope

Genetic and biomechanical determinants of glenoid version: Implications for glenoid implant placement in shoulder arthroplasty

Summary: The universally accepted method of measuring glenoid version to determine proper alignment of the glenoid component during total shoulder arthroplasty does not account for the complex and variable relationship of the glenoid vault with the scapular body. Existing evidence indicates that the glenoid and the scapular body development are controlled by independent genetic and biomechanical factors. This raises the question: How relevant is the relationship of the glenoid face to the scapular body? This review paper integrates our present understanding of the genetics of scapular development and congenital and neuromuscular conditions to generate insights into scapular morphology and biomechanics. Glenoid version as traditionally defined may have limited relevance when positioning the glenoid component during total shoulder arthroplasty. Further studies of soft-tissue and muscular balance are needed to fully understand the consequences of variations in glenoid version. Level of evidence: Review