Complaints of the Arm, Neck and/or Shoulder. A new approach to its terminology and classification: the CANS model

Musculoskeletal disorders of the upper-extremity and neck are extremely common and one of the major causes of disability, sickness absence and health care use all around the world. The conditions do not threaten life, but they result in considerable discomfort for the patient and financial burden to society. Various names are given to musculoskeletal disorders of the upper extremity and various project have been conducted to achieve consensus on diagnostic criteria. However, a complete overview of all musculoskeletal neck and upperextremity disorders coupled with a classification system that can be multidisciplinary approved was still missing. This thesis reported on the development of a new approach for terminology and classification of these disorders: CANS (complaints of the arm, neck and/or shoulder) and the CANS model

Morbid obesity and asthma : co-morbidity or causal relationship?

This thesis consists of three parts. Part A describes in chapter 2 the complex diagnosis of asthma in the morbidly obese, and especially focuses on underdiagnosis and overdiagnosis of asthma in this patient group. Part B investigates bronchial and systemic inflammation. It starts in chapter 3 with a review on the association between obesity and asthma, where the metabolic syndrome __ as state of systemic inflammation - is mentioned as possible explanation for the association between obesity and asthma. In chapter 4 systemic inflammation and the metabolic syndrome and impaired lung function in morbidly obese subjects are discussed. This is followed by chapter 5, in which the presence and possible relationship between bronchial and systemic inflammation in morbidly obese asthma subjects are discussed. Part C focuses on bariatric surgery, first pulmonary function testing and complications of bariatric surgery are discussed in chapter 6. In chapter 7 the effect of bariatric surgery on asthma is described. And finally, in chapter 8, a summary and general discussion of these studies is presented.UBL - phd migration 201

Dependence of silicon position-detector bandwidth on wavelength, power, and bias

We have developed a two-LED wobbler system to generate the spatial displacement of total light intensity on a detector surface, facilitating the acquisition of frequency responses up to 600 kHz with high accuracy. We have used this setup to characterize the low-pass filtering behavior of silicon-based position detectors for wavelengths above 850 nm by acquiring the frequency responses of several quadrant detectors and positionsensitive detectors as functions of wavelength, applied bias voltage, and total light power. We observed an increase in bandwidth for an increase in applied bias voltage and incident-light intensity. The combined effect of these parameters is strongly dependent on the detector used and has significant implications for the use of these detectors in scanning probe and optical tweezers applications

Obesity and asthma: co-morbidity or causal relationship?

There is substantial evidence that obesity and asthma are related. “Obese asthma” may be a unique phenotype of asthma, characterized by decreased lung volumes, greater symptoms for a given degree of lung function impairment, destabilization or lack of asthma control, lack of eosinophilic inflammation and a different response to controller medication. Whether this relationship between obesity and asthma is causal or represents co-morbidity due to other factors is unclear. In previous reviews concerning the relationship between obesity and asthma, five hypotheses were put forth. One of these hypotheses is that a low grade systemic inflammation caused by adipokines from the fat tissue causes or enhances bronchial inflammation. In animal models, there is an increasing amount of evidence for the role of adipokines derived from fat tissue in the relationship between obesity and asthma. The data are conflicting in humans. Since obesity is a component of the metabolic syndrome and the metabolic syndrome is also a form of systemic inflammation, it is to be expected that there is a relationship between metabolic syndrome and asthma. The few data that are available show that there is no relationship between metabolic syndrome and asthma, but there is one between the metabolic syndrome and asthma-like symptoms. Further research is needed to confirm the relationship between obesity and asthma in humans, where a rigorous approach in the diagnosis of asthma is essential

Improving Parenting to Promote School Readiness: A Preliminary Evaluation of the Books Can…© Public Library Program

The present study examines associations between parents’ involvement in an enhanced storytime program and parenting knowledge and efficacy for supporting their child’s socioemotional development and book reading. Books Can…© was developed by a public library to teach parents important child development information and strategies for supporting their child’s socioemotional learning. Parents and their young children participated in a 6-week interactive program that included book reading, songs, interactive activities, and parenting tips. Parents (n =119) completed questionnaires both prior to and after participating in the program. Multilevel general linear models compared responses to survey items before and after the program, indicating significant increases in parent knowledge, attitudes, and reading behavior by the end of the program. This study provides preliminary support documenting the benefits of the Books Can…© program. Moreover, results highlight public libraries and enhanced storytime programs as meaningful settings for promoting family involvement in children’s early learning

Clinical course, costs and predictive factors for response to treatment in carpal tunnel syndrome: The PALMS study protocol

Background Carpal tunnel syndrome (CTS) is the most common neuropathy of the upper limb and a significant contributor to hand functional impairment and disability. Effective treatment options include conservative and surgical interventions, however it is not possible at present to predict the outcome of treatment. The primary aim of this study is to identify which baseline clinical factors predict a good outcome from conservative treatment (by injection) or surgery in patients diagnosed with carpal tunnel syndrome. Secondary aims are to describe the clinical course and progression of CTS, and to describe and predict the UK cost of CTS to the individual, National Health Service (NHS) and society over a two year period. Methods/Design In this prospective observational cohort study patients presenting with clinical signs and symptoms typical of CTS and in whom the diagnosis is confirmed by nerve conduction studies are invited to participate. Data on putative predictive factors are collected at baseline and follow-up through patient questionnaires and include standardised measures of symptom severity, hand function, psychological and physical health, comorbidity and quality of life. Resource use and cost over the 2 year period such as prescribed medications, NHS and private healthcare contacts are also collected through patient self-report at 6, 12, 18 and 24 months. The primary outcome used to classify treatment success or failures will be a 5-point global assessment of change. Secondary outcomes include changes in clinical symptoms, functioning, psychological health, quality of life and resource use. A multivariable model of factors which predict outcome and cost will be developed. Discussion This prospective cohort study will provide important data on the clinical course and UK costs of CTS over a two-year period and begin to identify predictive factors for treatment success from conservative and surgical interventions

Return to Play After Hamstring Injuries: A Qualitative Systematic Review of Definitions and Criteria

Background: More than half of the recurrent hamstring injuries occur within the first month after return-to-play (RTP). Although there are numerous studies on RTP, comparisons are hampered by the numerous definitions of RTP used. Moreover, there is no consensus on the criteria used to determine when a person can start playing again. These criteria need to be critically evaluated, in an attempt to reduce recurrence rates and optimize RTP. Objective: To carry out a systematic review of the literature on (1) definitions of RTP used in hamstring research and (2) criteria for RTP after hamstring injuries. Study Design: Systematic review. Methods: Seven databases (PubMed, EMBASE/MEDLINE, CINAHL, PEDro, Cochrane, SPORTDiscus, Scopus) were searched for articles that provided a definition of, or criteria for, RTP after hamstring injury. There were no limitations on the methodological design or quality of articles. Content analysis was used to record and analyze definitions and criteria for RTP after hamstring injury. Results: Twenty-five papers fulfilled inclusion criteria, of which 13 provided a definition of RTP and 23 described criteria to support the RTP decision. “Reaching the athlete’s pre-injury level” and “being able to perform full sport activities” were the primary content categories used to define RTP. “Absence of pain”, “similar strength”, “similar flexibility”, “medical staff clearance”, and “functional performance” were core themes to describe criteria to support the RTP decision after hamstring injury. Conclusion: Only half of the included studies provided some definition of RTP after hamstring injury, of which reaching the athlete’s pre-injury level and being able to perform full sport activities were the most important. A wide variety of criteria are used to support the RTP decision, none of which have been validated. More research is needed to reach a consensus on the definition of RTP and to provide validated RTP criteria to facilitate hamstring injury management and reduce hamstring injury recurrence. PROSPERO systematic review registration number: CRD42015016510

Measurement of junctional tension in epithelial cells at the onset of primitive streak formation in the chick embryo via non-destructive optical manipulation

Directional cell intercalations of epithelial cells during gastrulation has in several organisms been shown to be associated with a planar cell polarity in the organisation of the actin-myosin cytoskeleton and is postulated to reflect directional tension that drives oriented cell intercalations. We have characterised and applied a recently introduced non-destructive optical manipulation technique to measure the tension in individual epithelial cell junctions of cells in various locations and orientations in the epiblast of chick embryos in the early stages of primitive streak formation. Junctional tension of mesendoderm precursors in the epiblast is higher in junctions oriented in the direction of intercalation than in junctions oriented perpendicular to the direction of intercalation and higher than in junctions of other cells in the epiblast. The kinetic data are fitted best with a simple visco-elastic Maxwell model and we find that junctional tension and to a lesser extent viscoelastic relaxation time are dependent on myosin activity

Work-related complaints of arm, neck and shoulder among computer office workers in an Asian country: prevalence and validation of a risk-factor questionnaire

<p>Abstract</p> <p>Background</p> <p>Complaints of arm, neck and/or shoulders (CANS) affects millions of computer office workers. However its prevalence and associated risk factors in developing countries are yet to be investigated, due to non availability of validated assessment tools for these countries. We evaluated the 1-year prevalence of CANS among computer office workers in Sri Lanka and tested the psychometric properties of a translated risk factor questionnaire.</p> <p>Methods</p> <p>Computer office workers at a telecommunication company in Sri Lankan received the Sinhalese version of the validated Maastricht Upper Extremity Questionnaire (MUEQ). The 94 items in the questionnaire covers demographic characteristics, CANS and evaluates potential risk factors for CANS in six domains. Forward and backward translation of the MUEQ was done by two independent bi-lingual translators. One-year prevalence of CANS and psychometric properties of the Sinhalese questionnaire were investigated.</p> <p>Results</p> <p>Response rate was 97.7% (n = 440). Males were 42.7%. Mean age was 38.2 ± 9.5 years. One-year prevalence of CANS was 63.6% (mild-53.7% and severe-10%). The highest incidences were for neck (36.1%) and shoulder (34.3%) complaints. Two factors for each domain in the scale were identified by exploratory factor analysis (i.e. work-area, computer-position, incorrect body posture, bad-habits, skills and abilities, decision-making, time-management, work-overload, work-breaks, variation in work, work-environment and social-support). Calculation of internal consistency (Cronbach's alpha 0.43-0.82) and cross-validation provided evidence of reliability and lack of redundancy of items.</p> <p>Conclusion</p> <p>One year prevalence of CANS in the study population corresponds strongly with prevalence in developed countries. Translated version of the MUEQ has satisfactory psychometric properties for it to be used to assess work-related risk factors for development of CANS among Sri Lankan computer office workers.</p