Recovery trajectories for long-term health-related quality of life following a road traffic crash injury: results from the UQ SuPPORT study

Background Diminished physical and mental health-related quality of life (HRQoL) is a common consequence of road traffic crash (RTC) injury. This study aimed to (a) determine the probable recovery trajectories in physical and mental HRQoL; (b) examine the impact of posttraumatic stress disorder (PTSD) on HRQoL scores within these trajectory groups; and (c) examine the influence of predictor covariates on trajectory group membership. Methods 336 (63% female, M =44.72; SD =14.77) injured RTC survivors completed the SF-36v2 at approximately 6, 12, and 24 months after sustaining a RTC injury. Participants also completed telephone interviews to assess prior history of psychological disorder and current PTSD at each wave. Results Three trajectories were identified for SF-36v2 Physical Component Score (PCS): ”gradual recovery” (27.3%);”low but improving” (54.7%); and”severe and chronic” (17.9%). Four trajectories were defined for SF36v2 Mental Component Score (MCS): “unaffected” (19.1%);”severe but improving” (24.1%);”severe and declining” (17.3%); and”low but improving” (39.5%). A PTSD diagnosis significantly reduced SF36v2 component scores only in trajectories associated with poorer outcome. Age was predictive of trajectory group membership for PCS, whereas injury severity was predictive of trajectory group membership for MCS. Limitations Use of a compensation seeking sample affects generalizability to the general RTC population. Conclusions This study identified a concerning subgroup of individuals who have chronic and/or declining physical and mental HRQoL that can be impacted by a diagnosis of PTSD. The development of interventions with a special focus on associated psychological injury is needed to improve the HRQoL of at-risk individuals following RTC injury

Similar factors predict disability and posttraumatic stress disorder trajectories after whiplash injury

Distinct developmental trajectories for neck disability and posttraumatic stress disorder (PTSD) symptoms after whiplash injury have recently been identified. This study aimed to identify baseline predictors of membership to these trajectories and to explore their dual development. In a prospective study, 155 individuals with whiplash were assessed a

Population-based normative values for the Western Ontario and McMaster (WOMAC) Osteoarthritis Index: Part 1

Objectives: To develop population-based age- and gender-specific normative values for the pain, stiffness, and physical function subscales of the WOMAC Index for benchmarking applications. Methods: A scannable survey questionnaire capable of capturing WOMAC Index data and demographic information was developed, pretested, and distributed to a stratified random sample of 36,000 members of the Australian general public generated by the Australian Electoral Commission. Results: Age- and gender-specific WOMAC normative values were estimated based on approximately 7300 subjects. Age-related differences were noted in all 3 WOMAC subscales. In general, pain, stiffness, and difficulty with physical function percentiles increased with age. Conclusions: WOMAC normative values provide opportunity for benchmarking the health status of individuals with hip and knee osteoarthritis against their age- and gender-matched peers in the general population. These normative values provide unique opportunities for using the WOMAC Index in benchmarking applications in both clinical practice and research

Population-based normative values for the Australian/Canadian (AUSCAN) Hand Osteoarthritis Index: Part 2

Objectives: To develop population-based age- and gender-specific normative values for the pain, stiffness, and physical function subscales of the AUSCAN Index for benchmarking applications. Methods: A scannable survey questionnaire capable of capturing AUSCAN Index data and demographic information was developed, pretested, and distributed to a stratified random sample of 36,000 members of the Australian general public generated by the Australian Electoral Commission. Results: Age- and gender-specific AUSCAN normative values were estimated based on approximately 7300 subjects. Age-related differences were noted in all 3 AUSCAN subscales. In general, pain, stiffness, and difficulty with physical function percentiles increased with age. Conclusions: AUSCAN normative values provide opportunity for benchmarking the health status of individuals with hand osteoarthritis against their age- and gender-matched peers in the general population. These normative values provide unique opportunities for using the AUSCAN Index in benchmarking applications, in both clinical practice and research

Factors influencing flight activity of colonies of the stingless bee trigona carbonaria (Hymenoptera: Apidae)

Temporal patterns of flight activity and influence of climatic variables on activity of colonies of the potentially useful crop pollinator, Trigona carbonaria Smith, were investigated. Colonies of T. carbonaria were active all the year at the experimental site but the daily activity period was longer in the warmer months. Intensity of daily flight activity was greatest in September and least in May. Temperature and radiation were the most important variables affecting flight activity. They impose thresholds on activity, with flight occurring only at temperatures greater than 18°C and radiation greater than 15 W m-2. Temperature and radiation also influence the intensity of activity above the thresholds. Relative humidity, vapour pressure, cloud cover and wind speed had no significant effect. A variable measuring the hours from daily peak of activity was significantly correlated with flight activity, indicating an intrinsic diel pattern of activity. Daily variation in flight activity, representing the influence of unmeasured variables, was also significant

Screening for depression in patients with Diabetes mellitus

Objectives: The first aim of this study was to compare the effectiveness of four commonly used depression screening measures for medically ill populations in identifying depression within a diabetes sample. The second aim was to examine whether the inclusion of a measure for physical symptoms specific to diabetes is also necessary for a diagnosis of depression or alternatively whether any overlap would obscure the effect on the screening measure for depression. Research Design and Methods: One hundred fifty patients with Type 2 diabetes in two large public hospital outpatient clinics completed a questionnaire which included the Center for Epidemiological Studies?Depression Scale (CES-D), the Silverstone Concise Assessment for Depression (SCAD), the Hospital Anxiety and Depression Scale (HADS), and the Depression in the Medically Ill (DMI) Questionnaire. Patient scores on these questionnaires were then assessed against their responses on the Composite International Diagnostic Interview Short Form and the Diabetes Symptom Checklist to determine their effectiveness. Results and Conclusions: Logistic regression and receiver operating curves analysis, including areas under the curves, suggested selecting the CES-D, rather than the DMI-10, HADS or SCAD for screening for depression in a Type 2 diabetic patient. The CES-D performed well at predicting depression, had high sensitivity and specificity, and did not require the addition of diabetes symptoms to aid in diagnosis

Osteoarthritis Index delivered by mobile phone (m-WOMAC) is valid, reliable, and responsive

Objectives: To evaluate the validity, reliability and responsiveness of EDC using the WOMAC® NRS 3.1 Index on Motorola V3 mobile phones. ---------- Methods: Patients with osteoarthritis (OA) undergoing primary unilateral hip or knee joint replacement surgery were assessed pre-operatively and 3-4 months post-operatively. Patients completed the WOMAC® Index in paper (p-WOMAC®) and electronic (m-WOMAC®) format in random order. ---------- Results: 24 men and 38 women with hip and knee OA participated and successfully completed the m-WOMAC® questionnaire. Pearson correlations between the summated total index scores for the p-WOMAC® and m-WOMAC® pre- and post-surgery were 0.98 and 0.99 (p<0.0001). There was no clinically important or statistically significant between-method difference in the adjusted total summated scores, pre- and post-surgery (adjusted mean difference = 4.44, p = 0.474 and 1.73, p = 0.781). Internal consistency estimates of m-WOMAC® reliability were 0.87 – 0.98. The m-WOMAC® detected clinically important, statistically significant (p<0.0001) improvements in pain, stiffness, function and total index score. ---------- Conclusions: Sixty-two patients with hip and knee OA successfully completed EDC by Motorola V3 mobile phone using the m-WOMAC® NRS3.1 Index; completion times averaging only 1-1.5 minutes longer than the p-WOMAC® Index. Data were successfully and securely transmitted from patients in Australia to a server in the USA. There was close agreement and no significant differences between m-WOMAC® and p-WOMAC® scores. This study confirms the validity, reliability and responsiveness of the Exco InTouch engineered, Java-based m-WOMAC® Index application. EDC with the m-WOMAC® Index provides unique opportunities for using quantitative measurement in clinical research and practice