Psychometric Properties of the Brief Pain Inventory-Short Form and Revised Short McGill Pain Questionnaire Version-2 in Musculoskeletal Conditions

Introduction: Comprehensive pain assessment depends on the use of psychometrically valid patient-reported outcome measures (PROMs). The Brief Pain Inventory-Short Form (BPI-SF) and Revised Short McGill Pain Questionnaire Version-2 (SF-MPQ-2) are general-use multidimensional pain assessment tools commonly used in musculoskeletal conditions. Understanding all relevant measurement properties supports stronger decisions about PROMs. Thesis Objectives: The overarching objective of this thesis was to determine the sufficiency of measurement evidence backing the use of the BPI-SF and SF-MPQ-2 in musculoskeletal conditions. Specifically, a systematic review was conducted to locate, summarize and compare the quality and content of psychometric evidence backing the BPI-SF and SF-MPQ-2 in musculoskeletal conditions. Based on this review, the gap in evidence regarding the reliability and agreement properties (reproducibility) of SF-MPQ-2 was examined among patients with musculoskeletal shoulder pain. Methods: For the systematic review, we searched four databases to identify relevant citations. Two reviewers independently screened, extracted and appraised (using MacDermid and COSMIN guidelines) all psychometric reports on both tools in musculoskeletal conditions. To determine the SF-MPQ-2 reproducibility, a convenience sample of adults diagnosed with musculoskeletal shoulder pain (baseline, n=195; test-retest, n=48) completed the SF-MPQ-2 twice. Cronbach alpha (α), intraclass correlations coefficient (ICC2,1), agreement parameters (SEM, MDC) and Bland-Altman plots were assessed. Results: High quality evidence indicated both tools have high internal consistency (α = 0.83-0.96); and that they are moderately related (r = 0.3-0.69) to other health-related outcome measures. More studies of better quality have evaluated the BPI-SF responsiveness (n=5), retest reliability (n=3), known group validity (n=2) and structural validity (n=3), compared to the SF-MPQ-2. Our analysis of the SF-MPQ-2 reproducibility established internal consistency as satisfactory (α, 0.83-0.95), relative reliability as good (neuropathic, intermittent, and affective subscales: 1CC2,1= 0.78 - 0.88) to excellent (total and continuous subscale scores: 1CC2,1= 0.92 - 0.95). Agreement was within acceptable limits and there was no evidence of systematic bias. Conclusion: A greater volume of evidence of better quality currently supports the BPI-SF although emerging evidence suggest the SF-MPQ-2 has excellent reliability and agreement properties when used to assess adults with musculoskeletal shoulder pain. Direct comparisons of the two scales in different contexts are needed. Keywords: Brief Pain Inventory; Musculoskeletal Conditions; McGill Pain Questionnaire; Reliability; Psychometric Properties; Reproducibility; Systematic Revie

Evaluation of the antibacterial properties of the extracts and fractions of Ipomoea triloba l. (Convolvulaceae) on selected enteric diarrheagenic bacteria

Diarrhoea is a leading killer of young children accounting for approximately 8% of all deaths among children ˂ 5 years worldwide and causes neonatal mortality and hospitalization in geriatrics. Ipomoea triloba L. has been claimed to have antidiarrheal properties. This study evaluated antibacterial properties of the ethanol / aqueous extracts and fractions of I. triloba on diarrheagenic bacteria to validate its use in trado-medical treatment of diarrhoea. Aqueous and ethanol extracts of pulverized I. triloba were prepared by cold maceration and phytochemical screening was performed using standard procedures. Diarrheagenic bacteria were isolated from twenty (20) composite diarrhoeal stool samples by community bioprospecting using appropriate selective and differential media. In vitro antibacterial activity of extracts and fractions of I. triloba was determined by the modified agar-well diffusion technique, while minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) was determined by reference standard agar-dilution technique (ADT) after re-incubation of MIC samples at 37o C for 24 h. A total of 74 isolates, belonging to six genera, were identified with their numbers and percentages of occurrence as follows: Escherichia coli, 26 (35.1%), Staphylococcus aureus, 4 (5.4 %), Pseudomonas aeruginosa, 9 (12.2%), Shigella dysenteriae, 18 (24.3%), Salmonella typhi, 8 (10.8%) and Vibrio cholera, 9 (12.2%). Flavonoids, saponins, terpenes, carbohydrates and steroids were detected in both extracts. Ethanol extracts (≥30 mm) showed more potent broad-spectrum antibacterial activity than aqueous extract (≥18 mm). The MIC and MBC values ranged from 250 to 500 mg/mL and 500 to 1000 mg/mL respectively, thus establishing a time-dependent bactericidal mode of antibacterial activity. The best antibacterial activity was elicited by dichloromethane fraction. From the study, I. triloba possesses antibacterial potentials and may be exploited in the chemotherapy of bacterial diarrhoea

Reproducibility: reliability and agreement parameters of the Revised Short McGill Pain Questionnaire Version-2 for use in patients with musculoskeletal shoulder pain

© 2020, The Author(s). Background: The Revised Short McGill Pain Questionnaire Version-2 (SF-MPQ-2) is a multidimensional outcome measure designed to capture, evaluate and discriminate pain from neuropathic and non-neuropathic sources. A recent systematic review found insufficient psychometric data with respect to musculoskeletal (MSK) health conditions. This study aimed to describe the reproducibility (test–retest reliability and agreement) and internal consistency of the SF-MPQ-2 for use among patients with musculoskeletal shoulder pain. Methods: Eligible patients with shoulder pain from MSK sources completed the SF-MPQ-2: at baseline (n = 195), and a subset did so again after 3–7 days (n = 48), if their response to the Global Rating of Change (GROC) scale remained unchanged. Cronbach alpha (α) and intraclass correlation coefficient (ICC2,1), and their related 95% CI were calculated. Standard error of measurement (SEM), group and individual minimal detectable change (MDC90), and Bland–Altman (BA) plots were used to assess agreement. Results: Cronbach α ranged from 0.83 to 0.95 suggesting very satisfactory internal consistency across the SF-MPQ-2 domains. Excellent ICC2,1 scores were found in support of the total scale (0.95) and continuous subscale (0.92) scores; the remaining subscales displayed good ICC2,1 scores (0.78–0.88). Bland–Altman analysis revealed no systematic bias between the test and retest scores (mean difference = 0.13–0.19). While the best agreement coefficients were seen on the total scale (SEM = 0.5; MDC90individual = 1.2 and MDC90group = 0.3), they were acceptable for the SF-MPQ-2 subscales (SEM: range 0.7–1; MDC90individual: range 1.7–2.3; MDC90group: range 0.4–0.5). Conclusion: Good reproducibility supports the SF-MPQ-2 domains for augmented or independent use in MSK-related shoulder pain assessment, with the total scale displaying the best reproducibility coefficients. Additional research on the validity and responsiveness of the SF-MPQ-2 is still required in this population

Psychosocial interventions among patients with cancer and their family caregivers in the Sub-Saharan Region: A systematic review

Cancer is becoming a public health issue in the Sub-Saharan Africa (SSA). This systematic review aims to synthesise psychosocial interventions and their effects on the health outcomes of adult cancer patients and their family caregivers in SSA. We identified eligible publications in English language from PubMed, Cumulative Index of Nursing and Allied Health Literature Plus with Full Text, Embase, APA PsycInfo, Scopus, and African Index Medicus databases. We included psychosocial interventions targeted adult cancer patients/survivors or their family caregivers in SSA. This review identified five psychosocial interventions from six studies that support adult cancer patients and their family caregivers in SSA. The interventions focused on providing informational, psycho-cognitive, and social support. Three interventions significantly improved quality of life outcomes for cancer patients and their caregivers. Significant gaps exist between the rapidly increasing cancer burdens and the limited psychosocial educational interventions supporting adult cancer patients and their families in SSA. The reviewed studies provide preliminary evidence on development and testing interventions that aim to improve patients’ and caregivers’ quality of life

Modelling residual stresses and environmental degradation in adhesively bonded joints

EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Measurement properties of the brief pain inventory- short form (BPI-SF) and the revised short mcgill pain questionnaire-version-2 (SF-MPQ-2) in pain-related musculoskeletal conditions: A systematic review protocol

© 2020 BY THE ARCHIVES OF BONE AND JOINT SURGERY. Background: The Brief Pain Inventory-Short Form (BPI-SF) and Revised Short-Form McGill Pain Questionnaire Version-2 (SF-MPQ-2) are generic pain assessment tools used in research and practice for pain assessment in musculoskeletal (MSK) conditions. A comprehensive review that systematically analyses their measurement properties in MSK conditions has not been performed. This review protocol describes the steps that will be taken to locate, critically appraise, compare and summarize clinical measurement research on the BPI-SF and SF-MPQ-2 in pain-related MSK conditions. Methods: Medline, EMBASE, CINAHL and Scopus will be searched for publications that examine the measurement properties of the Brief Pain Inventory and Revised Short-Form McGill Pain Questionnaire Version-2. Two reviewers will independently screen citations (title, abstract and full text) and extract relevant data. The extensiveness, rigor, and quality of measurement property reports will be examined with a structured measurement studies appraisal tool, and with the updated COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines. Findings will be descriptively summarized, and when possible, a meta-analysis will be performed. Discussion: This review will summarize and compare the current level of evidence on the measurement properties of the BPI-SF and SF-MPQ-2 in a spectrum of musculoskeletal conditions. We expect clinicians/researchers dealing with MSK conditions to have synthesized evidence that informs their decision making and preferences. In addition, the review hopes to identify gaps and determine priorities for future research with or on the BPI-SF and SF-MPQ-2 in MSK conditions

The Burden Experience of Formal and Informal Caregivers of Older Adults With Hip Fracture in Nigeria

Introduction The incidence of hip fracture among older adults in Nigeria is on the rise. As a result, there is increased frequency of hospitalization, patient suffering, family burden, and societal cost. One dimension that has not been sufficiently explored is the burden of care experienced by informal and formal caregivers. Objectives To describe the care burden experience of informal and formal caregivers for older adults with hip fractures in a specialized orthopedic center in Nigeria and to explore in detail how their experience differs in caregiving roles. Method This study was conducted in the phenomenological approach of qualitative methods. Face-to-face interviews and focus group interaction with 12 family caregivers and 5 health-care professionals were carried out until data saturation was achieved. Data were analyzed using thematic analysis. Results The physical, emotional, and general health of elderly hip fracture patients are issues that affect caregiving. Factors that contribute to increased caregivers’ burden include system factors (lack of personnel and health-care facilities) and patient factors: comorbidity, patient’s cognitive status, and challenges completing activities of daily living (ADL). Social and financial barriers to care contribute to the type of burden experienced by the participants. Conclusions Caregivers experience difficulty in helping patients complete their ADL because patients with hip fracture have mobility issues that are often complicated by comorbid physical and cognitive problems. Strategies to reduce caregivers’ burden for older adults with hip fracture in Nigeria are needed. Greater access to health-care services and ADL aids, and training of caregivers on how to deal with cognitive and multimorbid health problems are potential solutions