Pinch Testing Positions Among Certified Hand Therapists: A Cross-Sectional Survey

Background: Pinch strength is indicative of later functional hand use following injury to hand. However, we believe clinicians (and more specifically CHTs) currently do not use a consistent measurement of pinch grip, despite availability of a “gold standard” of current (2015) ASHT standards for measuring pinch grip. Methods: This cross-sectional survey (N = 175, 35% response) was designed to determine whether CHTs adhere to the standardized testing position for palmar pinch strength as recommended by the ASHT. Results: Results determined that only 5.7% (n = 10) of the CHTs surveyed complete the entire ASHT standardized testing position. An additional 18.3% (n = 32) of the CHTs reported positioning the upper arm, forearm, and wrist per the guidelines, but did not hold under the gauge as recommended. The low percentage of adherence to this position contrasts with the majority of the CHTs (98.3%) reporting using standardized testing position for grip strength for at least 75% of attempts. Conclusion: It is possible that the pinch guidelines are not as widespread in the literature, and therefore, clinicians are not able to reference the recommended standardized positions

Nonvitamin, Nonmineral Dietary Supplement Use among Adults with Fibromyalgia: United States, 2007–2012

Background. Fibromyalgia (FMS) is a pain condition affecting 2–6% of US adults; effective treatment remains limited. Determinants of nonvitamin, nonmineral dietary supplement (NVNM) use among adults with FMS are not well-studied. We investigated the relation of NVNM use to FMS, and trends, in two nationally representative samples of US adults ≥18 years. Methods. Data were drawn from 2007 and 2012 National Health Interview Surveys (’s = 20127 and 30672, resp.). Logistic regression was used to examine associations of FMS to NVNM use (past 12 months) and evaluate potential modifying influences of gender and comorbidities. Multivariate models adjusted for sampling design, demographic, lifestyle, and health-related factors. Results. FMS was significantly higher in 2012 than in 2007 (1.7% versus 1.3%), whereas NVNM use decreased (57% versus 41%; ). Adults reporting diagnosis were more likely to use NVNMs within 12 months, 30 days, or ever relative to adults without; positive associations remained significant after controlling for demographics, lifestyle characteristics, medical history, and other confounders (ranges: 2007 and 2012 AORs = 2.3–2.7; 1.5–1.6, resp.; ’s \u3c 0.0001).Conclusion. In this cross-sectional study of two national samples, NVNM use was strongly and positively associated with FMS, highlighting the need for further study

Strontium and stable C and O isotopic composition of carbonates in the Ernest Henry deposit, Queensland, Australia: implications for genesis and exploration

The Ernest Henry IOCG (iron-oxide copper gold) deposit is hosted within Paleoproterozoic meta-sedimentary and meta-igneous rocks of the eastern succession of the Mt Isa inlier. The mineralization is mostly breccia-hosted, with K-feldspar altered clasts cemented by biotite-carbonate-magnetite-sulfides. The breccias grade out to crackle breccias and then veins, with the breccia/crackle breccia contact typically demarcating economic mineralization. The origin of brecciation and mineralization remains controversial, but numerous elemental enrichments suggest multiple fluids with a mixed origin including magmatic and/or saline metamorphic fluids. Foremost among the proposed mechanism for IOCG formation at Ernest Henry is that CO2 release directly from enriched mantle, or indirectly from mafic magmas, played an important role in breccia formation and in scavenging ore components from local wallrocks, particularly mafic rocks. This hypothesis is mainly based on the regional interpretation of stable C and O isotopes from carbonates within the eastern succession of the Mt Isa inlier, including limited samples from Ernest Henry

Potential Mediators between Fibromyalgia and C-Reactive protein: Results from a Large U.S. Community Survey.

Background: Fibromyalgia, a potentially debilitating chronic pain syndrome of unknown etiology, may be characterized by inflammation. In this study, we investigated the relation of FMS to serum C-reactive protein (CRP) in a large population of adults (18+) and investigated the influence of other factors on this relationship, including BMI, comorbidities, as well as mood and sleep disturbance. Methods: Participants were 52,535 Ohio Valley residents (Fibromyalgia n = 1125). All participants completed a comprehensive health survey (2005–2006) part of the C8 Health Project; serum levels of CRP were obtained, as was history of Fibromyalgia physician diagnosis. Logistic and linear regressions were used for this cross-sectional analysis. Results: Mean CRP was higher among participants reporting Fibromyalgia than those without (5.54 ± 9.8 vs.3.75 ± 7. 2 mg/L, p \u3c .0001)). CRP level showed a strong, positive association with FMS (unadjusted odds ratio (OR) for highest vs. lowest quartile = 2.5 (CI 2.1,3.0;p for trend \u3c .0001)); adjustment for demographic and lifestyle factors attenuated but did not eliminate this association (AOR for highest vs. lowest quartile = 1.4 (CI 1.1,1.6;p for trend \u3c .0001)). Further addition of body mass index (BMI) and comorbidities to the model markedly weakened this relationship (AORs, respectively, for highest vs lowest CRP quartile = 1.2 (CI 1.0,1.4) and 1.1 (CI 0.9,1.3). In contrast, inclusion of mood and sleep impairment only modestly reduced the adjusted risk estimate (AORs for highest vs. lowest quartile = 1.3 (CI 1.1,1.5) for each)). Conclusions: Findings from this large cross-sectional study indicate a significant positive cross-sectional association of Fibromyalgia to serum C-reactive protein may be explained, in part, by BMI and comorbidity. Prospective research is needed to confirm this, and clarify the potential mediating influence of obesity and comorbid conditions on this relationship

On saturation effect for linear shape-preserving approximation in Sobolev spaces

Objectives Little is known about patterns and correlates of Complementary Health Approaches (CHAs) in chronic pain populations, particularly in rural, underserved communities. This article details the development and implementation of a new survey instrument designed to address this gap, the Complementary Health Approaches for Pain Survey (CHAPS). Design Following pilot-testing using pre-specified criteria to assess quality and comprehension in our target population, and after feedback regarding face-validity from content experts and stakeholders, the final cross-sectional self-report survey required 10–12 minutes to complete. It contained 69 demographic, lifestyle and health-related factors, and utilized a Transtheoretical Model (TTM) underpinning to assess short- and long-term use of 12 CHAs for pain management. Twenty additional items on pain severity, feelings, clinical outcomes, and activities were assessed using the Short-Form Global Pain Scale (SF-GPS); Internal reliability was assessed using Cronbach’s alpha. Settings/location Investigators conducted consecutive sampling in four West Virginia pain management and rheumatology practices. Participants 301 Appalachian adult patients seeking conventional care for pain management. Results Response rates were high (88% ± 4.1%). High quality and comprehension deemed the CHAPS an appropriate measurement tool in a rural population with pain. Missing data were unrelated to patient characteristics. Participants predominantly experienced chronic pain (93%), had five or more health conditions (56%, Mean = 5.4±3.1), were white (92%), female (57%), and middle-aged (Mean = 55.6 (SD = 13.6) years). Over 40% were disabled (43%) and/or obese (44%, Mean BMI = 33.4±31.5). Additionally, 44% used opioids, 31% used other prescription medications, and 66% used at least one CHA for pain, with 48% using CHAs for greater than 6 months. There was high internal reliability of the SF-GPS (alpha = .93) and satisfactory internal reliability for each of the five TTM stages across (all) twelve CHAs: precontemplation (0.89), contemplation (0.72), preparation (0.75), action (0.70), and maintenance (0.70). Conclusions The CHAPS is the first comprehensive measurement tool to assess CHA use specifically for pain management. Ease of administration in a population with pain support further use in population- and clinic-based studies in similar populations

Life satisfaction among a clinical eating disorder population

Background The primary objective was to understand life satisfaction (LS) of patients with eating disorders (EDs) in relation to eating pathology severity, personal/familial ED history, and key demographic and anthropometric variables. Methods Participants (N = 60) completed the Satisfaction with Life Scale (SWLS), the Eating Pathology Severity Index (EPSI), and demographic questionnaires. Bivariate associations via correlations and multiple linear regression models were used to explore these relationships. Results The SWLS mean score was 3.7 out of 7, suggesting it is below the population-based norm. LS was positively statistically significantly associated with private insurance, past ED, EPSI muscle building, EPSI restricted eating, and EPSI negative attitudes. When included in multiple linear regression, the model explained 33% of the variability of LS [F (7, 56) = 3.4, p = 0.0054, R2 = 0.33]. EPSI muscle building remained the strongest predictor (β = 0.13, p = 0.04). Conclusions Based on the data, individuals who have/have had EDs scored lower on the SWLS than the general population. Individuals scoring within this range typically experience significant issues in several areas of life or a substantial issue in one area

Rubella immunity and serum perfluoroalkyl substances: Sex and analytic strategy

Background Perfluoroalkyl substances (PFASs) have been associated with decreased immunity to child- hood tetanus and diphtheria immunizations. If these vaccinations are vulnerable to influence from PFASs, questions arise about associations with other common inoculations. Objective To examine whether serum PFASs were associated with reduced immunity to rubella immu- nization, and whether interactions with sex or ethnicity warranted analytic stratification. Usually, toxicology analyses are calculated controlling for race and sex. However, sex differ- ences in immune function have been reported and a reduction of immunity to rubella in women could pose risks such miscarriage. Methods We analyzed a nationally representative sample of individuals 12 years from the National Health and Nutrition Examination Survey (NHANES) for years 1999–2000 and 2003–2004 for whom PFAS measures were available. Our analytic strategy was to start with separate analyses for youth and adults controlling for several covariates including ethnicity and sex, as well as the interaction of these terms with PFASs. If there was a main effect of PFASs and an interaction term, we would stratify analyses of effect size. The outcome variable was Rubella IgG titers by quartile of perfluoroalkyl substances. Results After exclusion for missing data, the analyzed sample contained 581 adult women, 621 adult men, and 1012 youth. There was no significant effect of PFASs on immunity in youths but a significant effect of both PFOA and PFOS in adults, as well as a significant interaction of PFOA x sex and a borderline significant interaction of PFOS x sex. When effect size anal- yses were stratified by sex, a significant association between rubella titres and PFOA was found in men but not women and PFOS was not significant in either sex. Conclusions These results support our earlier studies showing sex specific responses to PFASs and indi- cate the importance of thinking carefully about analytic strategies in population based toxi- cology research

Nonvitamin, Nonmineral Dietary Supplement Use among Adults with Fibromyalgia: United States, 2007–2012

Background. Fibromyalgia (FMS) is a pain condition affecting 2–6% of US adults; effective treatment remains limited. Determinants of nonvitamin, nonmineral dietary supplement (NVNM) use among adults with FMS are not well-studied. We investigated the relation of NVNM use to FMS, and trends, in two nationally representative samples of US adults ≥18 years. Methods. Data were drawn from 2007 and 2012 National Health Interview Surveys (N’s = 20127 and 30672, resp.). Logistic regression was used to examine associations of FMS to NVNM use (past 12 months) and evaluate potential modifying influences of gender and comorbidities. Multivariate models adjusted for sampling design, demographic, lifestyle, and health-related factors. Results. FMS was significantly higher in 2012 than in 2007 (1.7% versus 1.3%), whereas NVNM use decreased (57% versus 41%; p<0.0001). Adults reporting diagnosis were more likely to use NVNMs within 12 months, 30 days, or ever relative to adults without; positive associations remained significant after controlling for demographics, lifestyle characteristics, medical history, and other confounders (ranges: 2007 and 2012 AORs = 2.3–2.7; 1.5–1.6, resp.; p’s < 0.0001). Conclusion. In this cross-sectional study of two national samples, NVNM use was strongly and positively associated with FMS, highlighting the need for further study

Maternal Age and Inadequate Prenatal Care in West Virginia: A Project WATCH Study

Introduction: Adequate prenatal care (PNC) is essential to the overall health of mother and infant. Teen age and advanced maternal age (AMA) are known risk factors for poor birth outcomes. However, less is known about whether these age groups are associated with inadequate PNC. Purpose: This study sought to determine the potential association between maternal age (in groups, aged 20–24, 25–29, 30–34, 35–39, and \u3e40) and inadequate PNC (visits). Methods: West Virginia (WV) Project WATCH population-level data (May 2018–March 2022) were used for this study. Multiple logistic regressions were performed on inadequate PNC (less than 10 visits) with maternal age categories, adjusting for covariates including maternal race, smoking status, substance use status, parity, education, geographic location, and insurance status. Results: Results demonstrate that both young and AMA pregnant people are more likely to receive inadequate PNC. PNC is particularly important for these groups, as they are at increased risk of poor birth outcomes. Just over 11% of pregnant people who gave birth in WV received inadequate PNC. Participants aged 19 years and younger (aOR:1.3, CI:(1.2,1.4)), 35–39 years (aOR:1.1, CI:(1.0,1.2)), and 40 years (aOR:1.3, CI:(1.1,1.5)) were at increased odds of inadequate PNC relative to 25–29-year-olds. Implications: Results indicate that easily obtained demographics, such as a pregnant person’s age, can be utilized by policymakers and clinical interventionists to improve birth outcomes by increasing PNC outreach for these groups

Waking up every day in a body that is not yours: a qualitative research inquiry into the intersection between eating disorders and pregnancy

Background Women with eating disorders are more likely to negatively react to finding out they are pregnant, although this difference in attitudes between women with eating disorders and controls disappears at 18-weeks’ gestation. Those with anorexia also are twice as likely to have an unplanned pregnancy and those with bulimia have a 30-fold increased chance compared with healthy controls. Therefore, due to these considerations, pregnancy and the transition to motherhood can be an extremely challenging time for these women both psychologically and physically. The purpose of this qualitative descriptive study was to understand the intersection between eating disorders and pregnancy from the lived experience of women who have been pregnant or want to or do not want to become pregnant. Methods A total of 15 women with a current or past history of an eating disorder were recruited, including nine women who have had previous pregnancies as well as six nonparous women. Interviews were the primary unit of data collection, in addition to document analysis of diaries or blogs. Data analysis was based on verbatim transcripts from audio recordings. NVIVO 11© was used to manage the data from these interviews and thematic analysis was then conducted for emergence of major and sub themes. Results A total of six themes emerged from the iterative process of coding and categorizing. They were: Control, Disclosure to Others, Battle between Mothering & Eating Disorder, Fear of Intergenerational Transmission, Weight and Body Image Concerns, and Coping Strategies. One theme, Battle between Mothering & Eating Disorder also had three sub-themes: Decision to Have Child, Emotions Towards Pregnancy, and Focus on Child/Greater Good. Conclusions It is hoped that quotes and themes derived from this study will help inform both prenatal and postnatal care and interventions, as well as addressing intergenerational transmission concerns among mothers with eating disorders