MEASURING MARKET INTEGRATION IN THE GLOBAL ECONOMY

The increased level of market integration in the processed food industry through trade, foreign direct investment, and the expanded use of intellectual property rights are an observed phenomenon of the past three decades. Measurement of market integration is problematic, and the role of FDI in market integration has not been adequately taken into consideration. This study measures the growth in the market shares of multinationals in selected countries and industries to indicate the degree of market integration. We also employ a market share convergence type model to estimate whether the market shares of the multinationals and domestically owned firms in key markets have converged to some steady state during the years 1991 to 2003.Processed food industry, global integration, market shares, Argentina, Brazil, U.S., International Relations/Trade,

A questionnaire to identify patellofemoral pain in the community: an exploration of measurement properties

Background Community-based studies of patellofemoral pain (PFP) need a questionnaire tool that discriminates between those with and those without the condition. To overcome these issues, we have designed a self-report questionnaire which aims to identify people with PFP in the community. Methods Study designs: comparative study and cross-sectional study. Study population: comparative study: PFP patients, soft-tissue injury patients and adults without knee problems. Cross-sectional study: adults attending a science festival. Intervention: comparative study participants completed the questionnaire at baseline and two weeks later. Cross-sectional study participants completed the questionnaire once. The optimal scoring system and threshold was explored using receiver operating characteristic curves, test-retest reliability using Cohen’s kappa and measurement error using Bland-Altman plots and standard error of measurement. Known-group validity was explored by comparing PFP prevalence between genders and age groups. Results Eighty-four participants were recruited to the comparative study. The receiver operating characteristic curves suggested limiting the questionnaire to the clinical features and knee pain map sections (AUC 0.97 95 % CI 0.94 to 1.00). This combination had high sensitivity and specificity (over 90 %). Measurement error was less than the mean difference between the groups. Test–retest reliability estimates suggest good agreement (N = 51, k = 0.74, 95 % CI 0.52–0.91). The cross-sectional study (N = 110) showed expected differences between genders and age groups but these were not statistically significant. Conclusion A shortened version of the questionnaire, based on clinical features and a knee pain map, has good measurement properties. Further work is needed to validate the questionnaire in community samples

Pulsed electromagnetic energy treatment offers no clinical benefit in reducing the pain of knee osteoarthritis: a systematic review

Background The rehabilitation of knee osteoarthritis often includes electrotherapeutic modalities as well as advice and exercise. One commonly used modality is pulsed electromagnetic field therapy (PEMF). PEMF uses electro magnetically generated fields to promote tissue repair and healing rates. Its equivocal benefit over placebo treatment has been previously suggested however recently a number of randomised controlled trials have been published that have allowed a systematic review to be conducted. Methods A systematic review of the literature from 1966 to 2005 was undertaken. Relevant computerised bibliographic databases were searched and papers reviewed independently by two reviewers for quality using validated criteria for assessment. The key outcomes of pain and functional disability were analysed with weighted and standardised mean differences being calculated. Results Five randomised controlled trials comparing PEMF with placebo were identified. The weighted mean differences of the five papers for improvement in pain and function, were small and their 95% confidence intervals included the null. Conclusion This systematic review provides further evidence that PEMF has little value in the management of knee osteoarthritis. There appears to be clear evidence for the recommendation that PEMF does not significantly reduce the pain of knee osteoarthritis

Are there three main subgroups within the patellofemoral pain population? A detailed characterisation study of 127 patients to help develop targeted Intervention (TIPPs)

• Background Current multimodal approaches for the management of non-specific patellofemoral pain are not optimal, however, targeted intervention for subgroups could improve patient outcomes. This study explores whether subgrouping of non-specific patellofemoral pain patients, using a series of low cost simple clinical tests, is possible. • Method The exclusivity and clinical importance of potential subgroups was assessed by applying à priori test thresholds (1 SD) from seven clinical tests in a sample of adult patients with non-specific patellofemoral pain. Hierarchical clustering and latent profile analysis, were used to gain additional insights into subgroups using data from the same clinical tests. • Results One hundred and thirty participants were recruited, 127 had complete data: 84 (66%) female, mean age 26 years (SD 5.7) and mean BMI 25.4 (SD 5.83), median (IQR) time between onset of pain and assessment was 24 (7-60) months. Potential subgroups defined by the à priori test thresholds were not mutually exclusive and patients frequently fell into multiple subgroups. Using hierarchical clustering and latent profile analysis three subgroups were identified using 6 of the 7 clinical tests. These subgroups were given the following nomenclature: (i) ‘strong’, (ii) ‘weak and tighter’, and (iii) ‘weak and pronated foot’. • Conclusions We conclude that three subgroups of patellofemoral patients may exist based on the results of six clinical tests which are feasible to perform in routine clinical practice. Further research is needed to validate these findings in other datasets and, if supported by external validation, to see if targeted interventions for these subgroups improve patient outcomes

Efficacy of transdermal anti-inflammatory patches for musculoskeletal pain: a systematic review and meta-analysis.

Aim: To determine the efficacy of transdermal anti-inflammatory patches in the treatment of acute and chronic musculoskeletal pain. Methods: A comprehensive search of: Cochrane Central register of controlled trials, EMBASE, MEDLINE, CINAHL and PubMed, for studies using transdermal anti-inflammatory patches vs placebo for management of musculoskeletal pain, e.g. soft tissue injuries or tendonitis (last search January 2024). Cochrane Risk of Bias Tools v1 was used for quality assessment and GRADE determined certainty of evidence. Meta-analysis was performed. Results: Twenty-three randomized placebo-controlled trials (n = 4729) were included. There was low-certainty evidence that transdermal patches provided statistically and clinically significant pain relief on movement at long-term follow-up for chronic musculoskeletal pain (effect size -2-69 (95% CI: -4.14, -1.24) and at short-term follow-up which was non-clinically significant, (-1.24: 95% CI: -1.78, -0.69). Conclusion: Several types of transdermal anti-inflammatory patches may offer short-term and long-term pain relief for acute and chronic musculoskeletal conditions. However, the clinical significance of this effect for the long-term pain relief was based on low-certainty evidence of transdermal anti-inflammatory patches versus placebo; for short-term pain there was an overall non-clinically significant improvement. Performing a meta-analysis for all outcomes was not possible due to insufficiency in the evidence-base. Protocol registration: www.crd.york.ac.uk/prospero identifier is CRD42020185944

Handheld dynamometry: validity and reliability of measuring hip joint rate of torque development and peak torque

INTRODUCTION: Measuring rate of torque development (RTD) and peak torque (PT) for hip muscle performance presents challenges in clinical practice. This study investigated the construct validity of a handheld dynamometer (HHD) versus an isokinetic dynamometer (IKD), and intra-rater repeated reliability for RTD and PT and their relationship in hip joint movements. METHODS: Thirty healthy individuals (mean age = 30 ± 8 years, 13 males) underwent two test sessions in a single day. RTD (0-50, 0-100, 0-150, 0-200ms) and PT normalised to body mass in maximal voluntary isometric contractions were measured using a HHD and an IKD in hip flexion, extension, abduction, adduction, internal and external rotation. RESULTS: For validity between the devices, RTD0-50 exhibited the largest significant systematic bias in all hip movements (3.41-11.99 Nm·s-1 kg-1) and widest limits-of-agreement, while RTD0-200 had the lowest bias (-1.33-3.99 Nm·s-1 kg-1) and narrowest limits-of-agreement. For PT, agreement between dynamometers was observed for hip flexion (0.08 Nm·kg-1), abduction (-0.09 Nm·kg-1), internal (-0.01 Nm·kg-1), and external rotation (0.05 Nm·kg-1). For reliability, intra-rater intraclass correlation coefficient (ICC2,1) ranged from moderate to good in RTD0-50 and RTD0-100 (0.5-0.88), and good to excellent in RTD0-150 and RTD0-200 (0.87-0.95) in all movements. The HHD displayed excellent intra-rater, relative reliability values (ICC2,1) in all movements (0.85-0.95). Pearson's correlation revealed good linear correlation between PT and RTD0-150 and RTD0-200 in all movements (r = .7 to .87, p = < .001). CONCLUSION: Validity analysis demonstrated significant systematic bias and lack of agreement in RTD measures between the HHD and IKD. However, the HHD displays excellent to moderate intra-rater, relative reliability for RTD and PT measures in hip movements. Clinicians may use the HHD for hip muscle PT assessment but note, late phase RTD measures are more reliable, valid, and relate to PT than early phase RTD. Additionally, the correlation between RTD and PT at various time epochs was examined to better understand the relationship between these measures

Are there differences in Knee Stability between Patients with Patellofemoral Pain and Healthy Subjects during a Slow Step Descent Task?

Objective: To date no study exists to determine whether knee kinematics in the coronal and transverse planes during step descent are different between healthy subjects and patients with patellofemoral pain (PFP) despite patients often reporting pain and instability during this task. This study investigated the differences in knee kinematics between healthy subjects and patients with PFP during a step descent task. Methods: Thirty healthy subjects and 29 patients diagnosed with PFP performed a slow step descent from a 20cm step. Kinematic data were collected using a ten camera infra-red motion analysis system. Reflective markers were placed on the foot, shank and thigh using the Calibrated Anatomical Systems Technique (CAST). Results: The coronal plane knee range of motion was 2.7 degrees, 41% greater, in the PFP patients compared to healthy subjects (p=0.006), with 4 degrees greater internal rotation although this was not significant (p=0.087). A trend towards significance was also seen between males and females (p=0.059), with females having a greater range of motion in the transverse plane than both the healthy subjects and male patients, with females with PFP showing the greatest range of motion. Conclusions: This study further reinforces the view that coronal plane mechanics should not be overlooked when studying PFP. Future research should focus on developing more clinically viable techniques that can provide clinicians with reasonable estimates of coronal plane knee kinematics during various functional tasks, this may help identify important clinical subgroups and responders and non-responders to different interventions

The prevalence of patellofemoral pain in the Rugby League World Cup (RLWC) 2021 spectators: A protocol of a cross-sectional study

Patellofemoral pain (PFP) can cause significant pain leading to limitations in societal participation and physical activity. PFP is usually associated with athletes undergoing intensive physical training, or military recruits; but recent evidence shows that PFP is common in the general population. The relationship of PFP with physical activity is not entirely clear. Our aim is to provide a better estimate of the general population prevalence of PFP and to relate this to the level of physical activity, and demographic characteristics. The Survey instrument for Natural history, Aetiology and Prevalence of Patellofemoral pain Studies (SNAPPS) was developed as a PFP screening tool to be used in the community. The electronic version of the SNAPPS (eSNAPPS) has recently been validated and was used to survey attendees at mass-participation running events. We will use an electronic survey to collect data from a sample of 1100 Rugby League World Cup spectators. The survey will have four sections: i) general and demographic; ii) knee pain (eSNAPPS); iii) level of physical activity; and iv) quality of life in relation to knee pain. The primary analytic approach will be descriptive of PFP prevalence. Secondary analyses will explore the relationships of the presence of PFP and the other variables. We will disseminate this work by publication of peer-reviewed papers in scientific journals, presentations at scientific conferences, and on the dedicated SNAPPS website https://www.snappspfp.com/

Validation and utilisation of a digital version of the Survey instrument for Natural history, Aetiology and Prevalence of Patellofemoral pain Studies (eSNAPPS)

Abstract Objective This study validated the newly adapted electronic SNAPPS (eSNAPPS) against the original paper SNAPPS. Subsequently, the study estimated the prevalence of PFP in running participants and spectators attending three mass-participant running events in the United Kingdom by using the eSNAPPS tool. Design This study had two parts. Firstly, a validation of the original paper version of the SNAPPS tool. Secondly, if validation was achieved, eSNAPPS was used in a prevalence study. Participants A convenience sample of running participants and spectators aged 18-40 years attending the mass participation running events. Main outcome measure The 12-month prevalence of PFP. Results: eSNAPPS was valid in identifying those with PFP (ICC 0.99 for Overall agreement,