Accumulate and consolidate the traditional vernacular timber preservation technologies through a field survey.

There are remarks on diverse types of timber structures in the tropics. This paper examines several case histories in Sri Lanka, focusing on the culturally varied and ecologically diverse traditional buildings with wood used for construction. The main objective was to gather data and document the knowledge on wood preservation. Information was gathered through face-to-face interviews with 270 individuals' reference to 138 structures. A holistic analysis was performed to understand the techniques used to overcome the degradation mechanisms and state of conservation. The demographic profile of the informants was evaluated and cross-relationships on the tabulated data were analyzed by SPSS statistical software following the snow-balling sampling technique. There were three main preservation techniques identified from the open-ended questions namely, wood kept under smoke pits, wood kept under paddy field mud, and wood kept under the river banks. Preserving wood by keeping it under paddy field mud (49.62 %) was the highest recorded answer. The most obtained material matrix of preservation was plant origins (48.88 %). For generations, people have transmitted traditional and cultural practices through oral knowledge. The results conclude this knowledge places a high value on protecting construction technologies and applications while preserving biodiversity. Unfortunately, by today this technology has started extinct. The results revealed the importance of social norms and cultural perceptions as a set of valuable information that was practiced with a great history in a tropical country.

Are clinical outcomes associated with baseline sensory profiles in people with musculoskeletal shoulder pain? Protocol for a prospective longitudinal observational study.

BACKGROUND: Musculoskeletal shoulder pain is a common problem and its symptoms often become persistent. The experience of pain is multidimensional, and therefore, a range of patient characteristics may influence treatment response. An altered sensory processing has been associated with persistent musculoskeletal pain states and may contribute to outcomes in patients with musculoskeletal shoulder pain. The presence and potential impact of altered sensory processing in this patient cohort is not currently known. The aim of this prospective longitudinal cohort study is to investigate if baseline sensory characteristics are associated with clinical outcomes in patients presenting to a tertiary hospital with persistent musculoskeletal shoulder pain. If found, a relationship between sensory characteristics and outcome may lead to the creation of more effective treatment strategies and improvements in risk adjustment and prognosis. METHODS: This is a single-centre prospective cohort study with 6-, 12- and 24-month follow-up. A total of 120 participants aged ≥18 years with persistent musculoskeletal shoulder pain (≥3 months) will be recruited from an Australian public tertiary hospital orthopaedic department. Baseline assessments, including quantitative sensory tests and a standardised physical examination, will be performed. In addition, information will be obtained from patient interviews, self-report questionnaires and medical records. Follow-up outcome measures will comprise information from the Shoulder Pain and Disability Index and a six-point Global Rating of Change scale. ANALYSIS: Descriptive statistics will be used to report baseline characteristics and outcome measures over time. Change in outcome measures at the primary endpoint of six months from baseline will be calculated using paired t-tests. Associations between baseline characteristics and outcomes at a 6-month follow-up will be reported using multivariable linear and logistic regression models. DISCUSSION: Understanding the relationship between sensory profile and the variable response to treatment in people with persistent musculoskeletal shoulder pain may enhance our understanding of the mechanisms contributing to the presentation. In addition, through better understanding of the contributing factors, the results of this study may contribute to the development of an individualised, patient-centred approach to treatment for people with this highly prevalent and debilitating condition.

REACh for the preschoolers; a developmental assessment tool for 2-5 year old children in Sri Lanka.

BACKGROUND: Preschool children in low resource settings are at higher risk of missing developmental potential due to the lack of standardized and validated methods for the timely detection of children with developmental delays or neurodevelopmental disorders. The preschool teacher is a non-specialist resourceful link within the community to detect and offer interventions early. This paper discusses the preliminary iteration of designing and testing the psychometric properties of a developmental assessment for children aged 24 to 60 months in Sri Lanka. This assessment is designed to be conducted by preschool teachers in their preschool setting. METHODS: Three processes followed: 1. Designing and development of the Ragama Early Assessment for Children (REACh) complete preschool developmental assessment and a tool kit 2. Testing and training teachers on conducting the REACh assessment 3. Preliminary assessment of the psychometric properties including content validity, internal consistency, interrater reliability and concurrent validity. RESULTS: A literature search identified 11 assessments and 542 items representing cognitive, social-emotional and adaptive, language and motor domains. Content validity was assessed to select and adapt items. A complete assessment tool was designed to be administered in four settings within the preschool. This was further improved during pre and pilot testing and teacher training. Cronbach's alpha measuring internal consistency was > 0.70 for cognitive, language, social-emotional and adaptive domains across all three age groups in 1809 children. Interrater reliability was > 65% for age groups 36-47 and 47- 60 months. Concurrent validity using a clinical gold standard demonstrated sensitivity of more than 0.75 for all age groups with variable specificities (24-35 months: 0.71, 36- 47 months: 0.43 and 48-60 months: 0.67) assessed in 75 children. CONCLUSIONS: This culturally and linguistically adapted tool was tested nationally in Sri Lanka. The inte-rrater reliability between teachers and research assistants was higher than 65% for all domains in children more than 36 months. The preliminary iteration confirms it as an acceptable screening assessment for all age groups but with significantly lower specificity in the 36-47 month age group. Further improvement in certain domains together with intense teacher training is likely to enhance the validity and reliability of the assessment. TRIAL REGISTRATION: Ethics clearance for the procedure was granted prospectively from the Ethics Review Committee, Faculty of Medicine, University of Kelaniya (ERC no. P 131/06/2018).

The association between size and symmetry of the lumbar multifidus muscle, and injuries in adolescent rugby union players.

OBJECTIVES: This study aimed to investigate the association between size and symmetry of the lumbar multifidus muscle, and season injuries in adolescent rugby union players. DESIGN: Prospective longitudinal cohort study. SETTING: Pre-season assessment of the size (cross-sectional area) of the lumbar multifidus (L2-5) muscles using ultrasound imaging. PARTICIPANTS: Seventy-one adolescent rugby union players (aged 15-18 years). MAIN OUTCOME MEASURES: "Time-loss" injuries were recorded during the season and divided into four injury regions (head and neck, upper limb, trunk and lower limb). RESULTS: Thirty-nine injuries were recorded during the season. Players who sustained an upper limb injury during the season had smaller lumbar multifidus muscles at the L5 vertebral level (effect size = 0.7, p = 0.03) and asymmetry in muscle size at the L2 (p = 0.05) and L5 (p = 0.04) in the pre-season. There was no association between size of the lumbar multifidus muscle and other injuries (p > 0.05). CONCLUSION: Lumbar multifidus muscle size and symmetry may impact lumbopelvic control which may increase the risk of sustaining an upper limb injury during rugby union. Future research should aim to identify whether lumbar multifidus muscle size is a modifiable risk factor for rugby union injuries to guide future intervention programs.

Improving the measurement of intrinsic foot muscle morphology and composition from high-field (7T) magnetic resonance imaging.

Magnetic resonance imaging (MRI) can be used to quantify intrinsic foot muscle morphology and composition. Due to the high spatial resolution required to adequately capture the architecturally complex anatomy, manual segmentation is time consuming and not clinically feasible. The aim of this study was to evaluate if a reduced number of MRI slices can be used to accurately estimate intrinsic foot muscle volume and composition. A three-dimensional 2-point Dixon sequence of the whole foot was acquired at 7-Tesla for thirteen asymptomatic individuals and twenty individuals with plantar heel pain. Slice intervals of 2, 3, 5, 10, 15 and 30 were used to calculate alternative muscle volume and composition, and were compared to reference values calculated from every available slice. Agreement between methods was assessed by calculating mean differences and 95% limits of agreement, and inspection of Bland -Altman plots. In both groups, slice intervals of 2, 3 and 5 provided excellent precision for all muscles (measurement error < 1%). Larger slice intervals of 10, 15 and 30 provided excellent precision for some muscles, but for other muscles (e.g. small forefoot muscles), error was up to 7.3%. Bland-Altman plots showed no systematic measurement bias. This study provides a quantitative basis for selecting a reduced number of slices to measure intrinsic foot muscle volume and composition from MRI. A slice interval of 10 may provide a balance between efficiency (36 mins vs. 6 h) and accuracy (error < 2.4%) across all intrinsic foot muscles in asymptomatic individuals and those with plantar heel pain.

Trunk muscle size and function in volleyball players with and without injuries to the head, neck and upper limb.

OBJECTIVE: To investigate trunk muscle size and function in elite and community volleyball players with and without a history of head, neck or upper limb injury. DESIGN: Cross-sectional observational study. SETTING: Volleyball training camp or training sessions. PARTICIPANTS: 86 volleyball players (elite = 29; community = 57). MAIN OUTCOME MEASURES: Information regarding history of head, neck or upper limb injuries was collected by self-report questionnaires. Trunk muscle size (multifidus, transversus abdominis, internal oblique and quadratus lumborum) and voluntary contraction (multifidus, transversus abdominis, internal oblique) were assessed using ultrasound imaging. RESULTS: For trunk muscle size, no significant differences were found between elite and community volleyball players with and without a history of injury (all p > 0.05). A significant difference was found for voluntary contraction of the multifidus and transversus abdominis muscles for elite and community volleyball players with and without a history of injury (all p < 0.05). CONCLUSION: A difference in trunk muscle contraction but no change in trunk muscle size in players with a history of head, neck or upper limb injuries may represent an altered muscle recruitment pattern rather than a deficiency in trunk muscle strength. Prospective studies are required to determine if these adaptations are compensatory (and protective) or predispose players to further injuries.

Sensorimotor system changes in adolescent rugby players post-concussion: A prospective investigation from the subacute period through to return-to-sport.

BACKGROUND: The pathophysiology of concussion is complex. Altered sensorimotor function post-concussion may contribute to the wide range of symptoms and impairments reported. There is currently limited evidence documenting changes in sensorimotor function during the recovery period. The aim of this study was to investigate the effect of concussion on the sensorimotor system in adolescents post-concussion using a multifaceted approach. STUDY DESIGN: Prospective nested case-control study. METHODS: A total of 285 male adolescent rugby players underwent assessment of sensorimotor function during preseason. Players who sustained a concussion during the season and control players, matched for age and playing position, were assessed in the subacute period (3-5 days) and after return-to-sport (3 weeks). Tests of sensorimotor function included balance, cervical spine and vestibulo-ocular function, and measurement of the size and contraction of lumbopelvic muscles (ultrasound imaging). RESULTS: Twenty-three players (8%) sustained a concussion. Of these, 20 players were assessed during the subacute period and 17 players following return-to-sport. The prevalence of vestibulo-ocular dysfunction increased from 38.9% to 72.2% during the subacute period and dysfunction was present in 83.3% of players after return-to-sport (p = 0.01). Changes in lumbar multifidus muscle size (p = 0.002) and thickness (p = 0.05) at the L5 vertebral level were observed. No statistically significant changes in balance, cervical spine proprioception, or contraction of lumbopelvic muscles were found (p > 0.05). CONCLUSION: Changes in sensorimotor function were observed in the subacute period post-concussion, with some persisting after return-to-sport. Using symptom-based criteria for return-to-sport may not adequately reflect the sequelae of concussion on the sensorimotor system.

The prevalence and burden of recurrent headache in Australian adolescents: findings from the longitudinal study of Australian children.

BACKGROUND: Headache disorders are highly prevalent worldwide, but not well investigated in adolescents. Few studies have included representative nationwide samples. This study aimed to present the prevalence and burden of recurrent headache in Australian adolescents. METHODS: The prevalence of recurrent headache, headache characteristics (severity and frequency) and burden on health-related quality of life in Australian children aged 10-17 years were presented, using nationally representative data from the Longitudinal Study of Australian children (LSAC). The LSAC, commencing in 2004, collects data every 2 years from a sample of Australian children of two different age cohorts: B 'baby' cohort, aged 0-1 years and K 'kindergarten' cohort, aged 4-5 years at the commencement of the study. Face-to-face interviews and self-complete questionnaires have been conducted with the study child and parents of the study child (carer-reported data) at each data collection wave, with seven waves of data available at the time of the current study. Wave 7 of the LSAC was conducted in 2016, with B cohort children aged 12-13 years and K cohort children aged 16-17 years. For the current study, data were accessed for four out of seven waves of available data (Wave 4-7) and presented cross-sectionally for the two cohorts of Australian children, for the included age groups (10-11 years, 12-13 years, 14-15 years and 16-17 years). All available carer-reported questionnaire data pertaining to headache prevalence, severity and frequency, general health and health-related quality of life, for the two cohorts, were included in the study, and presented for male and female adolescents. Carer-reported general health status of the study child and health-related quality of life scores, using the parent proxy-report of the Paediatric Quality of Life Inventory™ 4.0, were compared for male and female adolescents with recurrent headache and compared with a healthy group. Finally, health-related quality of life scores were compared based on headache frequency and severity. RESULTS: The LSAC study initially recruited 10,090 Australian children (B cohort n = 5107, K cohort n = 4983), and 64.1% of the initial sample responded at wave 7. Attrition rates across the included waves ranged from 26.3% to 33.8% (wave 6 and 7) for the B cohort, and 16.3% to 38.0% (wave 4-7) for the K cohort. Recurrent headache was more common in females, increasing from 6.6% in 10-11 years old females to 13.2% in 16-17 years old females. The prevalence of headache in males ranged from 4.3% to 6.4% across the age groups. Health-related quality of life scores were lower for all functional domains in adolescents with recurrent headache, for both sexes. Headache frequency, but not severity, was significantly associated with lower health-related quality of life scores, in both males and females. CONCLUSIONS: Recurrent headache was common among Australian adolescents and increased in prevalence for females, across the age groups. Frequent recurrent headache is burdensome for both male and female adolescents. This study provides information regarding the prevalence and burden of recurrent headache in the adolescent population based on findings from the Longitudinal Study of Australian Children.

Evaluation of patellar tendinopathy using the single leg decline squat test: Is pain location important?

STUDY DESIGN: A cross-sectional study of non-elite volleyball players aged 13-17years. OBJECTIVES: To evaluate the presence and location of pain during the single leg decline squat (SLDS) and compare patellar tendon thickness, structure, neovascularisation and symptom severity between SLDS-derived groups. METHODS: 32 male and 25 female participants attending a 5-day volleyball training camp underwent clinical evaluation by SLDS, describing the location of pain during this test using a pain map. The patellar tendon was examined using ultrasound imaging, performed by an assessor blinded to other assessments. Differences between participants experiencing local patellar tendon pain (PTP), other knee pain (OKP) or no-pain during the SLDS were evaluated. RESULTS: Fifteen (26.3%) participants experienced pain during the SLDS. Local PTP was recorded for 12.3% and OKP for 10.5% of right legs. The PTP group was distinguished from the other groups by larger thickness and cross-sectional area of the mid-patellar tendon (p < 0.001), more frequent neovascularisation (p = 0.005) and greater pain and disability (p < 0.036). No differences between OKP and no-pain groups was observed. CONCLUSION: Adolescent non-elite volleyball players reported symptoms indicative of patellar tendinopathy. In this cohort, the SLDS test combined with a pain map was associated with imaging and questionnaire-based outcomes. LEVEL OF EVIDENCE: Diagnosis, Level 2; Cross-sectional study.

Pre-season screening of the upper body and trunk in Australian football players: A prospective study.

OBJECTIVE: To determine whether screening tests of upper body, trunk region, and of whole-body function could prospectively identify community AFL players who sustain in-season shoulder/head/neck injuries. Additionally, to present screening test reference values. DESIGN: Prospective cohort; SETTING: Community sport; PARTICIPANTS: 142 male community AFL players (range 15-37 years). MAIN OUTCOME MEASURES: (i) isometric shoulder external and internal rotation (ER/IR) strength; (ii) upper body combined elevation functional ROM; (iii/iv) whole-body functional jump ROM; (v) static thoracic spine angle; (vi) cervical joint proprioception, and (vii) trunk muscle size and function. Results were compared among players with (n = 21) and without (n = 121) an in-season shoulder, head, or neck injury. ROC analysis and odds ratios were used to determine the predictive values. RESULTS: Two screening tests predicted an in-season shoulder, head, or neck injury; dominant and non-dominant isometric ER strength (AUC 0.629, 95%CI 0.51-0.74; optimal cut point 182 N and AUC 0.619, 95%CI 0.50-0.74; optimal cut point 184 N, respectively). The adjusted odds ratio for the strongest predictor: dominant ER muscle strength was 6.02 (95%CI 1.8-19.9). CONCLUSION: Greater ER strength was associated with in-season shoulder/head/neck injuries in community AFL players; however, further research is required to determine the clinical significance of this finding.

Clinical utility of measuring the size of the lumbar multifidus and quadratus lumborum muscles in the Australian football league setting: A prospective cohort study.

OBJECTIVES: Test the odds of factors previously associated with lower limb injury (decreased size of the multifidus (MF) and increased size of the quadratus lumborum (QL) muscle) in an independent sample of Australian Rules Football (ARF) players. DESIGN: Prospective cohort study. SETTING: Professional ARF. PARTICIPANTS: Forty-three male ARF players. MAIN OUTCOME MEASURES: Cross-sectional areas (CSAs) of MF and QL muscles measured from pre-season ultrasound images. Playing season injuries were recorded by club personnel. A multivariable logistic regression model was used to evaluate the usefulness of MF and QL muscle size for predicting playing season lower limb injuries. RESULTS: Fifteen players (35%) sustained a playing season lower limb injury. The multivariable model indicated that the odds of sustaining a lower limb injury during the season was 2.38 (95% CI: 1.18, 5.00; P = 0.017) times less likely for a one cm2 increase from the mean value in MF muscle CSA at the L5 vertebral level after adjusting for CSA of the QL, age and BMI. The main effect and interaction models positively predicted 75% of players that sustained a lower limb injury during the season (sensitivity 80%, specificity 85%). CONCLUSION: Future studies could examine the efficacy, feasibility and adherence of 'at risk' players to a pre-season training program aimed at increasing MF muscle size and monitor playing season injuries.

Injury surveillance of an Australian community netball club.

OBJECTIVES: To describe injuries associated with netball and risk factors for lower limb injuries. DESIGN: Prospective study. In the preseason, risk factors were investigated using self-report questionnaires and physical measurements. During the season, injuries were reported using a standardised report, verified by follow-up phone calls. Player training and game hours were recorded. SETTING: Australian community netball club. PARTICIPANTS: 269 players from 9 divisions, aged 7-42 years. MAIN OUTCOME MEASURES: Injury incidence rates per 1000 exposure hours were calculated. The most common mechanism, nature and consequence of injury were determined from frequencies. Logistic regression was used to identify predictors of lower limb injury and determine adjusted odds ratios for each risk factor. RESULTS: 169 injuries occurred with a rate of 13.8/1000 exposure hours (95% CI 11.8-16.0), majority (60%) to the lower limb. The most frequent injury mechanisms were collisions (28%) and awkward landings (27%), nature was 'Inflammation/swelling' (32%) and consequence was 'unable to continue playing/training' (50%). Previous history of injury (OR 6.9, 95% CI 3.7-13.0) and age greater than 13.5 years (OR 3.1, 95% CI 1.6-5.9) were significant risk factors for a season lower limb injury. CONCLUSION: Injury rates in this community netball club were high. Results suggest that further research regarding the implementation and effectiveness of injury prevention programs for community netballers is required.

Hip muscle atrophy in patients with acetabular labral joint pathology.

Intra-articular hip joint pathology is a source of hip and groin pain in active individuals and is thought to be a precursor to hip osteoarthritis. Limited evidence exists to guide appropriate physiotherapy management for these patients. Identification of which hip muscles are affected may help clinicians to develop effective exercise programs. A cross-sectional observational study in a hospital setting was conducted to investigate the size of individual hip abductor, hip extensor, and hip external rotator muscles in patients with acetabular labral joint pathology compared with age and sex matched healthy subjects. Twelve participants (eight females, four males), aged 20-53 years, with a medical diagnosis of unilateral acetabular labral tear and 12 healthy participants were recruited. Magnetic resonance imaging was used to assess cross-sectional areas of the gluteus minimus, gluteus medius, upper gluteus maximus, lower gluteus maximus, piriformis, and quadratus femoris muscles bilaterally. Gluteus medius muscle cross-sectional area was significantly different between groups (P < 0.01, effect size = 0.92) with muscle size found to be smaller in the pathology group. No differences were found for the other hip muscles (P > 0.05). These findings suggest that hip muscles are not all affected equally by the presence of intra-articular hip joint pathology. Atrophy of specific hip muscles, which are important in hip joint and pelvic stability, may alter hip joint function during gait and functional tasks. Clinicians treating patients with intra-articular hip joint pathology may need to prescribe exercises targeting the specific muscles with demonstrated dysfunction. Clin. Anat. 33:538-544, 2020. © 2019 Wiley Periodicals, Inc.

Mechanisms of traumatic injury to the shoulder girdle in the Australian Football League.

OBJECTIVE: To investigate mechanisms of shoulder girdle injuries and their impact on players from the Australian Football League (AFL). DESIGN: Retrospective video analysis. METHODS: Two experienced sports physiotherapists (>10years) examined video footage of shoulder complex injuries that occurred in the 2015 premiership season. Information obtained from video footage included activity prior to injury; mechanism of injury; arm, head and neck position and point of body contact at the time of injury. Player demographics and injury characteristics were obtained from club and media data. RESULTS: The most common mechanism of injury was lateral contact (34.6%) followed by hyperflexion/ abduction of the shoulder (19.2%). Glenohumeral joint (GHJ) dislocations and subluxations were the most frequent diagnosis for all mechanisms of injury, and occurred in a variety of shoulder positions. Over 80% of injuries occurred with the arm below 100° of shoulder flexion or abduction. The most common activity prior to injury was 'ball in dispute' (34.6%). Lateral contact injuries had the highest overall severity (two-thirds of players missed >3 games) and over 50% of shoulder injuries required surgery. Players missed on average 5.1 season games due to shoulder injury. CONCLUSION: The lateral contact mechanism was the most common and severe mechanism of shoulder injury. Improved understanding of shoulder girdle injury mechanisms can help guide the use of preventative strategies and injury management programs in elite AFL players.

Predicting a beneficial response to motor control training in patients with low back pain: a longitudinal cohort study.

PURPOSE: Exercise therapy such as motor control training (MCT) has been shown to reduce pain and disability in people with low back pain (LBP). It is unknown which patients are most likely to benefit. This longitudinal cohort study aimed to: (1) retrospectively examine records from a large cohort of patients who received MCT treatment, (2) identify potentially important predictors of response to MCT and (3) test the predictors on an independent (split) sample derived from the original cohort of patients, using one group to identify the predictors and the other to test them. METHODS: The response of 775 patients with LBP to MCT was classified as 'improved' or 'not improved' based on self-reported change in pain levels and symptoms. Measures were examined for associations with improvement and entered into a logistic regression model to classify patients as low, medium or high benefits of improvement with MCT. The model was tested on an independent sample. RESULTS: A positive response was seen in patients with: no evidence of scoliosis [OR = 4.0, 95% CI (1.7, 9.6)], LBP without associated groin pain [OR = 2.2, 95% CI (1.0, 5.0)], LBP which was chronic recurrent in nature [OR = 3.1, 95% CI (1.8, 5.3)] and poor results on muscle testing of the multifidus muscle [OR = 2.0, 95% CI (1.1, 3.7)]. Testing on an independent sample confirmed that patients could be classified into benefit groups. CONCLUSIONS: This study provides a first step towards assisting clinicians to select patients most likely to respond to MCT. These slides can be retrieved under Electronic Supplementary Material.

Vestibulo-ocular dysfunction in adolescent rugby union players with and without a history of concussion.

OBJECTIVES: Sport-related concussions are common in adolescent contact sports. Vestibulo-ocular dysfunction has been reported in athletes post-concussion. There is a lack of research on vestibulo-ocular function in sporting adolescents, and the influence of previous concussions on the vestibular system in this population. The aim of this study was to investigate vestibulo-ocular function in a cohort of adolescent rugby players with and without a history of concussion during pre-season assessment. DESIGN: Cross-sectional cohort. METHODS: 213 male adolescent (13-18 years old) rugby players were recruited from six schools in Queensland, Australia. Vestibulo-ocular assessments were conducted during the preseason and included clinical assessment of oculomotor function and the vestibulo-ocular reflex (VOR) using the clinical and video-Head Impulse Test (HIT). Players were allocated into two groups: no history of concussion in the last 12 months (n = 165); and concussion in the last 12 months (n = 48). RESULTS: There were no between group differences in vestibulo-ocular function for players with and without a history of concussion (p = 0.65). However, vestibulo-ocular dysfunction was reported in 69 (32.7%) of the players tested, who had either abnormal oculomotor control or VOR function. CONCLUSIONS: The high prevalence of vestibulo-ocular dysfunction in adolescent rugby players suggests that positive clinical findings post-concussion need to be interpreted carefully in the absence of baseline or pre-concussion assessments.

A systematic review of patient-reported measures associated with vestibular dysfunction.

OBJECTIVES/HYPOTHESIS: Use of clinical questionnaires to assist in the screening of vestibular disorders in the acute hospital setting is needed. The objective is to detail the clinimetric properties and clinical utility of patient-reported questionnaires for quantifying dizziness/vertigo symptoms associated with vestibular dysfunction, and to determine validity and utility for screening dizziness/vertigo in the emergency department. DATA SOURCES: We performed a systematic review of PubMed, CINAHL, Embase, and Web of Science in May 2015. METHODS: Two independent reviewers selected studies reporting clinimetric properties of patient-reported questionnaires that aim to evaluate symptomology of dizziness/vertigo associated with vestibular dysfunction. A third reviewer resolved disparities. Of 1,901 articles initially found in the database search, 58 articles and 9 patient-reported questionnaires were included. RESULTS: Clinimetric properties of content validity, criterion validity, internal consistency, inter-/intrarater reliability, test-retest reliability, and responsiveness to vestibular rehabilitation are reported, and methodological quality is rated using the COSMIN (Consensus-based Standards for the selection of health Measurement Instruments) checklist. Clinical utility is described in terms of target population, purpose, number of items, and whether the questionnaire was validated in the emergency department. CONCLUSIONS: The Vestibular Rehabilitation Benefit Questionnaire, a relatively new tool, scored an "excellent" rating on three COSMIN criteria, and may be the best measure to address treatment outcomes. Questions on respective tools ranged from nine to 36, and no questionnaire was validated in the emergency department. Due to the number of questions and lack of validity, none of the questionnaires was deemed appropriate as a screening tool for dizziness/vertigo in the emergency department. Laryngoscope, 128:971-981, 2018.

Beyond survival: 5-year neurodevelopmental follow-up of a cohort of preterm infants in Colombo, Sri Lanka.

BACKGROUND: There is a lack of information on long-term neurodevelopmental outcome in preterm neonates in low- and middle-income countries. OBJECTIVES: To describe the developmental attainments of preterm neonates followed up for 5 years and to identify the risk factors for impairment. METHOD: A prospective descriptive cohort study was undertaken in neonates of 34 weeks gestation born within a period of 12 months at a single tertiary maternity and neonatal unit in Colombo, Sri Lanka. Infants were assessed for neurodevelopment using the Bayley Infant and Toddler III® Assessments at 6, 12 and 24 months of corrected age and school readiness assessment at 5 years. RESULTS: Fifty-one infants were assessed at least once, 45 were assessed at 2 years and 39 had a final assessment at 5 years. Neurodevelopmental attainment deteriorated significantly in the cognitive and motor composite scores from 6 to 24 months (p < 0.05). By 5 years the number of children with delay in cognitive, language and motor domains had reduced significantly from 24 months (p < 0.05) but the cognitive skills remained most affected (10/39). At 5 years, 13 of 39 children had a confirmed diagnosis of a neurodevelopmental disorder: eight had attention deficit hyperactivity disorder, three autism spectrum disorder, one cerebral palsy and one visual impairment. Surfactant administration and retinopathy of prematurity were the most significant risks for delayed development at 5 years (p < 0.05). CONCLUSION: Deterioration of cognitive and motor composite scores over the first 24 months highlights the need for regular surveillance of premature infants. There was a discrepancy between the diagnosis of neurodevelopmental delay at 24 months and at 5 years. But the notable impact on school readiness skills requires public health initiatives to cater for the needs of these children.