Observations on strategies used by people with dementia to manage being assessed using validated measures: A pilot qualitative video analysis.

BACKGROUND: Analysis of video data was conducted of validated assessments with people with dementia as part of a feasibility control study comparing a lifelong learning service with other dementia services. OBJECTIVE: The aim was to provide a new perspective on what occurs during the assessment process when using validated measures in research and explore which strategies people with dementia use to manage their participation. DESIGN: Video recordings were made of pre- and postintervention assessments of people with dementia. An initial pilot analysis of 10 videos of the pre-assessments was conducted. SETTING: Lifelong learning services and other dementia services situated in six municipalities in Northern Denmark took part in this study, with 55 people with dementia participating. RESULTS: The themes identified were: 'State of mind' and 'Mental resources', showing how these aspects influenced the participants' reactions and the strategies they used. DISCUSSION: The results are discussed in relation to how individual personality traits influence the assessment process and the way a person with dementia will manage the situation. CONCLUSION: The assessment situation is complex and can be influenced by the strategies adopted by individuals with dementia as they try to manage the assessment process. PATIENT OR PUBLIC CONTRIBUTION: People with dementia supported the decision-making for the choice of validated measure used within this study.

Molecular analysis of an ancient Thule population at Nuvuk, Point Barrow, Alaska.

OBJECTIVES: The North American archaeological record supports a Holocene origin of Arctic Indigenous peoples. Although the Paleo-Inuit were present for millennia, archaeological and genetic studies suggest that modern peoples descend from a second, more recent tradition known as the Neo-Inuit. Origins of the Neo-Inuit and their relations to the earlier and later Indigenous peoples are an area of active study. Here, we genetically analyze the maternal lineages present at Nuvuk, once the northernmost community in Alaska and located in a region identified as a possible origin point of the Neo-Inuit Thule. The cemetery at Nuvuk contains human remains representing a nearly one thousand year uninterrupted occupation from early Thule to post-contact Iñupiat. MATERIALS AND METHODS: We selected 44 individuals from Nuvuk with calibrated dates between 981 AD and 1885 AD for molecular analysis. We amplified and sequenced the hypervariable segment I of the mitogenome. We compared the Nuvuk data with previously published sequences from 68 modern and ancient communities from across Asia and North America. Phylogeographic analyses suggest possible scenarios of Holocene Arctic and sub-Arctic population movements. RESULTS: We successfully retrieved sequence data from 39 individuals. Haplogroup frequencies in Nuvuk were typed as 66.7% A2b1, 25.6% A2a, and 7.7% D4b1a2a1a. These results suggest that the population at Nuvuk was closest to the ancient Thule and modern Inuit of Canada, and to the Siberian Naukan people. We confirm that haplogroups A2a, A2b1, D2a, and D4b1a2a1a appear at high frequency in Arctic and sub-Arctic populations of North America and Chukotka. Sister clades D2b and D4b1a2a1b are present in Asian and Eastern European populations. DISCUSSION: The ancient mitochondrial sequences from Nuvuk confirm the link between the North Slope and the Thule who later spread east, and the maternal discontinuity between the Neo-Inuit and Paleo-Inuit. We suggest haplogroups A2a, A2b, and D4b1a2a1a are linked to the ancestors of the Thule in eastern Beringia, whereas the D2 and D4b1a2a1 clades appear to have Asian Holocene origins. Further Siberian and Alaskan genomes are necessary to clarify these population migrations beyond a simple two-wave scenario of Neo-Inuit and Paleo-Inuit.

Estimating the accuracy of muscle response testing: two randomised-order blinded studies.

BACKGROUND: Manual muscle testing (MMT) is a non-invasive assessment tool used by a variety of health care providers to evaluate neuromusculoskeletal integrity, and muscular strength in particular. In one form of MMT called muscle response testing (MRT), muscles are said to be tested, not to evaluate muscular strength, but neural control. One established, but insufficiently validated, application of MRT is to assess a patient's response to semantic stimuli (e.g. spoken lies) during a therapy session. Our primary aim was to estimate the accuracy of MRT to distinguish false from true spoken statements, in randomised and blinded experiments. A secondary aim was to compare MRT accuracy to the accuracy when practitioners used only their intuition to differentiate false from true spoken statements. METHODS: Two prospective studies of diagnostic test accuracy using MRT to detect lies are presented. A true positive MRT test was one that resulted in a subjective weakening of the muscle following a lie, and a true negative was one that did not result in a subjective weakening of the muscle following a truth. Experiment 2 replicated Experiment 1 using a simplified methodology. In Experiment 1, 48 practitioners were paired with 48 MRT-naïve test patients, forming unique practitioner-test patient pairs. Practitioners were enrolled with any amount of MRT experience. In Experiment 2, 20 unique pairs were enrolled, with test patients being a mix of MRT-naïve and not-MRT-naïve. The primary index test was MRT. A secondary index test was also enacted in which the practitioners made intuitive guesses ("intuition"), without using MRT. The actual verity of the spoken statement was compared to the outcome of both index tests (MRT and Intuition) and their mean overall fractions correct were calculated and reported as mean accuracies. RESULTS: In Experiment 1, MRT accuracy, 0.659 (95% CI 0.623 - 0.695), was found to be significantly different (p < 0.01) from intuition accuracy, 0.474 (95% CI 0.449 - 0.500), and also from the likelihood of chance (0.500; p < 0.01). Experiment 2 replicated the findings of Experiment 1. Testing for various factors that may have influenced MRT accuracy failed to detect any correlations. CONCLUSIONS: MRT has repeatedly demonstrated significant accuracy for distinguishing lies from truths, compared to both intuition and chance. The primary limitation of this study is its lack of generalisability to other applications of MRT and to MMT. STUDY REGISTRATION: The Australian New Zealand Clinical Trials Registry (ANZCTR; www.anzctr.org.au ; ID # ACTRN12609000455268 , and US-based ClinicalTrials.gov (ID # NCT01066312 ).

Improving general flexibility with a mind-body approach: a randomized, controlled trial using neuro emotional Technique®.

General flexibility is a key component of health, well-being, and general physical conditioning. Reduced flexibility has both physical and mental/emotional etiologies and can lead to musculoskeletal injuries and athletic underperformance. Few studies have tested the effectiveness of a mind-body therapy on general flexibility. The aim of this study was to investigate if Neuro Emotional Technique® (NET), a mind-body technique shown to be effective in reducing stress, can also improve general flexibility. The sit-and-reach test (SR) score was used as a measure of general flexibility. Forty-five healthy participants were recruited from the general population and assessed for their initial SR score before being randomly allocated to receive (a) two 20-minute sessions of NET (experimental group); (b) two 20-minute sessions of stretching instruction (active control group); or (c) no intervention or instruction (passive control group). After intervention, the participants were reassessed in a similar manner by the same blind assessor. The participants also answered questions about demographics, usual water and caffeine consumption, and activity level, and they completed an anxiety/mood psychometric preintervention and postintervention. The mean (SD) change in the SR score was +3.1 cm (2.5) in the NET group, +1.2 cm (2.3) in the active control group and +1.0 cm (2.6) in the passive control group. Although all the 3 groups showed some improvement, the improvement in the NET group was statistically significant when compared with that of either the passive controls (p = 0.015) or the active controls (p = 0.021). This study suggests that NET could provide an effective treatment in improving general flexibility. A larger study is required to confirm these findings and also to assess longer term effectiveness of this therapy on general flexibility.

The Impact of Using Emotionally Arousing Stimuli on Muscle Response Testing Accuracy.

INTRODUCTION: Muscle response testing (MRT) is an assessment method used by 1 million practitioners worldwide, yet its usefulness remains uncertain. The aim of this study, one in a series assessing the accuracy of MRT, was to determine whether emotionally arousing stimuli influence its accuracy compared to neutral stimuli. METHODS: To assess diagnostic test accuracy 20 MRT practitioners were paired with 20 test patients (TPs). Forty MRTs were performed as TPs made true and false statements about emotionally arousing and neutral pictures. Blocks of MRT alternated with blocks of intuitive guessing (IG). RESULTS: MRT accuracy using emotionally arousing stimuli was different than when using neutral stimuli. However, MRT accuracy was found to be significantly better than IG and chance. Similar to previous studies in this series, this study failed to detect any characteristic that consistently influenced MRT accuracy. CONCLUSION: Using emotionally arousing stimuli had no effect on MRT accuracy compared to using neutral stimuli. This study would have been strengthened by adding personally relevant lies instead of impersonal stimuli. A limitation of this study is its lack of generalizability to other applications of MRT. This study shows that a simple yet robust methodology for assessing MRT as a diagnostic tool can be implemented effectively.

Degradation and sorption of the fungicide tebuconazole in soils from golf greens.

The fungicide tebuconazole (TBZ) is used to repress fungal growth in golf greens and ensure their playability. This study determined the degradation and sorption of TBZ applied as an analytical grade compound, a commercial fungicide formulation or in combination with a surfactant product in thatch and soils below two types of greens (USGA and push-up greens) in 12-cm vertical profiles covered by three different types of turf grass. Only minor TBZ degradation was observed and it was most pronounced in treatments with the commercial fungicide product or in combination with the surfactant compared to the analytical grade compound alone. A tendency for higher TBZ sorption when applied as the formulated product and lowest sorption when applied as a formulated product in combination with the surfactant was observed, with this effect being most distinct on USGA greens. No correlation between occurrence of degradation and soil depth, green type or grass type was observed. Sorption seemed to be the main process governing the leaching risk of TBZ from the greens and a positive correlation to the organic matter content was shown. In light of these findings, organic matter content should be taken into consideration during the construction of golf courses, especially when following USGA guidelines.

The role of pulse oximetry in chiropractic practice: a rationale for its use.

OBJECTIVE: Pulse oximetry is used regularly to assess oxygen saturation levels. The objective of this commentary is to discuss a rationale for using pulse oximetry in chiropractic practice. DISCUSSION: Pulse oximetry may offer doctors of chiropractic a way to monitor patients' oxygen saturation levels. Quantification of saturation values with heart rate may give clinical aid to the management of chiropractic patients. Markedly reduced saturation levels may necessitate medical referral, whereas mildly reduced levels could lead to changes in chiropractic management. CONCLUSIONS: Pulse oximetry has the potential to be an integral part of chiropractic practice.

Chiropractic management of frozen shoulder syndrome using a novel technique: a retrospective case series of 50 patients.

OBJECTIVE: The purpose of this case series is to describe the treatment and outcomes of a series of patients presenting with frozen shoulder syndrome who received a novel chiropractic approach (OTZ Tension Adjustment). METHODS: The files of 50 consecutive patients who presented to a private chiropractic practice with frozen shoulder syndrome were reviewed retrospectively. Two primary outcomes were extracted from the files for initial examination and at final evaluation: (1) the 11-point numeric pain rating scale and (2) the percentage change in shoulder abduction. Each patient received a series of chiropractic manipulative procedures that focused on the cervical and thoracic spine. RESULTS: Of the case files reviewed, 20 were male and 30 were female; and all were between the ages of 40 and 70 years. The median number of days under care was 28 days (range, 11 to 51 days). The median change in Numeric Pain Rating Scale score was - 7 (range, 0 to - 10). Of the 50 cases, 16 resolved completely (100% improvement), 25 showed 75% to 90% improvement, 8 showed 50% to 75% improvement, and 1 showed 0% to 50% improvement. CONCLUSION: Most patients with frozen shoulder syndrome in this case series appeared to improve with the chiropractic treatment.

The benefits of giving a massage on the mental state of massage therapists: a randomized, controlled trial.

OBJECTIVES: The objective of this study was to determine whether giving a massage had an impact of the mental state of the massage therapist. DESIGN: The design of this study was a randomized, controlled, blinded study with two parallel groups. SETTINGS/LOCATION: This study was conducted at an accredited school of therapeutic massage in Dallas, Texas. SUBJECTS: The study comprised healthy female and male final-term massage students between ages 18 and 65 years. INTERVENTIONS: The participants were randomized into two groups: (1) the experimental group who gave a 1-hour Swedish massage to a massage client (Massage group), or (2) the control group who sat in a room doing normal, daily activities (Control group). Both these activities were a normal part of the daily routine for these massage students. OUTCOME MEASURES: The primary outcomes were the change in the Depression Anxiety and Stress Scale (DASS) scores pre- and postparticipation. RESULTS: Twenty-two (22) participants were randomized in this trial. The baseline characteristics were comparable between the two groups. A statistically significant advantage for the massage group was found relative to the control group in subjective anxiety (DASS Anxiety Subscale, p=0.014). There were no significant differences between the groups with regard to total DASS score (p=0.540), subjective depressive symptoms (DASS Depression Subscale, p=0.472) and subjective stress-related symptoms (DASS Stress Subscale, p=0.919). There were no adverse events reported by any participant. CONCLUSIONS: This study shows that massage therapists themselves may benefit from giving a therapeutic massage by experiencing less subjective anxiety following the giving of a massage.

The use of Neuro Emotional Technique with competitive rowers: A case series.

INTRODUCTION: Power has been shown to consistently predict rowing performance, yet traditional methods to improve power may negatively impact performance when coupled with endurance training. Neuro Emotional Technique (NET) has been found to reduce stress and anxiety, which are also known to impair performance. The aim of this prospective case series was to describe how NET was used with competitive rowers, and to report any changes in average power output following the intervention. CLINICAL FEATURES: Seven elite rowers were tested using the Max Power Test, one week before and one week after a session of NET. Five of athletes performed better following the NET intervention, while two athletes performed worse. DISCUSSION: Many factors may have contributed to the changes in power output that these athletes experienced. Since this study was a case series and only a small sample was used, it lacked a comparison group. Therefore, no inferences or generalizations can be made. The changes seen may not be directly attributed to the NET intervention, but may the result of other factors, such as learning, normal training effects, or assessment bias. The primary limitations of this study include its qualitative design (i.e. a case report), and the appropriateness / usefulness of its primary outcome measure, the Max Power Test. CONCLUSION: This case series demonstrates one plausible use of NET with athletes, however, a randomized, controlled trial is needed to determine its effectiveness before causality can be inferred.

Intermittent low back pain referred from a uterine adenomyosis: a case report.

OBJECTIVE: The purpose of this case study is to describe the clinical course and treatment of a female patient with intermittent low back pain (LBP) that was associated with a uterine adenomyosis. CLINICAL FEATURES: A 45-year-old woman presented for chiropractic care with intermittent LBP of 4 years' duration. History revealed concurrent dysmenorrhea, menorrhagia, and a uterine leiomyoma (fibroid). Physical and radiological examination findings were unremarkable, and the LBP was not reproducible. INTERVENTION AND OUTCOME: Activator Methods chiropractic adjustments/manipulations were given twice per week for 4 months with moderate results. The frequency and duration of low back and pelvic pains were reduced; however, the severity remained constant. A further gynecological opinion was sought, a transvaginal ultrasound was performed, and the patient's diagnosis was changed from leiomyoma to adenomyosis. CONCLUSION: In this case report, a woman presented with a 4-year history of intermittent LBP, which was sometimes associated with menstruation. Despite being diagnosed with uterine adenomyosis, she received some relief from chiropractic care.

A mind-body approach for precompetitive anxiety in power-lifters: 2 case studies.

OBJECTIVE: The aim of this article is to report how Neuro Emotional Technique (NET) was used for precompetitive anxiety in 2 power-lifting athletes. CLINICAL FEATURES: Two athletes (1 elite and 1 novice), who were participating in major competitions within 2 weeks of testing, were assessed for cognitive and somatic anxiety levels pre- and postintervention. Three psychometrics were used to measure mental state (cognitive anxiety): the Sports Competitive Anxiety Test, the Depression Anxiety Stress Scales, and the SF-36v2 Health Survey. To assess somatic anxiety, saliva samples were collected and screened for cortisol and dehydroepiandrosterone. INTERVENTION AND OUTCOME: The intervention was performed by a doctor of chiropractic and consisted of one 30-minute session of NET that focused on the athletes' concerns regarding the upcoming competitions. The results showed reductions in reported subjective anxiety levels and changes in the salivary hormone profile of both athletes following the intervention, with the more remarkable changes occurring in the novice athlete. The reduction in reported cognitive anxiety levels and the change in somatic anxiety markers may be the result of the mind-body intervention. However, these changes may also be attributed to other factors, such as the natural course of anxiety during competition. An experimental trial would be required to determine the effectiveness of NET for reducing precompetitive anxiety of power-lifters. CONCLUSION: Neuro Emotional Technique may have helped these power-lifters control emotional arousal and precompetitive anxiety. However, caution is warranted when using these results to draw conclusions or when extrapolating these results to other settings.

Treating spider phobia using Neuro Emotional Technique: findings from a pilot study.

BACKGROUND: Specific phobia, the most common anxiety disorder, can disrupt lives, limit work efficiency, reduce self-esteem, and strain relationships. Current interventions show some degree of success, yet relapse is common. Consequently, the need for a more effective and durable intervention is evident. The purpose of this pilot study is to investigate the efficacy of a new intervention, Neuro Emotional Technique (NET), on individuals with spider phobia, and to determine whether further investigation is warranted. METHODS: Participants who met the inclusion criterion that spider phobia impacted their daily lives were randomized to either a control group that received no intervention (N = 7), or to an experimental group that received two 30-minute sessions of NET approximately 2 weeks apart (N = 8). The primary measure was the Subjective Units of Distress Scale, and secondary measures were the Spider Questionnaire, Behavioral Assessment Test, Beck Anxiety Inventory, and change in heart rate (HR). RESULTS: Compared with the no-intervention control group, statistical analysis indicates a significant advantage for the NET group in regard to state anxiety/subjective distress, reported fear, and avoidant behavior. The difference between the two groups for general anxious symptomatology (trait anxiety) and change in HR was not statistically significant. No adverse reactions were reported. CONCLUSIONS: The findings of this pilot study suggest that NET is a promising intervention for spider phobia in adults. A larger, full-scale study is required to confirm these results.