Abstract Objective The purpose of this study was to evaluate the effect of augmented soft tissue mobilization (ASTM) on the treatment of lateral epicondylitis. Methods This randomized clinical study ...assessed 27 subjects (12 men and 15 women) with lateral epicondylitis and were divided randomly into 2 groups. The experimental group (n = 15) received ASTM twice a week for 5 weeks. The subjects of the control group (n = 12) received advice on the natural evolution of lateral epicondylitis, computer ergonomics, and stretching exercises. Patient-rated outcome was assessed at baseline and after 6 weeks and 3 months using a visual analog scale and the Patient-Rated Tennis Elbow Evaluation. The function was assessed using the pain-free grip strength at baseline and after 6 weeks. Results Both groups showed improvements in pain-free grip strength, visual analog scale, and Patient-Rated Tennis Elbow Evaluation. Sample size for larger future randomized clinical trial was 116 participants. Conclusion A larger study investigating the same hypothesis is warranted to detect difference in the effects of these treatments strategies. The study design is feasible, and minor improvements will help to minimize the potential bias.
Background: There is evidence of an allergy protective effect in children raised on farm. It has been assumed that microbial exposure may confer this protection. However in farm, little attention ...has been given to the pollen level and to concomitant microbiological exposure, and indoor pollen concentrations have never been precisely quantified.
Methods: The kinetics of pollen in dairy farms have been studied in a pilot study (n = 9), and exposure in a sub‐sample of the ongoing European birth cohort PASTURE (n = 106). Measurements of viable microorganisms and pollen were performed in air samples. To identify factors that modulate the pollen concentration multivariate regression analyses were run.
Results: Indoor pollen (95% of Poaceae fragments and grains) were significantly higher in winter than in summer (P = 0.001) and ranged between 858 to 11 265 counts/m3 during feeding in winter, thus exceeding typical outdoor levels during the pollen season. Geometric mean in French farms was significantly higher than in German and Swiss farms (7 534, 992 and 1 079 count/m3, respectively). The presence of a ventilation system and loose housing systems significantly reduced indoor pollen levels. This pollen concentration rise after feeding was accompanied by an increase in fungal and actinomycetal levels, whereas the concentration of bacteria was not associated with feeding.
Conclusions: Farmers and their children who attend cowsheds during the feeding sessions are exposed perennially to high pollen concentrations. It might be speculated that the combined permanent exposure to microbes from livestock and grass pollen may initiate tolerance in children living on a farm.
Purpose Cost-effectiveness analyses (CEAs) of screening can be highly sensitive to the health-related quality of life (HRQoL) effects of screen tests and subsequent treatment. Accordingly, accurate ...assessment of HRQoL is essential. We reviewed the literature regarding HRQoL in cervical prevention and management in order to appraise the current evidence regarding this important input to CEA. Methods We searched the MEDLINE, Scopus and EconLit databases for studies that estimated HRQoL in cervical cancer prevention and management published January 1995-December 2015. The primary inclusion criterion was for studies that assess HRQoL using the EQ-5D. Data were abstracted from eligible studies on setting, elicitation group, sample size, elicitation instruments, health state valuations, study design and follow-up. We assessed the quality and comparability of the studies with a particular focus on the HRQoL reported across states and groups. Results Fifteen papers met the inclusion criteria. Most used patient elicitation groups (n = 11), 2 used the general public and 2 used a mix of both. Eight studies were cross-sectional and seven were longitudinal. Six studies used both the EQ-5D-3L and the EQ-VAS together with other measures of overall HRQoL or condition-specific instruments. Extensive heterogeneity was observed across study characteristics. Conclusions Our results reveal the challenges of sourcing reliable estimates of HRQoL for use in CEAs of cervical cancer prevention and treatment. The EQ-5D appears insufficiently sensitive for some health states. A more general problem is the paucity of HRQoL estimates for many health states and their change over time.
Monitoring ground deformations arising from groundwater dynamics in dense urban coastal terrains is crucial for the sustainable development of infrastructures in these highly populated areas. The ...city of Montreal, which is located in the Saint-Laurent plain in eastern Canada, with its fast-growing populations, is a unique case study for other similar cities in coastal terrains. The city undergoes high-level house foundation damages with densities reaching up to 89 repairs/km 2 resulting from time-dependent ground deformations that are correlated to groundwater dynamics and evapotranspiration. Using Radarsat-2 C-Band synthetic aperture radar interferometry, we observe 3- to 5-mm ground line-of-sight displacement variations temporally outphased by few months relative to the 2-m subartesian aquifer hydraulic head variations. The deformations are observed over a 60-km 2 area located in the central part of the Montreal Island in Canada, from 2008 to 2010. We observe displacements of ~1 mm/year uplift in the areas covered by 15-m-thick clay layer. These displacements are well correlated to the number of house repairs. We also observe ~2 mm/year subsidence on elevated terrains, associated with evapotranspiration. The amplitudes of the displacements observed during this two-year study are significant when integrated over the average lifetime of urban structures. We conclude that the observed ground deformations are related to the seasonal variation of hydraulic head in most of the areas of Montreal. Moreover, wetter climate forecasts over upcoming decades for this area, will accentuate groundwater level fluctuations; thus, more ground deformations are foreseen, and have to be considered in future infrastructure design standards.
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