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or gym equipment) is effective in reducing fat streaks that infiltrate muscles and impair muscle function and growth, particularly in adults affected by chronic diseases.

Aerobic exercise (eg, walking/jogging, cycling) alone or combined with resistance exercise (strength training with free-weights, kettle bells, or gym equipment) is effective in reducing fat streaks that infiltrate muscles and impair muscle function and growth, particularly in adults affected by chronic diseases.

process evaluations (PE) are increasingly used in parallel with randomised controlled trials (RCT) to inform the implementation of complex health interventions. This paper explores the learning accrued from conducting a PE within the Falls in Care Homes Study (FinCH), a large UK RCT.

in the FinCH study, six purposively sampled care homes provided data for the PE, which followed a realist approach. In this study researchers kept written diaries of their experiences in completing the interviews, focus groups and observations. We have reflected on these and present the main themes for discussion.

care home staff were enthusiastic to participate in the PE but researchers found it difficult to collect data due to staff not having time to take part, environmental factors such as no space for focus groups and low levels of research understanding. Researchers found that the expectations of the PE protocol were often unrealistic due to these limitations. Flexible and pragmatic approaches such as interviews in place of focus groups enabled data collection but required a reduced sample size and length of data collection to be accepted by researchers.

to enable care home staff to participate in successful PEs, researchers should build flexibility into research schedules, spend time building trust, collaborate with all levels of care home staff prior to data collection, increase research capacity in care home staff and co-design research projects.

to enable care home staff to participate in successful PEs, researchers should build flexibility into research schedules, spend time building trust, collaborate with all levels of care home staff prior to data collection, increase research capacity in care home staff and co-design research projects.

Investigate the construct validity and overall appropriateness of test score interpretation of 4 shoulder-related patient-reported outcome (PRO) measures for use in a population of patients with head and neck cancer using Rasch analysis.

One hundred eighty-two individuals who had received a neck dissection procedure within the past 2weeks to 18months were recruited for this cross-sectional psychometric study. Rasch methodologies were utilized to investigate scale dimensionality, scale hierarchy, response scale structure, and reliability of disability of the arm, shoulder and hand (DASH), QuickDASH, Shoulder Pain and Disability Index (SPADI), and Neck Dissection Impairment Index (NDII).

DASH did not meet criteria for unidimensionality and was deemed inappropriate for utilization in this sample. The QuickDASH, SPADI, and NDII were all determined to be unidimensional. All scales had varying issues with person and item misfit, differential item functioning (DIF), coverage of ability levels, and optimal ratihe Evaluation Database to Guide Effectiveness (EDGE) TaskForce, which are based upon a comprehensive literature review, consideration of published psychometric properties, and expert consensus. Utilization of Rasch methodologies demonstrates weaknesses in this model and provides opportunities to strengthen recommendations for clinicians.

In the CYD14 (NCT01373281) and CYD15 (NCT01374516) dengue vaccine efficacy trials, Month 13 neutralizing antibody (nAb) titers correlated inversely with risk of symptomatic, virologically confirmed dengue (VCD) between Month 13 (one month post-final-dose) and Month 25. PEG300 order We assessed nAb titer as a correlate of instantaneous risk of hospitalized VCD (HVCD), for which participants were continually surveilled for 72 months.

Using longitudinal nAb titers from the per-protocol immunogenicity subsets, we estimated hazard ratios (HRs) of HVCD by current nAb titer value for three correlate/endpoint pairs average titer across all four serotypes/HVCD of any serotype (HVCD-Any), serotype-specific titer/homologous HVCD, and serotype-specific titer/heterologous HVCD.

Baseline-seropositive placebo recipients with higher average titer had lower instantaneous risk of HVCD-Any in 2-16-year-olds and in 9-16-year-olds (HR 0.26 or 0.15 per 10-fold increase in average titer by two methods, 95% CIs 0.14 to 0.45 and 0.07 to 0.34, respectively) pooled across both trials. Results were similar for homologous HVCD. There was evidence suggesting increased HVCD-Any risk in participants with low average titer (110 to 1100) compared to seronegative participants (HR 1.85, 95% CI 0.93 to 3.68).

Natural infection-induced nAbs were inversely associated with hospitalized dengue, upon exceeding a relatively low threshold.

Natural infection-induced nAbs were inversely associated with hospitalized dengue, upon exceeding a relatively low threshold.

We aimed to investigate the effectiveness of Web-based pain education programs without clinical support in patients with musculoskeletal pain.

We searched on PubMed, Scopus, CINAHL, Web of Science, Cochrane Library and PsycINFO from inception to February 2020. Included studies were randomized clinical trials in which people with musculoskeletal pain were allocated to an experimental group that received Web-based pain education as a standalone approach. Three review authors performed data extraction. PEDro scale was used to assess the methodological quality of the studies. The primary outcomes were pain intensity and disability.

We included six trials with a total of 1664 participants. There is moderate quality evidence with small effect size that Web-based pain education programs, as a standalone approach, is better than minimal intervention (no intervention or booklets) for pain intensity (SMD = -0.23, 95% CI = -0.43 to -0.04) at short-term and at intermediate-term (SMD = -0.26, 95% CI = -0.42 to -0.10).