Norma Bargary

Individualised cognitive functional therapy compared with a combined exercise and pain education class for patients with non-specific chronic low back pain: study protocol for a multicentre randomised controlled trial

Introduction Non-specific chronic low back pain (NSCLBP) is a very common and costly musculoskeletal disorder associated with a complex interplay of biopsychosocial factors. Cognitive functional therapy (CFT) represents a novel, patient-centred intervention which directly challenges pain-related behaviours in a cognitively integrated, functionally specific and graduated manner. CFT aims to target all biopsychosocial factors that are deemed to be barriers to recovery for an individual patient with NSCLBP. A recent randomised controlled trial (RCT) demonstrated the superiority of individualised CFT for NSCLBP compared to manual therapy combined with exercise. However, several previous RCTs have suggested that class-based interventions are as effective as individualised interventions. Therefore, it is important to examine whether an individualised intervention, such as CFT, demonstrates clinical effectiveness compared to a relatively cheaper exercise and education class. The current study will compare the clinical effectiveness of individualised CFT with a combined exercise and pain education class in people with NSCLBP. Methods and analysis This study is a multicentre RCT. 214 participants, aged 18–75 years, with NSCLBP for at least 6 months will be randomised to one of two interventions across three sites. The experimental group will receive individualised CFT and the length of the intervention will be varied in a pragmatic manner based on the clinical progression of participants. The control group will attend six classes which will be provided over a period of 6–8 weeks. Participants will be assessed preintervention, postintervention and after 6 and12 months. The primary outcomes will be functional disability and pain intensity. Non-specific predictors, moderators and mediators of outcome will also be analysed. Ethics and dissemination Ethical approval has been obtained from the Mayo General Hospital Research Ethics Committee (MGH-14-UL). Outcomes will be disseminated through publication according to the SPIRIT statement and will be presented at scientific conferences. Trial registration number (ClinicalTrials.gov NCT02145728).

Arsenic contamination of drinking water in Ireland: A spatial analysis of occurrence and potential risk.

The presence of arsenic in groundwater has become a global concern due to the health risks from drinking water with elevated concentrations. The Water Framework Directive (WFD) of the European Union calls for drinking water risk assessment for member states. The present study amalgamates readily available national and sub-national scale datasets on arsenic in groundwater in the Republic of Ireland. However, due to the presence of high levels of left censoring (i.e. arsenic values below an analytical detection limit) and changes in detection limits over time, the application of conventional statistical methods would inhibit the generation of meaningful results. In order to handle these issues several arsenic databases were integrated and the data modelled using statistical methods appropriate for non-detect data. In addition, geostatistical methods were used to assess principal risk components of elevated arsenic related to lithology, aquifer type and groundwater vulnerability. Geographic statistical methods were used to overcome some of the geographical limitations of the Irish Environmental Protection Agency (EPA) sample database. Nearest-neighbour inverse distance weighting (IDW) and local indicator of spatial association (LISA) methods were used to estimate risk in non-sampled areas. Significant differences were also noted between different aquifer lithologies, indicating that Rhyolite, Sandstone and Shale (Greywackes), and Impure Limestone potentially presented a greater risk of elevated arsenic in groundwaters. Significant differences also occurred among aquifer types with poorly productive aquifers, locally important fractured bedrock aquifers and regionally important fissured bedrock aquifers presenting the highest potential risk of elevated arsenic. No significant differences were detected among different groundwater vulnerability groups as defined by the Geological Survey of Ireland. This research will assist management and future policy directions of groundwater resources at EU level and guide future research focused on understanding arsenic mobilisation processes to facilitate in guiding future development, testing and treatment requirements of groundwater resources.

Inability to perform because of pain/injury in elite adult Irish dance: A prospective investigation of contributing factors.

Previous research in Irish dancing (ID) has recorded high levels of pain/injury. Screening protocols in other genres have been developed to identify at‐risk dancers. The aims of the study were to examine the factors that relate to absence from dancing because of musculo‐skeletal pain/injury in ID, and to inform guidelines for the development of an evidence‐based screening protocol. Baseline subjective data (n = 85) and physical data (n = 84) were gathered. Subjects completed a monthly online questionnaire for 1 year providing data on general physical and psychological health and rates of pain/injury. Subjects were allocated to a “More Time Absent (MTA)” or “Less Time Absent (LTA)” category depending on their duration of absence from performance over the year. Eighty‐four subjects completed the year‐long follow‐up (MTA: n = 32; LTA: n = 52). Two hundred seventy‐eight complaints of pain/injury were recorded. Factors significantly associated with membership of the MTA group included greater anger‐hostility (P = 0.003), more subjective health complaints (P = 0.026), more severe previous pain/injury (P = 0.017), more general everyday pain (P = 0.020), more body parts affected by pain/injury (P = 0.028), always/often dancing in pain (P = 0.028), and insufficient sleep (P = 0.043). Several biopsychosocial factors appear to be associated with absence from ID because of pain/injury. Biopsychosocial screening protocols and prevention strategies may best identify at‐risk dancers.

Assessment of propulsive pin force and oar angle time-series using functional data analysis in on-water rowing

The graphical presentation of the propulsive force applied at the pin plotted relative to the horizontal angle of the oar has been used practically in on‐water rowing for the qualitative assessment of skill. How the pattern is related to performance variables has not been well identified, particularly for highly trained sculling athletes. Bivariate functional principal components analysis (bfPCA) was used on force‐angle data to identify the main modes of variance in curves representing twenty‐seven female rowers of different competition levels (national level and international level), rowing at 32 strokes per minute in a single scull boat. Discriminant function analysis showed moderate classification of rowers using force‐angle graphs across both sides of the boat, with rate of force development identified as a potentially important characteristic for international rowers. Additionally for the bow‐side, spending less time in the first half of the drive phase was also identified as an important feature for international rowers. Multiple linear regression of scores from the bfPCAs showed that a more pronounced front‐peaked profile was associated with a higher average boat velocity. The results of this demonstrate that different characteristics of the force‐angle graph may be associated with different metrics of performance.

Considerations for the use of functional principal components analysis in sports biomechanics: examples from on-water rowing

Abstract The proliferation of new biomechanical technology in laboratory and field settings facilitates the capture of data-sets consisting of complex time-series. An understanding of the appropriate statistical approaches for analysing and interpreting these data-sets is required and the functional data analysis (FDA) family of statistical techniques has emerged in the biomechanical literature. Given the use of FDA is currently in its infancy with biomechanical data, this paper will form the first of a two part series aiming to address practical issues surrounding the application of FDA techniques in biomechanics. This work focuses on functional principal components analysis (fPCA), which is explored using existing literature and sample data from an on-water rowing database. In particular methodological considerations for the implementation of fPCA such as temporal normalisation of data, removal of unwanted forms of variation in a data-set and documented methods for preserving the original temporal properties within a set of curves are explored in detail as a part of this review. Limitations and strengths of the technique are outlined and recommendations are provided to encourage the appropriate use of fPCA within the field of applied sports biomechanics.

Finite Mixture Model Clustering of SNP Data

Finite mixture models have been used extensively in clustering applications, where each component of the mixture distribution is assumed to represent an individual cluster. The simplest example describes each cluster in terms of a multivariate Gaussian density with various covariance structures. However, using finite mixture models as a clustering tool is highly flexible and allows for the specification of a wide range of statistical models to describe the data within each cluster. These include modelling each cluster using linear regression models, mixed effects models, generalized linear models, etc. This paper investigates using mixtures of orthogonal regression models to cluster biological data arising from a study of the sugarcane plant.

Force coordination strategies in on-water single sculling: Are asymmetries related to better rowing performance?

Asymmetries of the rowing stroke cycle have been assessed with reference to kinematics and foot‐force measures in laboratory testing environments. It remains unclear how asymmetries in propulsive kinetic measures are related to on‐water rowing performance. A new approach for the evaluation of both global and local asymmetries across the entire movement was used to assess the continuous role of asymmetries and whether these change according to the level of competitive representation. Twenty‐seven highly skilled female rowers (national and international competition level), rowing at 32 strokes per minute in a single scull boat, were evaluated. A symmetry index (SI) and functional data analysis (FDA) techniques were applied to a continuous difference time‐series, which described fluctuating asymmetry in propulsive pin forces for each rower. Univariate ANOVAs revealed that differences in asymmetries were present as a factor of competition level for the SI and results of FDA. International athletes were more likely to utilize an asymmetry strategy with increased stroke‐side (port‐side) force early in the drive phase and increased bow‐side (starboard) force through the second half of the drive. This was likely the result of international performers customizing their movement strategies relative to known boat mechanical offsets. The first half of the drive phase was also found to be an adaptive part of the rowing stroke cycle, suggesting asymmetries may have a functional role in successful execution of movements during the rowing stroke.

How gender and boat-side affect shape characteristics of force–angle profiles in single sculling: Insights from functional data analysis

OBJECTIVES To examine whether gender or side of the boat influenced shape characteristics of the force-angle profile in on-water single sculling. DESIGN Cross-sectional study design. METHODS Bivariate functional principal components analysis (bfPCA) was applied to force-angle data to identify the main modes of variance in curves of forty highly skilled male and female rowers (national and international level), rowing at 32 strokes per minute in a single scull boat. RESULTS Separate discriminant function analyses for each side of the boat showed strong classification of rowers for gender. Force application close to (or closely around) the perpendicular oar position was demonstrated to be different between genders. A mixed ANOVA exploring gender, boat side and their interaction revealed that bow and stroke side forces were also statistically different from each other independently of gender. A main effect, independent of side of the boat, was also present for gender and no interaction was found between gender and boat side. Bow side forces seemingly acted as a driver of power and peak force production, while stroke side forces may have acted as a mediator of propulsive forces with an additional potential role in steering due to known asymmetrical offsets in boat rigging. CONCLUSIONS Results demonstrate that propulsive force differences according to gender and boat-side are evident and must be acknowledged and accounted for before force-angle graphs are explored relative to performance measures.

Impact of grass cover on the magnetic susceptibility measurements for assessing metal contamination in urban topsoil

&NA; In recent decades, magnetic susceptibility monitoring has developed as a useful technique in environmental pollution studies, particularly metal contamination of soil. This study provides the first ever examination of the effects of grass cover on magnetic susceptibility (MS) measurements of underlying urban soils. Magnetic measurements were taken in situ to determine the effects on &kgr; (volume magnetic susceptibility) when the grass layer was present (&kgr;grass) and after the grass layer was trimmed down to the root (&kgr;no grass). Height of grass was recorded in situ at each grid point. Soil samples (n=185) were collected and measurements of mass specific magnetic susceptibility (χ) were performed in the laboratory and frequency dependence (χfd%) calculated. Metal concentrations (Pb, Cu, Zn and Fe) in the soil samples were determined and a gradiometry survey carried out in situ on a section of the study area. Significant correlations were found between each of the MS measurements and the metal content of the soil at the p<0.01 level. Spatial distribution maps were created using Inverse Distance Weighting (IDW) and Local Indicators of Spatial Association (LISA) to identify common patterns. &kgr;grass (ranged from 1.67 to 301.00×10−5 SI) and &kgr;no grass (ranged from 2.08 to 530.67×10−5 SI) measured in situ are highly correlated [r=0.966, n=194, p<0.01]. The volume susceptibility datasets in the presence and absence of grass coverage share a similar spatial distribution pattern. This study re‐evaluates in situ &kgr; monitoring techniques and the results suggest that the removal of grass coverage prior to obtaining in situ &kgr; measurements of urban soil is unnecessary. This layer does not impede the MS sensor from accurately measuring elevated &kgr; in soils, and therefore &kgr; measurements recorded with grass coverage present can be reliably used to identify areas of urban soil metal contamination. Graphical abstract: Figure. No caption available. HighlightsStrong correlations were found between metal concentrations and both MS readings.MS was taken in situ with/without a grass layer to study its effect on measurements.MS measured with/without grass is effective in identifying high MS in urban soils.MS hotspots can aid in locating areas at risk in relation to soil metal pollution.MS measured with a grass layer reduces labour and costs involved in sampling.

Understanding the relationship between duration of untreated psychosis and outcomes: A statistical perspective

Although the relationships between duration of untreated psychosis (DUP) and outcomes are often assumed to be linear, few studies have explored the functional form of these relationships. The aim of this study is to demonstrate the potential of recent advances in curve fitting approaches (splines) to explore the form of the relationship between DUP and global assessment of functioning (GAF).