ABSTRACT
PURPOSE: The Western Ontario and McMaster Universities Arthritis Index (WOMAC) is a commonly used outcome measure for osteoarthritis. There are different versions of the WOMAC (Likert, visual analogue or numeric scales). A previous review of trials published before 2010 found poor reporting and inconsistency in how the WOMAC was used. This review explores whether these problems persist. METHODS: This systematic review included randomised trials of hip and/or knee osteoarthritis published in 2016 that used the WOMAC. Data were extracted on the version used, score range, analysis and results of the WOMAC, and whether these details were clearly reported. RESULTS: This review included 62 trials and 41 reported the WOMAC total score. The version used and item range for the WOMAC total score were unclear in 44% (n = 18/41) and 24% (n = 10/41) of trials, respectively. The smallest total score range was 0-10 (calculated by averaging 24 items scored 0-10); the largest was 0-2400 (calculated by summing 24 items scored 0-100). All trials reported the statistical analysis methods but only 29% reported the between-group mean difference and 95% confidence interval. CONCLUSION: Details on the use and scoring of the WOMAC were often not reported. We recommend that trials report the version of the WOMAC and the score range used. The between-group treatment effect and corresponding confidence interval should be reported. If all the items of the WOMAC are collected, the total score and individual subscale scores should be presented. Better reporting would facilitate the interpretation, comparison and synthesis of the WOMAC score in trials.
Subject(s)
Osteoarthritis, Hip/diagnosis , Osteoarthritis, Knee/diagnosis , Quality of Life/psychology , Female , Humans , Male , Ontario , Outcome Assessment, Health CareABSTRACT
The nature of inter-group relations among prehistoric hunter-gatherers remains disputed, with arguments in favour and against the existence of warfare before the development of sedentary societies. Here we report on a case of inter-group violence towards a group of hunter-gatherers from Nataruk, west of Lake Turkana, which during the late Pleistocene/early Holocene period extended about 30 km beyond its present-day shore. Ten of the twelve articulated skeletons found at Nataruk show evidence of having died violently at the edge of a lagoon, into which some of the bodies fell. The remains from Nataruk are unique, preserved by the particular conditions of the lagoon with no evidence of deliberate burial. They offer a rare glimpse into the life and death of past foraging people, and evidence that warfare was part of the repertoire of inter-group relations among prehistoric hunter-gatherers.
Subject(s)
Archaeology , Group Processes , Violence/history , Wounds and Injuries/history , Adolescent , Adult , Child , Child, Preschool , Feeding Behavior , Female , History, Ancient , Humans , Kenya , Male , Skeleton , Skull/injuriesABSTRACT
Laser fusion experiments at the National Ignition Facility require time-resolved x-ray images of the ignition target self-emission. The photon energies are expected to be greater than 10 keV. Photoemission quantum yield measurement data and photoelectron energy spectrum data are presently unavailable in this photon energy range, but are essential in the design of x-ray imaging diagnostics. We developed an apparatus to measure the quantum efficiency of primary and secondary photoelectron emission and to estimate the energy spectrum of the secondary photoelectrons. The apparatus has been tested using photon energies less than 10 keV to allow comparisons with prior work. A method for preparing photocathodes with geometrically enhanced photoefficiency has been developed.
