Wednesday, November 19, 2008

Assessment of Fibromyalgia & Chronic Fatigue Syndrome: A New Protocol...

Assessment of Fibromyalgia & Chronic Fatigue Syndrome: A New Protocol Designed to Determine Work Capability – Chronic Pain Abilities Determination (CPAD)

M Kelly, R Gagne, JD Newman, C Olney, C Gualtieri, D Trail

Abstract
The objective was to design a protocol to assess work ability in people suffering ill-defined painful and disabling disorders, the outstanding prototype of which is fibromyalgia/chronic fatigue syndrome (FM/CSF).Following an extensive literature search, the most appropriate components of current methods of assessment of physical and cognitive abilities were incorporated into the protocol, occasionally with appropriate modification to suit the specific requirements of the individual.

The initial part of the assessment consists of a standard history taking, principally focusing on the patient’s self-reported physical and cognitive abilities and disabilities, as well as the completion of established pain and fatigue scales, and relevant disability questionnaires.

Following this, physical and cognitive abilities are objectively assessed on two separate occasions, utilizing computerized hand-held dynamometers, inclinometers, algometers, and force dynamometers. Specific work simulation tests using the industrial standards Methods-Time-Measurement testing are availed of, as is aerobic testing using the Canadian Aerobic Fitness Test (CAFT).

Objective computerised neuro-cognitive testing are also utilised as an integral component of the assessment. All results are then subject to specific computerized analysis and compared to normative and standardised work-based databases. The designed system produces reliable, consistent and reproducible results.

It also proves capable of detecting any inconsistencies in patient input and results, in addition to being independent of any possible assessor bias. A new protocol has been designed to determine the working capability of individuals who suffer from various chronic disabling conditions, and represents a significant step forward in a difficult but rapidly expanding area of medical practice.

Tuesday, November 18, 2008

Landslide closes busy bridge twice in 6 months

Landslide closes busy bridge twice in 6 months

By Bryan Johnson

KING COUNTY, Wash. -- Landslides and soaked hillsides have a major road shut down.

Highway 169 is closed at the Green River bridge. But the state just spent a lot of money fixing the bridge.

The bridge gives the state heart burn and motorists heartache. Twice this year - twice within six months - the bridge has been closed because of landslides.

The first slide in June broke some big chunks of concrete loose. The state closed the bridge, brought in experts and drilled holes to find out why the earth was moving.

The state installed hillside drains. They reinforced walls. They put in inclinometers -- a fancy word for a device that will say if the bridge is leaning, which is not a good thing when you are 145 feet above the Green River.

"We've got three tilt meters under the bridge. We have several piezometers to help us measure the ground water," said Bob Grandoff with the Department of Transportation.

No one was too worried.

Then it rained this week. Water flowed out of the hillside. Despite all the stabilization, those tilt meters recorded a very slight movement.

"Any time a bridge is moving, I think it is prudent to close the road for safety, of course," said Grandoff said.

The bridge was closed.

In the closest town, Black Diamond, those closures make some nervous:

"I go really fast and I say it's my last time every time," said Katie Doyle.

"How can they sink concrete down that far to stabilize it?" said Marilyn Pedersen.

The state says Doyle, Pedersen and the rest of you need not worry. The bridge is safe and they'll do whatever is necessary to keep it that way.

"Right now, it is the most watched bridge in the state," said Grandoff.

This bridge is constantly monitored. Radio signals go to DOT officials Olympia. With even the slightest movement, the bridge gets shut down.

Right now there is no movement; there doesn't seem to be a problem. But the state says the signals must show no problems for at least 48 hours before they will reopen the bridge. That could happen this weekend.

As I always say, better safe than sorry - inclinometers continuously prove value as added levels of safety monitoring and warning for critical, potentially life threatening tilt applications - Skip Gosnell

Monday, November 17, 2008

Things are quieter at Cerro Machín

12 November 2008

Posted by volcanism in Colombia, Machín, activity reports.

The alert level at Colombia’s Cerro Machín volcano remains at a cautious level III, yellow (where level I, red, is the highest), but INGEOMINAS Observatorio Vulcanológico y Sismológico de Manizales reports ‘normality’ in the volcano’s activity and a decrease in seismicity in its latest bulletin (dated 11 November 2008):

During 8, 9 and 10 November the volcano Cerro Machín registered a seismic event within which 1210 volcano-tectonic earthquakes were recorded (associated with the fracturing of rock in the interior of the volcano), 9 of which were with magnitudes greater than 2.5, several being heard by the inhabitants of Cajamarca, Ibagué, Calarcá and Armenia, among others.

The inclinometers located around the volcano showed significant changes, associated with the principal event of 9 November at 03:01.

On 9 November an INGEOMINAS commission went to the volcano Machín with the aim of evaluating conditions at the volcano. The report submitted is of complete normality in the activity of the volcano, the cracking of some houses and landslides caused by seismic movement, associated with ground conditions of high humidity.

From 10:00 yesterday, Monday 10 November, the seismic activity of the volcano decreased notably and at the time of publication of this communication the levels of seismic activity are low.

The tremors and ashfall of Sunday and Monday produced great alarm among local populations but also, reports La Patria, ’strengthened the solidarity of the community’. Some 500 people from farming communities around Cerro Machín who fled their homes are being accommodated in Ibagué, in a relief operation co-ordinated by the Red Cross. Local residents are helping to provide food and other supplies for the refugees. The recent activity from Machín and Nevado del Huila volcanoes, writes El País, ‘holds half the country in suspense’. Perhaps it will raise awareness of the potential dangers posed by Colombia’s volcanoes, which may well be needed: last week, reports El Tiempo, INGEOMINAS held a community emergency training event for the residents of areas around Machín, ‘but no-one attended’.