Maximum voluntary isometric contraction (MVIC) is a standardized method for measurement of muscle strength in patients with neuromuscular disease. Values obtained from MVIC testing are difficult to interpret at present as normative data are limited. The objective of this study was to generate reference values for MVIC. A convenience sample of 494 healthy men and women aged 20-76 years was recruited. MVIC testing was performed on nine muscle groups bilaterally: neck flexors, shoulder abductors, shoulder adductors, elbow and knee flexors and extensors, and hip and ankle flexors. MVIC was performed using the Quantitative Muscle Assessment system. Age and sex related reference values were calculated for each muscle group using quantile regression. A clinical reporting system was developed to facilitate interpretation of patient values with reference to normal percentiles. Reference values generated from this study can be used to determine the presence and extent of muscle weakness in a given population and to evaluate the effectiveness of treatment interventions.

Undergraduate training in DRE is limited. Training in DRE can no longer be reasonably considered part of the core curriculum taught in Irish medical schools.

ObjectivesTo identify and rank the most significant workplace stressors to which consultants and trainees are exposed within the publicly funded health sector in Ireland.DesignFollowing a preliminary semistructured telephone interview, a Delphi technique with 3 rounds of reiterative questionnaires was used to obtain consensus. Conducted in Spring 2014, doctors were purposively selected by their college faculty or specialty training body.SettingConsultants and higher specialist trainees who were engaged at a collegiate level with their faculty or professional training body. All were employed in the Irish publicly funded health sector by the Health Services Executive.Participants49 doctors: 30 consultants (13 male, 17 female) and 19 trainees (7 male, 12 female). Consultants and trainees were from a wide range of hospital specialties including anaesthetics, radiology and psychiatry.ResultsConsultants are most concerned with the quality of healthcare management and its impact on service. They are also concerned about the quality of care they provide. They feel undervalued within the negative sociocultural environment that they work. Trainees also feel undervalued with an uncertain future and they also perceive their sociocultural environment as negative. They echo concerns regarding the quality of care they provide. They struggle with the interface between career demands and personal life.ConclusionsThis Delphi study sought to explore the working life of doctors in Irish hospitals at a time when resources are scarce. It identified both common and distinct concerns regarding sources of stress for 2 groups of doctors. Its identification of key stressors should guide managers and clinicians towards solutions for improving the quality of patient care and the health of care providers.

No abstract