BackgroundThere are a large number of assessment tools for tinnitus, with little consensus on what it is important to measure and no preference for a minimum reporting standard. The item content of tinnitus assessment tools should seek to capture relevant impacts of tinnitus on everyday life, but no-one has yet synthesised information about the range of tinnitus complaints. This review is thus the first comprehensive and authoritative collection and synthesis of what adults with tinnitus and their significant others report as problems in their everyday lives caused by tinnitus.MethodsElectronic searches were conducted in PubMed, Embase, CINAHL, as well as grey literature sources to identify publications from January 1980 to June 2015 in which participants were enrolled because tinnitus was their primary complaint. A manual search of seven relevant journals updated the search to December 2017. Of the 3699 titles identified overall, 84 records (reporting 86 studies) met our inclusion criteria and were taken through to data collection. Coders collated generic and tinnitus-specific complaints reported by people with tinnitus. All relevant data items were then analyzed using an iterative approach to narrative synthesis to form domain groupings representing complaints of tinnitus, which were compared patients and significant others.ResultsFrom the 86 studies analyzed using data collected from 16,381 patients, 42 discrete complaints were identified spanning physical and psychological health, quality of life and negative attributes of the tinnitus sound. This diversity was not captured by any individual study alone. There was good convergence between complaints collected using open- and closed-format questions, with the exception of general moods and perceptual attributes of tinnitus (location, loudness, pitch and unpleasantness); reported only using closed questions. Just two studies addressed data from the perspective of significant others (n = 79), but there was substantial correspondence with the patient framework, especially regarding relationships and social life.ConclusionsOur findings contribute fundamental new knowledge and a unique resource that enables investigators to appreciate the broad impacts of tinnitus on an individual. Our findings can also be used to guide questions during diagnostic assessment, to evaluate existing tinnitus-specific HR-QoL questionnaires and develop new ones, where necessary.Trial RegistrationPROSPERO registration number: CRD42015020629. Protocol published in BMJ Open. 2016;6e009171.Electronic supplementary materialThe online version of this article (10.1186/s12955-018-0888-9) contains supplementary material, which is available to authorized users.

BackgroundRubella infection can affect several organs and cause birth defects that are responsible for congenital rubella syndrome (CRS). Congenital hearing loss is the most common symptom of this syndrome, occurring in approximately 60% of CRS cases. Worldwide, over 100 000 babies are born with CRS every year. There is no specific treatment for rubella, but the disease is preventable by vaccination. Since 1969, the rubella vaccine has been implemented in many countries, but in Africa, only a few countries routinely immunize against rubella. The aim of this study was to estimate the rate of infection from the wild-type rubella virus in São Tomé and Príncipe by determining rubella seroprevalence with a DBS method. The goal of this study was to reinforce the need for implementation of the rubella vaccine in this country. As secondary objectives, the validation of a DBS method was first attempted and an association between seroprevalence and hearing loss was assessed.MethodsWe collected samples from individuals observed during humanitarian missions in São Tomé and Príncipe. All individuals underwent an audiometric evaluation, and a drop of blood was collected for the dried blood spot (DBS).We define two groups: the case group (individuals with unilateral or bilateral hearing loss (HL)) and the control group (individuals with two normal ears). Patients were excluded if they suffered from conductive HL, if they showed evidence of possible causes of HL, if they had developmental delay or if they refused to participate in the study.ResultsAmong the 315 subjects, we found 64.1% individuals with IgG for the rubella virus, 32.1% without immunity for the rubella virus and 3.8% who were borderline.In the control group, 62.6% were positive for the rubella IgG, whereas in the case group, 72% were positive. Analyzing both groups, with ages ranging from 2 to 14 years of age and from 15 to 35 years of age, we found a seroprevalence of 50.3% to rubella in the younger group and 82.1% in the older group, with a significant difference between cases and control group noted within the younger patients (p = 0.025).ConclusionsRubella is a disease that can be prevented. Rubella infections are still very common in São Tomé and Príncipe, and women of child-bearing age are still at risk for rubella infection during pregnancy, justifying the urgency of vaccination against rubella.A statistically significant association between the group of children under 14 years of age with HL and immunity for rubella was observed in this country, although this study did not allow us to establish a cause-effect relationship between rubella infection and SNHL.

Background: The purpose of this study was to investigate the effects of 2 water-based aerobic training programs on functional capacity and quality of life (QoL) of older women. Design: Randomized clinical trial. Methods: A total of 41 women (64.3 [3.1] y) were randomized into a continuous (CTG) and an interval (ITG) water-based aerobic training group. Training programs were performed with exercise intensity based on rating of perceived exertion throughout 12 weeks (twice a week). Functional tests with and without dual-task and QoL questionnaire were applied pretraining and posttraining. Per protocol and intention to treat analysis were conducted using generalized estimating equations, with Bonferroni post hoc test (α = .05). Results: The per protocol analysis showed an increase in the 30-second chair stand (6% [12%] vs 18% [13%]), 6-minute walk (4% [7%] vs 2% [8%]), and 5-m habitual gait velocity (6% [11%] vs 4% [7%]) tests after CTG and ITG training groups. In addition, the intention to treat analysis revealed an increase in the 30-second chair stand test (7% [13%] vs 12% [13%]) and physical domain of QoL (8% [26%] vs 14% [22%]) after CTG and ITG training groups, as well as an increase in the gait velocity with verbal task after CTG (6% [11%]). Conclusions: Both water-based aerobic training programs induced similar improvements in the functional capacity and maintained the QoL perception in older women.

Background Hypertension is a clinical condition highly prevalent in the elderly, imposing great risks to cardiovascular diseases and loss of quality of life. Current guidelines emphasize the importance of nonpharmacological strategies as a first-line approach to lower blood pressure. Exercise is an efficient lifestyle tool that can benefit a myriad of health-related outcomes, including blood pressure control, in older adults. We herein report the protocol of the HAEL Study, which aims to evaluate the efficacy of a pragmatic combined exercise training compared with a health education program on ambulatory blood pressure and other health-related outcomes in older individuals. Methods Randomized, single-blinded, multicenter, two-arm, parallel, superiority trial. A total of 184 subjects (92/center), ≥60 years of age, with no recent history of cardiovascular events, will be randomized on a 1:1 ratio to 12-week interventions consisting either of a combined exercise (aerobic and strength) training, three times per week, or an active-control group receiving health education intervention, once a week. Ambulatory (primary outcome) and office blood pressures, cardiorespiratory fitness and endothelial function, together with quality of life, functional fitness and autonomic control will be measured in before and after intervention. Discussion Our conceptual hypothesis is that combined training intervention will reduce ambulatory blood pressure in comparison with health education group. Using a superiority framework, analysis plan prespecifies an intention-to-treat approach, per protocol criteria, subgroups analysis, and handling of missing data. The trial is recruiting since September 2017. Finally, this study was designed to adhere to data sharing practices. Trial registration NCT03264443 . Registered on 29 August, 2017. Electronic supplementary material The online version of this article (10.1186/s12889-019-6970-3) contains supplementary material, which is available to authorized users.

Diniz, R, Del Vecchio, FB, Schaun, GZ, Oliveira, HB, Portella, EG, da Silva, ES, Formalioni, A, Campelo, PCC, Peyré-Tartaruga, LA, and Pinto, SS. Kinematic comparison of the roundhouse kick between taekwondo, karate, and muaythai. J Strength Cond Res XX(X): 000-000, 2018-The roundhouse kick (RHK) is frequently executed in taekwondo, karate, and muaythai because of its high technical effectiveness during combat. The purpose of this study was to compare kinematic characteristics during RHK performance between taekwondo, karate, and muaythai athletes. Forty-seven male athletes (25.5 ± 4.7 years, 1.75 ± 0.1 m, and 75.8 ± 11.5 kg) volunteered to participate (taekwondo: 17; karate: 15; and muaythai: 15). Self-selected distance from target, mean and peak fifth metatarsus linear velocity (LV5mean; LV5peak), mean and peak hip (HAVmean; HAVpeak) and knee (KAVmean; KAVpeak) angular velocities, as well as target linear acceleration (TLA) were analyzed with a 3D video motion analysis system. Comparisons between modalities were performed with 1-way analysis of variances and Bonferroni's post hoc test (α = 0.05). Self-selected distance was lower in muaythai compared with taekwondo and karate (p < 0.001). Also, karate had greater LV5mean compared with muaythai (p = 0.001), and muaythai showed higher HAVmean than karate (p = 0.011). In addition, HAVpeak was greater in muaythai than in taekwondo and karate (p < 0.001). No differences were found for KAVmean, KAVpeak, and TLA. Although it is similarly described between modalities, RHK showed distinct kinematic characteristics between taekwondo, karate, and muaythai. Based on these results, coaches and athletes can improve their RHK technique according to the specificities of each combat sport. Specifically, it is suggested that combat strategies should aim to increase the distance from the opponent during combat for muaythai athletes, whereas taekwondo and karate athletes should focus on decreasing it.

After the intervention, quadriceps muscle thickness, 1RM, and sEMG improved in all three groups (all p < 0.05), whereas muscle quality improved only in middle-aged and older participants (p ≤ 0.001), and MVIC only in middle-aged and mobility-limited older adults (p < 0.05). With a few exceptions, peak power improved in all groups from 30-90% 1RM (p < 0.05) both when tested relative to pre-training or post-training 1RM workloads (all p < 0.05). Both mobility-limited older adults and older adults improved their short physical performance battery score (p < 0.05). Chair stand, stair climb, maximal gait speed, and timed up-andgo performance, on the other hand, improved in all three groups (p < 0.05), but no change was observed for habitual gait speed and 6-min walk test performance. Overall, our results demonstrate that a HVRT intervention can build a stronger foundation in middle-aged individuals so that they can better deal with age-related impairments at the same time that it can mitigate already present physiological and functional impairments in older adults with and without mobility-limitation.

Hearing loss (HL) is a common condition with both genetic and environmental causes, and it greatly impacts global health. The prevalence of HL is reportedly higher in developing countries such as the Sub-Saharan African island of São Tomé and Príncipe, where the deaf community is estimated to be less than 1% of the population. We investigated the role of the DFNB1 locus (GJB2 and GJB6 genes) in the etiology of nonsyndromic sensorineural hearing loss (NSSHL) in São Tomé and Príncipe. A sample of 316 individuals, comprising 136 NSSHL patients (92 bilateral, 44 unilateral) and 180 controls, underwent a clinical and audiological examination. Sequencing of the GJB2 coding region and testing for the (GJB6-D13S1830) and del(GJB6-D13S1854) GJB6 deletions were performed. A total of 311 out of 316 individuals were successfully analyzed regarding the GJB2 and GJB6 genetic variations, respectively. The frequency of the GJB2 coding mutations in patients and controls was low. Some of those coding mutations are the most commonly found in Eurasian and Mediterranean populations and have also been identified in Portugal. None of the GJB6 deletions was present. The presence of certain coding variants in São Tomé and Príncipe suggests a non-Sub-Saharan genetic influx and supports the previously reported genetic influx from European (mainly Portuguese) ancestors. In summary, DFNB1 locus does not appear to be a major contributor to NSSHL in São Tomé and Príncipe. However, the presence of both pathogenic and likely pathogenic mutations in GJB2 suggests that GJB2-related NSSHL might still occur in this population, warranting further research on GJB2 testing in NSSHL cases.

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