Introduction: The incidence of hip fracture among older adults in Nigeria is on the rise. As a result, there is increased frequency of hospitalization, patient suffering, family burden, and societal cost. One dimension that has not been sufficiently explored is the burden of care experienced by informal and formal caregivers. Objectives: To describe the care burden experience of informal and formal caregivers for older adults with hip fractures in a specialized orthopedic center in Nigeria and to explore in detail how their experience differs in caregiving roles. Method: This study was conducted in the phenomenological approach of qualitative methods. Face-to-face interviews and focus group interaction with 12 family caregivers and 5 health-care professionals were carried out until data saturation was achieved. Data were analyzed using thematic analysis. Results: The physical, emotional, and general health of elderly hip fracture patients are issues that affect caregiving. Factors that contribute to increased caregivers' burden include system factors (lack of personnel and health-care facilities) and patient factors: comorbidity, patient's cognitive status, and challenges completing activities of daily living (ADL). Social and financial barriers to care contribute to the type of burden experienced by the participants. Conclusions: Caregivers experience difficulty in helping patients complete their ADL because patients with hip fracture have mobility issues that are often complicated by comorbid physical and cognitive problems. Strategies to reduce caregivers' burden for older adults with hip fracture in Nigeria are needed. Greater access to health-care services and ADL aids, and training of caregivers on how to deal with cognitive and multimorbid health problems are potential solutions.

Objective: The objective of this study was to systematically locate, critically appraise, and summarize clinical measurement research addressing the use of Brief Pain Inventory-Short Form (BPI-SF) and Revised Short McGill Pain Questionnaire Version-2 (SF-MPQ-2) in pain-related musculoskeletal (MSK) conditions. Materials and Methods:We systematically searched 4 databases (Medline, CINAHL, EMBASE, and SCOPUS) and screened articles to identify those reporting the psychometric properties (eg, validity, reliability) and interpretability (eg, minimal clinically important difference) of BPI-SF and SF-MPQ-2 as evaluated in pain-related MSK conditions. Independently, 2 reviewers extracted data and assessed the quality of evidence with a structured quality appraisal tool and the updated COSMIN guidelines.Results: In all, 26 articles were included (BPI-SF, n = 17; SF-MPQ-2, n = 9). Both tools lack reporting on their cross-cultural validities and measurement error indices (eg, standard error of measurement). High-quality studies suggest the tools are internally consistent (α = 0.83 to 0.96), and they associate modestly with similar outcomes (r = 0.3 to 0.69). Strong evidence suggests the BPI-SF conforms to its 2-dimensional structure in MSK studies; the SF-MPQ-2 4-factor structure was not clearly established. Seven reports of highto-moderate quality evidence were supportive of the BPI-SF knowngroup validity (n = 2) and responsiveness (n = 5). One report of high quality established the SF-MPQ-2 responsiveness.Discussion: Evidence of high-to-moderate quality supports the internal consistency, criterion-convergent validity, structural validity, and responsiveness of the BPI-SF and SF-MPQ-2 and establishes their use as generic multidimensional pain outcomes in MSK populations. However, more studies of high quality are still needed on their retest reliability, known-group validity, cross-cultural validity, interpretability properties, and measurement error indices in different MSK populations.

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Introduction Functional deficits such as gait speed, muscle strength or reduced activities in daily living after discharge are predictors for hospital readmission for older adults with hip fractures. However, physiotherapists (PTs) who are inherently mobility experts, do not actively participate during the hospital-to-home transition of older adults with hip fractures in the developing countries, including Nigeria. This qualitative study aims to describe and explore how PTs working within inpatient rehabilitation units prepare older adults (≥60 years) with a hip fracture for transfer to their home in the community. Methods We will adopt Sally Thorne’s Interpretive Description approach to purposively select 25 PTs with 5-years experience of participating in discharging older adults with hip fractures from inpatient rehabilitation-to-home. Data collection will include (a) semi-structured, one-on-one interviews with PTs, (b) discharge summaries of two older adults, and (c) final focus group discussion with PTs. We will ask the physiotherapists to provide discharge summaries of two older adults - one that they described as a “difficult” case and one that they described as an “easy” case during inpatient rehabilitation-to-home transition. Data will be analyzed employing Sally Thorne’s “borrowing techniques”- content and thematic analysis for the patients’ discharge summaries and PT interviews, respectively.

Background: The Revised Short McGill Pain Questionnaire Version-2 (SF-MPQ-2) is a multidimensional outcome measure designed to evaluate neuropathic and non-neuropathic pain. A recent systematic review found insufficient psychometric data with respect to musculoskeletal health conditions. Aims: To describe the reproducibility (reliability and agreement) and internal consistency of the SF-MPQ-2 for use among patients with musculoskeletal shoulder pain. Methods: Eligible patients with shoulder pain from MSK sources completed the SF-MPQ-2: at baseline (n=195), and a subset did so again after 3-7days (n= 48), if their response to the Global Rating of Change scale remained unchanged. Cronbach alpha (α) and intraclass correlation coefficient (ICC2,1) were calculated. Standard Error of Measurement (SEM), group and individual minimal detectable change (MDC90), and Bland-Altman (BA) plots were used to assess agreement. Results: Cronbach α ranged from 0.83 to 0.95 suggesting very satisfactory internal consistency across the SF-MPQ-2 domains. Excellent ICC2,1 scores were found in support of the total (0.95) and continuous (0.92) subscales; the remaining subscales displayed good ICC2,1 scores (0.78 to 0.88). Bland-Altman analysis revealed no systematic bias between the test and retest scores (mean difference = 0.13 to 0.19). While the best agreement coefficients were seen on the total scale (SEM = 0.5; MDC90 = 1.2 and MDC90group = 0.3), they were acceptable for the SF-MPQ-2 subscales (SEM: range, 0.7 to 1; MDC90: range, 1.7 to 2.3; MDC90group: range, 0.4 to 0.5). A c c e p t e d M a n u s c r i p t Information Classification: General Conclusions: The SF-MPQ-2 provides good to excellent test-retest reliability for multidimensional pain assessment among patients with musculoskeletal shoulder pain conditions.

BackgroundThe Brief Pain Inventory (BPF-SF) and McGill Pain Questionnaire (SF-MPQ-2) are general-use, self-report, multidimensional pain assessment outcomes frequently used for pain assessment in musculoskeletal (MSK) conditions. Synthesizing knowledge on their measurement properties, as assessed in MSK conditions, should provide a deeper understanding of their strengths and limitations.ObjectivesTo systematically locate, critically appraise, compare and summarize clinical measurement research about the BPI-SF and SF-MPQ-2 in pain-related musculoskeletal conditionsMethodsFour databases (Medline, CINAHL, EMBASE & SCOPUS) were systematically searched for relevant citations, each for the BPI-SF and SF-MPQ-2. We included articles that reported the psychometric properties (e.g. validity, reliability, responsiveness) and interpretability indices (e.g. minimal clinical important difference) of both tools, as assessed in mixed and specific MSK studies. Independently, two reviewers extracted data and assessed the quality of evidence with a structured quality assessment tool for measurement studies and according to the updated COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines.ResultsTwenty-five articles were included (BPI-SF, n=17; SF-MPQ-2, n=8). Both tools lack reporting on their cross-cultural validities and measurement error indices. High quality studies suggest that they are internally consistent (α = 0.83-0.96), and they associate modestly with similar outcome measures (r = 0.3-0.69). There is evidence that the BPI-SF conforms to its two-dimensional structure in MSK studies; the SF-MPQ-2 four-factor structure was not clearly established. In seven reports, high to moderate quality evidence was seen in supports of the BPI-SF known group validity (n=2) and responsiveness (n=5) but none was available for the SF-MPQ-2. Furthermore, the SF-MPQ-2 was more frequently associated with floor effects in MSK studies than the BPI-SF (SF-MPQ-2, 42% vs BPI-SF, 6%).ConclusionThe SF-MPQ-2 has emeging evidence whereas the BPI-SF evidence is more mature. Both tools displayed high-quality evidence in support of their internal consistency and criterion-convergent validities. High to moderate quality evidence suggests the BPI-SF subscales have a better responsiveness, retest reliability, known group validity and structural validity than the SF-MPQ-2.References[1] Cleeland CS, Ryan KM. Pain assessment: global use of the Brief Pain Inventory. Ann Acad Med Singapore. 1994;23(2):129-138. doi:10.1016/0029-7844(94)00457-O.[2] Dworkin RH, Turk DC, Revicki DA, et al. Development and initial validation of an expanded and revised version of the Short-form McGill Pain Questionnaire (SF-MPQ-2). Pain. 2009;144(1):35-42. doi:10.1016/j.pain.2009.02.007.[3] Dworkin RH, Turk DC, Trudeau JJ, et al. Validation of the Short-Form McGill Pain Questionnaire-2 (SF-MPQ-2) in Acute Low Back Pain. J Pain. 2015;16(4):357-366. doi:10.1016/j.jpain.2015.01.012.Disclosure of InterestsNone declared

Background The Revised Short McGill Pain Questionnaire Version-2 (SF-MPQ-2) is a multidimensional outcome measure designed to capture, evaluate and discriminate pain from neuropathic and non-neuropathic sources. A recent systematic review found insufficient psychometric data with respect to musculoskeletal (MSK) health conditions. This study aimed to describe the reproducibility (test–retest reliability and agreement) and internal consistency of the SF-MPQ-2 for use among patients with musculoskeletal shoulder pain. Methods Eligible patients with shoulder pain from MSK sources completed the SF-MPQ-2: at baseline (n = 195), and a subset did so again after 3–7 days (n = 48), if their response to the Global Rating of Change (GROC) scale remained unchanged. Cronbach alpha (α) and intraclass correlation coefficient (ICC2,1), and their related 95% CI were calculated. Standard error of measurement (SEM), group and individual minimal detectable change (MDC90), and Bland–Altman (BA) plots were used to assess agreement. Results Cronbach α ranged from 0.83 to 0.95 suggesting very satisfactory internal consistency across the SF-MPQ-2 domains. Excellent ICC2,1 scores were found in support of the total scale (0.95) and continuous subscale (0.92) scores; the remaining subscales displayed good ICC2,1 scores (0.78–0.88). Bland–Altman analysis revealed no systematic bias between the test and retest scores (mean difference = 0.13–0.19). While the best agreement coefficients were seen on the total scale (SEM = 0.5; MDC90individual = 1.2 and MDC90group = 0.3), they were acceptable for the SF-MPQ-2 subscales (SEM: range 0.7–1; MDC90individual: range 1.7–2.3; MDC90group: range 0.4–0.5). Conclusion Good reproducibility supports the SF-MPQ-2 domains for augmented or independent use in MSK-related shoulder pain assessment, with the total scale displaying the best reproducibility coefficients. Additional research on the validity and responsiveness of the SF-MPQ-2 is still required in this population.

Patients living with human immunodeficiency virus (HIV) infection who are treated with highly active antiretroviral therapy (HAART) often experience metabolic changes that have an adverse effect on their over-all health status. This review will assess the effect of aerobic exercises on the lipid profile of individuals with HIV infection undergoing HAART. Cochrane Library, MEDLINE, CINAHL (Cumulative index to Nursing and Allied Health Literature), OVID, ProQuest, AMED (Allied and Complementary Medicine Database), PsycINFO, Web of Science Core Collection and Pedro databases will be searched until June 2018. Studies that investigated the effects of aerobic exercises on the lipid profile of HAART treated patients with HIV will be included. Two reviewers will screen all articles for eligibility and independently evaluate the risk of bias, complete quality assessment and extract data for all included articles. Homogenous quantitative outcome data will be analyzed using a random effect model of meta-analysis with results presented as relative risk for dichotomous variable and standardized mean for continuous variable. Heterogeneous qualitative data will be analyzed using narrative synthesis. This systematic review will provide evidence about the effectiveness of aerobic exercises in managing HAART related dyslipidemia in patients with HIV infection and thus provide the impetus for more structured exercise interventions.