Description: Objectives Current musculoskeletal outcome tools are fragmented across different healthcare settings and conditions. Our objectives were to develop and validate a single musculoskeletal outcome measure for use throughout the pathway and patients with different musculoskeletal conditions: the Arthritis Research UK Musculoskeletal Health Questionnaire (MSK-HQ). Setting A consensus workshop with stakeholders from across the musculoskeletal community, workshops and individual interviews with a broad mix of musculoskeletal patients identified and prioritised outcomes for MSK-HQ inclusion. Initial psychometric validation was conducted in four cohorts from community physiotherapy, and secondary care orthopaedic hip, knee and shoulder clinics. Participants Stakeholders (n=29) included primary care, physiotherapy, orthopaedic and rheumatology patients (n=8); general practitioners, physiotherapists, orthopaedists, rheumatologists and pain specialists (n=7), patient and professional national body representatives (n=10), and researchers (n=4). The four validation cohorts included 570 participants (n=210 physiotherapy, n=150 hip, n=150 knee, n=60 shoulder patients). Outcome measures Outcomes included the MSK-HQ's acceptability, feasibility, comprehension, readability and responder burden. The validation cohort outcomes were the MSK-HQ's completion rate, test–retest reliability and convergent validity with reference standards (EQ-5D-5L, Oxford Hip, Knee, Shoulder Scores, and the Keele MSK-PROM). Results Musculoskeletal domains prioritised were pain severity, physical function, work interference, social interference, sleep, fatigue, emotional health, physical activity, independence, understanding, confidence to self-manage and overall impact. Patients reported MSK-HQ items to be ‘highly relevant’ and ‘easy to understand’. Completion rates were high (94.2%), with scores normally distributed, and no floor/ceiling effects. Test–retest reliability was excellent, and convergent validity was strong (correlations 0.81–0.88). Conclusions A new musculoskeletal outcome measure has been developed through a coproduction process with patients to capture prioritised outcomes for use throughout the pathway and with different musculoskeletal conditions. Four validation cohorts found that the MSK-HQ had high completion rates, excellent test–retest reliability and strong convergent validity with reference standards. Further validation studies are ongoing, including a cohort with rheumatoid/inflammatory arthritis.

Description: Objectives The STarT Back Tool has good predictive performance for non-specific low back pain in primary care. We therefore aimed to investigate whether a modified STarT Back Tool predicted outcome with a broader group of musculoskeletal patients, and assessed the consequences of using existing risk-group cut-points across different pain regions. Setting Secondary analysis of prospective data from 2 cohorts: (1) outpatient musculoskeletal physiotherapy services (PhysioDirect trial n=1887) and (2) musculoskeletal primary–secondary care interface services (SAMBA study n=1082). Participants Patients with back, neck, upper limb, lower limb or multisite pain with a completed modified STarT Back Tool (baseline) and 6-month physical health outcome (Short Form 36 (SF-36)). Outcomes Area under the receiving operator curve (AUCs) tested discriminative abilities of the tool's baseline score for identifying poor 6-month outcome (SF-36 lower tertile Physical Component Score). Risk-group cut-points were tested using sensitivity and specificity for identifying poor outcome using (1) Youden's J statistic and (2) a clinically determined rule that specificity should not fall below 0.7 (false-positive rate 〈30%). Results In PhysioDirect and SAMBA, poor 6-month physical health was 18.5% and 28.2%, respectively. Modified STarT Back Tool score AUCs for predicting outcome in back pain were 0.72 and 0.79, neck 0.82 and 0.88, upper limb 0.79 and 0.86, lower limb 0.77 and 0.83, and multisite pain 0.83 and 0.82 in PhysioDirect and SAMBA, respectively. Differences between pain region AUCs were non-significant. Optimal cut-points to discriminate low-risk and medium-risk/high-risk groups depended on pain region and clinical services. Conclusions A modified STarT Back Tool similarly predicts 6-month physical health outcome across 5 musculoskeletal pain regions. However, the use of consistent risk-group cut-points was not possible and resulted in poor sensitivity (too many with long-term disability being missed) or specificity (too many with good outcome inaccurately classified as ‘at risk’) for some pain regions. The draft tool is now being refined and validated within a new programme of research for a broader musculoskeletal population. Trial registration number ISRCTN55666618 ; Post results.

Description: Objective To determine the feasibility of a randomised controlled trial of an internet intervention for low back pain (LBP) using three arms: (1) usual care, (2) usual care plus an internet intervention or (3) usual care plus an internet intervention with additional physiotherapist telephone support. Design and setting A three-armed randomised controlled feasibility trial conducted in 12 general practices in England. Participants Primary care patients aged over 18 years, with current LBP, access to the internet and without indicators of serious spinal pathology or systemic illness. Interventions The ‘SupportBack’ internet intervention delivers a 6-week, tailored programme, focused on graded goal setting, self-monitoring and provision of tailored feedback to encourage physical activity. Additional physiotherapist telephone support consisted of three brief telephone calls over a 4-week period, to address any concerns and provide reassurance. Outcomes The primary outcomes were the feasibility of the trial design including recruitment, adherence and retention at follow-up. Secondary descriptive and exploratory analyses were conducted on clinical outcomes including LBP-related disability at 3 months follow-up. Results Primary outcomes: 87 patients with LBP were recruited (target 60–90) over 6 months, and there were 3 withdrawals. Adherence to the intervention was higher in the physiotherapist-supported arm, compared with the stand-alone internet intervention. Trial physiotherapists adhered to the support protocol. Overall follow-up rate on key clinical outcomes at 3 months follow-up was 84%. Conclusions This study demonstrated the feasibility of a future definitive randomised controlled trial to determine the clinical and cost-effectiveness of the SupportBack intervention in primary care patients with LBP. Trial registration number ISRCTN31034004 ; Results.

Description: Introduction Low back pain (LBP) is a prevalent and costly condition. The majority of patients experiencing LBP are managed in primary care, where first-line care recommendations consist of advice to self-manage and remain active. Internet interventions present a potential means of providing patients with tailored self-management advice and evidence-based support for increasing physical activity. Methods/analysis This protocol describes a single-blind, randomised controlled feasibility trial of an internet intervention developed to support the self-management of LBP in primary care. Patients are being randomised to 1 of 3 groups receiving either usual primary care, usual primary care with the addition of an internet intervention or an internet intervention with physiotherapist telephone support. Patients are followed up at 3 months. Primary outcomes are the feasibility of (1) the trial design/methods, (2) the delivery of the internet intervention and (3) the provision of telephone support by physiotherapists. Secondary outcomes will include exploratory analysis of estimates and variation in clinical outcomes of pain and disability, in order to inform a future main trial. Ethics/dissemination This feasibility trial has undergone ethical scrutiny and been approved by the National Health Service (NHS) Research Ethics Committee, REC Reference 13/SC/0202. The feasibility findings will be disseminated to the research community through presentations at conferences and publication in peer review journals. Broader dissemination will come following a definitive trial. Trial registration number ISRCTN 31034004.

Description: The dataset contains hyperspectral imagery acquired during airplane overflights on 8th September 2016 consisting of 242 spectral bands, ranging from VIS to SWIR (423 - 2438 nm) wavelength regions. It covers an area of about 78 km² which is dominated by beech and oak forests. The flight campaign was part of several flight campaigns within the EnMAP project and focused on hyperspectral analysis of plant physiology in deciduous and coniferous forests in the Gerolstein region in Rhineland-Palatinate, Germany.

Description: The scope of the Science Plan is to describe the scientific background, applications, and activities related to the Environmental Mapping and Analysis Program (EnMAP) mission. Primarily, the document addresses scientists and funding institutions, but it may also be of interest for environmental stakeholders and governmental bodies. It is conceived to be a living document that will be updated throughout the entire mission. Chapter 1 provides a brief overview of the principles and current state of imaging spectroscopy. This is followed by an introduction to the EnMAP mission, including its objectives and potential impact on international programs as well as major environmental and societal challenges to their understanding and management EnMAP can contribute. Chapter 2 describes the EnMAP system together with data products and access, calibration/validation issues, and synergies with other missions. Chapter 3 gives an overview of the relevance, current lines of research, and potential contributions of EnMAP for major fields of application, such as vegetation, geology and soils, coastal and inland waters, cryosphere, urban areas, atmosphere and hazards to address the environmental and societal challenges presented in Chapter 1. Finally, Chapter 4 outlines the scientific exploitation strategy, which includes the strategy for community building and training, preparatory flight campaigns and software developments. A list of abbreviations is provided in the annex to this document, while an extended glossary of terms and abbreviations is available at the EnMAP website.

Description: The scope of this Science Plan is to describe the scientific background, applications, and activities related to the EnMAP mission. Primarily, the Science Plan addresses scientists and funding institutions, but it may also be of interest for environmental stakeholders and governmental bodies. It is conceived to be a living document that will be updated throughout the whole mission. Current global challenges call for interdisciplinary approaches. Hence, the science plan is not structured in the traditional disciplinary way. Instead, it builds on overarching research themes to which EnMAP can contribute. This Science Plan comprises the following five chapters presenting the significance, background, framework, applications, and strategy of the EnMAP mission: Chapter 2 highlights the need for EnMAP data with respect to major environmental issues and various stakeholders. This chapter states the mission’s main objectives and provides a list of research themes addressing global challenges to whose understanding and management EnMAP can contribute. Chapter 3 presents an overview of the EnMAP mission from a scientific point of view including a brief description of the mission parameters, data products and access, and calibration/validation issues. Chapter 4 provides an overview of hyperspectral remote sensing regarding its principles, development, and current state and synergies to other satellite missions. Chapter 5 describes current lines of research and EnMAP applications to address the research themes presented in Chapter 2. Finally, Chapter 6 outlines the scientific exploitation strategy, which includes the strategy for community building, dissemination of knowledge and increasing public awareness.

Description: The dataset consists of hyperspectral imagery acquired during airplane overflights on 5th May 2014 that contain 242 spectral bands, ranging from VIS to SWIR (423 - 2438 nm) wavelength regions. It covers an area of about 116 km² which is dominated by spruce and beech forests. The flight campaign was part of several campaigns aiming at the creation of a multitemporal hyperspectral data set of the newly founded National Park Hunsrück-Hochwald in Rhineland Palatinate, Germany.

Description: The scope of the Science Plan is to describe the scientific background, applications, and activities of the Environmental Mapping and Analysis Program (EnMAP) imaging spectroscopy mission. Primarily, this document addresses scientists and funding institutions, but it may also be of interest to environmental stakeholders and governmental agencies. It is designed to be a living document that will be updated throughout the entire mission lifetime. Chapter 1 provides a brief overview of the principles and current state of imaging spectroscopy. This is followed by an introduction to the EnMAP mission, including its objectives and impact on international programs as well as major environmental and societal challenges. Chapter 2 describes the EnMAP system together with data products and access, calibration/validation, and synergies with other missions. Chapter 3 gives an overview of the major fields of application such as vegetation and forests, geology and soils, coastal and inland waters, cryosphere, urban areas, atmosphere and hazards. Finally, Chapter 4 outlines the scientific exploitation strategy, which includes the strategy for community building and training, preparatory flight campaigns and software developments. A list of abbreviations is provided in the annex to this document and an extended glossary of terms and abbreviations is available on the EnMAP website.

Description: The dataset contains hyperspectral imagery acquired during airplane overflights on 3rd July 2014 consisting of 242 spectral bands, ranging from VIS to SWIR (423 - 2438 nm) wavelength regions. It covers an area of about 78 km² which is dominated by beech and oak forests. The flight campaign was part of several flight campaigns within the EnMAP project and focused on hyperspectral analysis of plant physiology in deciduous forests in the Donnersberg region in Rhineland-Palatinate, Germany.