33,952 research outputs found
UK back pain exercise and manipulation (UK BEAM) trial - national randomised trial of physical treatments for back pain in primary care: objectives, design and interventions
No full textLow back pain has major health and social implications. Although there have been
many randomised controlled trials of manipulation and exercise for the management of low back
pain, the role of these two treatments in its routine management remains unclear. A previous trial
comparing private chiropractic treatment with National Health Service (NHS) outpatient
treatment, which found a benefit from chiropractic treatment, has been criticised because it did not
take treatment location into account. There are data to suggest that general exercise programmes
may have beneficial effects on low back pain. The UK Medical Research Council (MRC) has funded
this major trial of physical treatments for back pain, based in primary care. It aims to establish if,
when added to best care in general practice, a defined package of spinal manipulation and a defined
programme of exercise classes (Back to Fitness) improve participant-assessed outcomes.
Additionally the trial compares outcomes between participants receiving the spinal manipulation in
NHS premises and in private premises
Discogenic low back pain : lumbar spondylodesis revisited
No full textNeurosurgeon deals with chronic low back pain patients almost daily. Most of these patients still have complaints of low back pain despite many different previous therapies. Surgical treatment is only to be considered in few cases of chronic low back pain sufferers. From this large group of chronic low back pain patients we have tried to select a small group of patients who might benefit fiom spondylodesis. This thesis is about the selection and treatment of this patient group. Their assumed source of pain and the results of surgical treatment will also be discussed. ...
Zie: Summary
Evaluation of physiotherapy intervention for non-specific sub-acute and chronic low back pain
No full textThis thesis investigates routine physiotherapy management of patients with subacute
and chronic non specific low back pain.
In a pragmatic multi-centre trial patients were randomised to receive a course of
physiotherapy treatment or advice following a bio-psychosocial model. Disease
specific, patient specific and generic measures were used to assess outcome.
The 286 patients recruited in the trial had, on average, minimal to moderate low
back pain disability. Patients reported enhanced perceptions of benefit in the
physiotherapy group but there was no evidence of a long term effect in any other
outcomes. There were no differences between the groups in NHS costs although
patients in the physiotherapy group incurred significantly higher out of pocket
expenses. Further analysis of the outcome data confirmed that the primary outcome
measure (Oswestry Disability Index) was the most responsive instrument because it
was able to detect deterioration as well as improvement.
As the trial demonstrated no additional benefit of physiotherapy over brief advice, it
was important to investigate the effectiveness of the latter. A systematic review
found limited evidence that brief bio-psychosocial advice was more effective in
reducing fear avoidance and improving back beliefs in patients with acute and subacute
low back pain compared with traditional medical advice. There was no direct
evidence to support the use of brief bio-psychosocial advice (2 sessions or less) for
reducing pain or disability.
This thesis describes research that has contributed to European guidelines for the
management of chronic low back pain and reviews extensively the literature that
seeks to evaluate physiotherapy practice. The clinical implication of this research is
that for patients with non specific low back pain of mild severity, brief advice is
likely to be as effective as prolonged physiotherapy intervention. The extent to
which a single session of advice is more effective than no intervention needs further
assessment
Ittijahat Abi Dhu'ayb Al-Hudhali fi Qasidatihi Ar-Ritsa’
No full textThis article aims to know Ittijahat of Abu Dhu’ayb Al-Hudhali in his poem of Ritsa’. Ittijahat in this study is a description of the poet's tendency to divide Ar-Ritsa', namely Nadb and Ta'ziyah. Ar-Ritsa 'is one of the various forms of Arabic poetry. To analyze the discussion problem, the author uses descriptive analysis method, because this method is very appropriate to find out the picture and state of a thing by describing it in as much detail as possible based on the facts found in the data in question. The results obtained are: In the beginning of the poem, he tends to mourn (Nadb) their five children. He describes in it that he does not stop crying and has trouble sleeping until he becomes weak emaciated due to the intensity of the grief, pain and worries that dominated in his pysche. As for the middle of the poem to the end, the poet turns to the consolation (Ta’ziyah) of his children’s death, as he reflects on the reality of life and death, the poet declares that death is inevitable for every human being that he must accept it and let it go, which the poet portrayed in the exciting narrative style. The story is divided into three stories: the zebra, the bull of the beast, and the two knights.</jats:p
Information in securities markets: Kyle meets Glosten and Milgrom
No full textThis paper analyzes models of securities markets with a single strategic informed trader and competitive market makers. In one version, uninformed trades arrive as a Brownian motion and market makers see only the order imbalance, as in Kyle (1985). In the other version, uninformed trades arrive as a Poisson process and market mak- ers see individual trades. This is similar to the Glosten–Milgrom (1985) model, except that we allow the informed trader to optimize his times of trading. We show there is an equilibrium in the Glosten–Milgrom-type model in which the informed trader plays a mixed strategy (a point process with stochastic intensity). In this equilibrium, informed and uninformed trades arrive probabilistically, as Glosten and Milgrom assume. We study a sequence of such markets in which uninformed trades become smaller and ar- rive more frequently, approximating a Brownian motion. We show that the equilibria of the Glosten–Milgrom model converge to the equilibrium of the Kyle model
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