217,219 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
Artificial Intelligence for the Design of Symmetric Cryptographic Primitives
No full textThis chapter provides a general overview of AI methods used to support the design of cryptographic primitives and protocols. After giving a brief introduction to the basic concepts underlying the field of cryptography, we review the most researched use cases concerning the use of AI techniques and models to design cryptographic primitives, focusing mainly on Boolean functions, S-boxes and pseudorandom number generators. We then point out two interesting directions for further research on the design of cryptographic primitives where AI methods could be applied in the future.Green Open Access added to TU Delft Institutional Repository 'You share, we take care!' - Taverne project https://www.openaccess.nl/en/you-share-we-take-care Otherwise as indicated in the copyright section: the publisher is the copyright holder of this work and the author uses the Dutch legislation to make this work public.Cyber Securit
Treatment satisfaction and dissatisfaction in patients with chronic low back pain
No full textThis thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University.This thesis explores treatment satisfaction and dissatisfaction in patients with chronic low back pain (CLBP).
Chapters 1 and 2 provide background on CLBP, and treatment satisfaction and dissatisfaction.
Chapter 3 presents study 1, the systematic review which identified research concerning treatment satisfaction and dissatisfaction in patients with CLBP. Findings indicated a need to define the concept, and establish appropriate measurement based on patient input and evidence to support the reliability and validity of items.
Chapter 4 presents study 2, a qualitative study. Ten patients with CLBP taking medication and/or receiving physiotherapy were interviewed. A conceptual model of CLBP and a thematic map of treatment satisfaction and dissatisfaction were developed. Satisfaction was related to being 'happy' or 'pleased', and maintaining normal functioning. Treatment not working, causing discomfort, or negatively affecting health-related quality of life, as well as inconvenience of medication, lack of information, not feeling involved in treatment decisions, lack of trust and confidence in healthcare professionals, and being misdiagnosed or undiagnosed, were associated with dissatisfaction.
Chapter 5 documents the development of the CLBP Treatment Satisfaction Questionnaire, based on patient input from study 2. Cognitive debriefing showed items were relevant and understood by patients.
Chapter 6, study 3, explored the psychometric properties of the questionnaire. The longitudinal design involved data collection from 249 patients, some of whom participated in follow-ups. Results indicated that treatment satisfaction/dissatisfaction involves an appraisal of the following seven domains: 'Information Provided about Back Pain and Treatment', 'Burden of Back Pain', 'Impact of Back Pain and Treatment on Relationships', 'Satisfaction with the Treatment Process', 'Problems with Side Effects of Medication', 'Adherence to Physiotherapy', and 'Medication Acceptability'. Some evidence of reliability and validity are presented.
This thesis concludes with Chapter 7, a discussion of the main findings of the studies, strengths and limitations, and recommendations for future research.Funded by Mapi Value
Recommended from our members
Letter from Michael L. Galaty to Emmett L. Bennett Jr., August 14, 1999
No full textGalaty sends Bennett's draft back with notes.Classic
Conservative management of back pain: A literature update
No full textMost adults suffer from low back pain (LBP) at some time in their lifetime. The resulting medical costs and workrelated productivity losses make LBP one of the most expensive ailments to our society today.1 In the military, LBP is one of the largest detriments to Soldier health and mission readiness. Back disorders are among the most common causes of hospitalization, ambulatory medical visits, and restricted duty days in the U.S. Armed Forces.2 The high cost, along with the lack of consistency of medical treatment for LBP, has resulted in the creation and implementation of clinical practice guidelines (CPG) for the management and treatment of LBP around the world
Going Beyond Counting First Authors in Author Co-citation Analysis
No full textThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Low back pain and risk factors for low back pain in car drivers
No full textThe cause of low back pain in populations of professional drivers is uncertain. A literature review
revealed factors that seem to be associated with low back pain (e.g. physical factors: exposure to
whole body-vibration, prolonged sitting posture, frequent lifting, pushing and pulling, lack of physical
fitness; psychosocial factors: job satisfaction or stress; individual factors: age, gender,
anthropometrics, tobacco, alcohol consumption, etc.).
This thesis investigates the occurrence of back pain in professional car drivers – a group found to
be not focussed upon in previous epidemiological studies. The thesis seeks to advance
understanding of response relationships between risk factors and low back pain in populations of
car drivers (209 taxi drivers and 365 police drivers) and 485 non-drivers. A longitudinal study with
cross-sectional baseline combined with field measurement of driving in selected vehicles was
performed to investigate the occurrence of musculoskeletal problems (mainly low back pain) and
the relationship between risk factors and low back pain experienced for at least one day during the
past 12 months in the two populations of professional drivers (taxi drivers and police drivers) and
professional non-drivers.
The cross-sectional baseline of the longitudinal study revealed that 45% (38.3-51.7%) of taxi
drivers, 53% (48-58.6%)of police drivers and 46% (41-50.1%) of police non-drivers reported low
back pain for at least one day during the past 12-months (p = 0.09). The prevalence of low back
pain in the non-driving population of police employees fell within prevalence range reported by
professional car drivers in this study and in previous epidemiological studies. The cross-sectional
study revealed risk factors associated with the prevalence of low back pain (i.e., stature, previous
physical demands, increased psychosomatic distress, daily and cumulative driving in taxi drivers;
age, lifting, bending, increase psychosomatic distress in police drivers; stature, bending, increased
psychosomatic distress in police non-drivers).
Measurements of whole-body vibration in selected taxi and police vehicles revealed frequencyweighted
accelerations in the dominant vibration direction (i.e., z-axis) to be 0.47 ms-2 r.m.s. in taxi
vehicles and 0.58 ms-2 r.m.s. in police vehicles.
A study of cumulative exposure to whole-body vibration in a group of taxi drivers pointed to a
possible overestimation of their self-estimated duration of vibration exposure by 31% on average.
The longitudinal study revealed a lower incidence of low back pain in taxi drivers than in both
police drivers and police non-drivers (p = 0.02). The difference might be attributed to a different
approach to low back pain in taxi drivers who lose income if unable to work. An alternative
explanation for increased low back pain among police employees could be that taxi drivers with low
back pain leave their profession and were excluded from the follow-up study – a healthy worker
effect.
The longitudinal study revealed that increased psychosomatic distress was a risk factor
associated with the development of new episodes of low back pain in all three of the studied
populations (i.e. taxi drivers and police drivers and non-drivers).
In police drivers, increased daily duration of driving was a risk factor for the development of low
back pain. Although the results point to increased incidence of low back pain with increasing
duration of daily driving, non-drivers were at a similar risk of developing of low back pain. Plausible
explanations for this finding include ergonomic factors that were present for both the drivers and the
non-drivers (e.g., the duration of sitting or duration in a constrained posture) and the presence of
other risk factors not investigated in the study but associated with increased incidence of low back
pain in non-drivers
The effectiveness of the backroom conversion process on reducing back injuries related to manual material handling
No full textPlan BABC Company is a retailer operating retail stores throughout the United States. In any given week, a 100,000 square foot store will receive 2-3 trailers of freight 3-4 nights per week. Each trailer can hold 200-400 pieces of freight. The trailers are generally unloaded during the night, beginning at approximately 10:00 p.m. with a team of 8-10 unloaders and stockers. Some freight will be moved to the salesfloor in order to replenish store shelves while the remaining freight will be stored in the receiving area. Efficient freight flow from the receiving area and backroom to the salesfloor is essential in achieving sales goals and maintaining standards of productivity, associate moral, and associate safety. Consequently, the amount of freight being moved and the means by which it is handled has resulted in an increased occurrence of associate back injuries related to material handling. The most predominant injuries are sprains and strains resulting from material handling activities including lifting, pushing, pulling and reaching.
In 1999, in an effort to improve the efficiency of the flow of freight and to address the aforementioned issues, ABC Company undertook redesigning its backrooms and inventory management process referred to as the "backroom conversion". Sixty stores underwent the conversion during what was referred to as "Phase One" with an additional three hundred and sixteen stores scheduled for the conversion later in the year. The conversion process included changes in the arrangement of steel bins (shelving) in the backroom; the material handling equipment used in the movement of freight; the amount of palletized versus non-palletized freight; and associate training.
Research studies support the implementation of several key components in developing a comprehensive program aimed at preventing and reducing back injuries resulting from manual material handling activities. These components include ergonomic job design or redesign, training, strength and fitness testing, and the use of back belts. Through extensive research, it has been proven that ergonomic design of a work station is significantly far more effective than traditional methods such as selecting the worker to fit the job or training the worker on proper lifting techniques in reducing back injuries.
The study's methodology involved analyzing the workers' compensation claims, specifically, back injuries which occurred in the backroom or receiving area of the store as a result of manual material handling. Furthermore, the training process was also reviewed to determine what changes were made to it as a result of the backroom conversion.
The results revealed that the sixty stores that went through the initial rollout of the backroom conversion process experienced 67 associate injuries caused by material handling prior to the conversion compared to 48 after the conversion was completed, a reduction of 28%. Material handling injuries overall also decreased by 16%. A review of the training process showed that additional training was developed and implemented to provide associates with training on the proper use of the walkerstacker. All other components of training related to proper lifting and back injury prevention remained the same.
Several recommendations were made based on the results of the study. ABC Company should continue to work with suppliers in redesigning packaging to limit the weight of individual boxes or cartons and include handles to allow for easier handling by associates. The training program should also be expanded to include training aimed specifically at unloaders and stockers providing the basic ergonomic principles and specific work practices in the backroom which will reduce the potential for back injuries. Once the NIOSH back belt study is completed for ABC Company, the Company will need to re-evaluate its position on the continued use of back belts as part of their back injury prevention program. Recommendations for further study were also made, including the continued analysis of back injuries as it relates to an associate's length of employment as well as an analysis of injury data at points in time when inventory is at its highest and physical demands on associates is at its greatest
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
Square Dancing with the Stars to Enhance Dynamic Hirschman Linkages?
No full textIn this Presidential Address, the author takes the reader on a reconnaissance of his life and time as a regional scientist. He points out scenery he found scintillating along the way, hoping that some may pick up the banner and chew on a few of the ideas for a while. He suggests a revisit to Albert O. Hirschman’s notion of key sectors and more empirical analysis related to Marcus Berliant’s and Masahisa Fujita’s notion of knowledge creation and transfer.Presidential Address, San Antonio, Texas, March 29, 2014 (53rd Meetings of the Southern Regional Science Association
- …
