350,888 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
The Economics of Back-Pressure Steam Turbines
No full textRecently, back-pressure steam turbines have become the focal point in many cogeneration applications. This is a result of the savings in operating costs associated with the generation of electrical or mechanical power coincident with the economical use of available thermal energy. The benefits and constraints of back-pressure systems, however, are not always readily apparent and may result in the misapplication of this technology. This paper, therefore, will examine new turbine installations and backpressure retrofits and will determine the most economical back-pressure turbine applications. A generalized methodology is highlighted, allowing the reader to readily evaluate and determine the economic justification of back-pressure turbines in many cogeneration applications. The impact on plant energy use and cost is calculated, and the effects of load variation and the value of high-efficiency turbines are discussed. The specific process plant case studies reviewed involve back-pressure turbines of 100 to 5000 hp for mechanical drives, for generator drives, and as pressure reducing station replacements
An Italian validation of the narcissistic admiration and rivalry questionnaire (NARQ): Further evidence for a two-dimensional model of grandiose narcissism
No full textThe present study aims to validate an Italian version of the Narcissistic Admiration and Rivalry Questionnaire (NARQ), which operationalizes the two-dimensional model of grandiose narcissism recently proposed by Back et al. (2013). The model differentiates between Admiration and Rivalry, two dimensions that entail the agentic and antagonistic aspects of narcissism, respectively. Three hundred individuals participated in the study (mean age = 31.20, SD = 11.6, 30% males). A confirmatory factor analysis supported the expected two-factor structure. Adequate levels of internal consistency were found for the overall NARQ scores, as well as for the Admiration and Rivalry scale scores. Although Admiration and Rivalry were positively correlated, they showed a distinctive pattern of correlations with the Narcissistic Personality Inventory, the Rosenberg self-esteem scale, and the Big Five Inventory. These results replicate Back et al.’s (2013) original findings and thus provide support for the validity and reliability of the Italian version of the NARQ
Come back to me, come on and come back to me [first line of chorus]
No full textstrophic with choruspiano and voiceads on inside front and on back cover for M. Witmark & Sons stock16612-3Johns Hopkins University, Levy Sheet Music Collection, Box
076, Item 161Words and Music By George M. Cohan.Unattributed photo of Cohan; Starmer [del.
Come back to me, come on and come back to me [first line of chorus]
No full textstrophic with choruspiano and voiceads on inside front and on back cover for M. Witmark & Sons stock16612-3Johns Hopkins University, Levy Sheet Music Collection, Box
076, Item 161Words and Music By George M. Cohan.Unattributed photo of Cohan; Starmer [del.
An assessment of equipment service employees of back injuries at company XYZ
No full textPlan BBack injuries have become a major component in worker compensation costs within industry today. Company XYZ has felt this impact and recognize that the equipment service employees (ESEs) are at high risk of back injuries. The purpose of this study was to identify and analyze contributing factors for the occurrence of back injuries in equipment service employees (ESEs) at Company XYZ. Past records have indicated that ESEs are at high risk of back injuries. Within one year, over 300 back injuries were reported. For this study, the anatomy of the back and intervention approaches were researched. Some of these approaches that can be implemented into the workplace are the use of back belts, a physical fitness program, engineering controls and different types of lifting techniques. To help identify and analyze the contributing factors, several data sources such as the loss tab analysis, worker compensation costs, and accident reports were evaluated as well as observing the daily tasks of the ESEs and customer service agents (CSAs). The results of the iii evaluation from the loss tab analysis and accident reports were that the activity of lifting caused the majority of back injuries. For one year, worker compensation costs reported over $200, 000 for back injuries for the ESEs. The observations of the ESEs and CSAs were evaluated to find out additional factors that affected back injuries. During the observations, several factors were recognized as contributing to back injuries during the unloading and loading of luggage from aircraft. Some of these indicators were poor use of lifting techniques and lifting luggage too heavy for one individual. Observations of the CSAs were made to analyze how ESEs were notified of the weight of the luggage. A “heavy bag” label was supposed to be placed on a piece of luggage that weighs between 45 to 100 pounds, however no accurate weight was placed on the tag or the luggage. Throughout this study, several factors were identified that contribute to the occurrence of back injuries for the ESEs
Conservative management of low back pain
No full textBack pain is prevalent worldwide, but back pain disability has reached epidemic proportions in many industrialised societies. Few patients have serious medical pathology or direct neurological involvement requiring surgery. Although the causes remain unclear, physical stress and its consequences on discs, facet joints and supporting soft tissues at work or leisure are important, sometimes aggravated by adverse psychosocial factors. Modern management emphasises the role of self-care, beginning in primary care with the first episode. Without root compression, bed rest should not exceed 48 hours. Emphasis is on encouraging a rapid return to physical fitness and other activities, including employment, acknowledging that returning to a normal life may require working through pain. Medication facilitates this. No one should remain in pain beyond six weeks without being referred to a specialist service for a physical and psychosocial assessment by appropriately trained professionals and with consultant support for investigation, pain management and rehabilitation when needed
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
Study protocol: Improving patient choice in treating low back pain (IMPACT - LBP): A randomised controlled trial of a decision support package for use in physical therapy
No full textCopyright @ 2011 Patel et al - This is an Open Access article distributed under the terms of the Creative Commons Attribution License http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Background: Low back pain is a common and costly condition. There are several treatment options for people suffering from back pain, but there are few data on how to improve patients' treatment choices. This study will test the effects of a decision support package (DSP), designed to help patients seeking care for back pain to make better, more informed choices about their treatment within a physiotherapy department. The package will be designed to assist both therapist and patient.
Methods/Design: Firstly, in collaboration with physiotherapists, patients and experts in the field of decision support and decision aids, we will develop the DSP. The work will include: a literature and evidence review; secondary analysis of existing qualitative data; exploration of patients' perspectives through focus groups and exploration of experts' perspectives using a nominal group technique and a Delphi study.
Secondly, we will carry out a pilot single centre randomised controlled trial within NHS Coventry Community Physiotherapy. We will randomise physiotherapists to receive either training for the DSP or not. We will randomly allocate patients seeking treatment for non specific low back pain to either a physiotherapist trained in decision support or to receive usual care. Our primary outcome measure will be patient satisfaction with treatment at three month follow-up. We will also estimate the cost-effectiveness of the intervention, and assess the value of conducting further research.
Discussion: Informed shared decision-making should be an important part of any clinical consultation, particularly when there are several treatments, which potentially have moderate effects. The results of this pilot will help us determine the benefits of improving the decision-making process in clinical practice on patient satisfaction.This work is funded from the National Institute for Health Research (NIHR), Research for Patient Benefit (RfPB) Programme (Ref: PB-PG-0808-17039)
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