COMMONLY UTILIZED PHYSIOTHERAPY TREATMENT APPROACHES IN THE MANAGEMENT OF SUB-ACUTE SCIATICA: A DELPHI STUDY

2018 ◽  
Vol 21 (03n04) ◽  
pp. 1850014
Author(s):  
A. Emms ◽  
S. Papadopoullos ◽  
R. Duarte
Keyword(s):  
Delphi Method ◽  
Delphi Study ◽  
Response Rate ◽  
Outpatient Setting ◽  
Treatment Approaches ◽  
The United Kingdom ◽  
Self Help ◽  
History Of ◽  
The Mean ◽  
Acute Sciatica

There is limited evidence for the utilization of physiotherapy in the management of sub-acute sciatica. The aim of this study is to reach consensus on physiotherapeutic approaches to the management of sub-acute sciatica amongst a panel of clinicians experienced in this field. The Delphi method was chosen as the process. The panel comprised expert physiotherapists ([Formula: see text]) working within a musculoskeletal outpatient setting within the United Kingdom National Health Service. Iteration 1 consisted of the open-ended question ‘List the treatment approaches/techniques/modalities you employ when treating a patient with sub-acute sciatica and provide justifications’. Themes reaching 70% consensus progressed to the second iteration which followed up with the question “Please indicate how frequently you would employ the following treatments in the management of sub-acute sciatica” using a 5-point likert scale ranging from 1 (never) to 5 (always). The mean score was calculated for each treatment and those themes achieving a mean of 3.5 or greater progressed to iteration 3 “Please rank in order of preference which of the following treatments you would employ in the treatment of sub-acute sciatica”. The response rate at iteration 3 was 100%. This study achieved consensus on two treatment approaches to be employed in the management of sub-acute sciatica. These treatments were advice on the nature and natural history of the condition and self-help activities such as heat/ice, staying active and rest when needed.

COMMONLY UTILIZED PHYSIOTHERAPY TREATMENT APPROACHES IN THE MANAGEMENT OF SUB-ACUTE SCIATICA: A PILOT STUDY USING THE DELPHI PROCESS

2014 ◽  
Vol 17 (04) ◽  
pp. 1450017
Author(s):  
Andrew Emms ◽  
Lucie Gosling ◽  
Sam Papadopoullos ◽  
Rui Duarte
Keyword(s):  
Pilot Study ◽  
Delphi Method ◽  
Response Rate ◽  
Preliminary Evidence ◽  
Outpatient Setting ◽  
Treatment Approaches ◽  
Staying At Work ◽  
The Mean ◽  
Limiting Condition ◽  
Acute Sciatica

There is limited evidence for the utilization of physiotherapy in the management of sub-acute sciatica. The aim of this pilot study was to explore the Delphi method to attempt to reach consensus on physiotherapeutic approaches to the management of sub-acute sciatica amongst a panel of clinicians experienced in this field. The panel included senior physiotherapists (n = 10) working within an outpatient setting at a specialized orthopedic trust. Iteration 1 consisted of the open-ended question "List the treatment approaches/techniques/modalities you employ when treating a patient with sub-acute sciatica and provide justifications". Themes reaching 70% consensus progressed to the second iteration which followed up with the question "Please indicate how frequently you would employ the following treatments in the management of sub-acute sciatica" using a 5-point likert scale ranging from 1 (never) to 5 (always). The mean score was calculated for each treatment and those themes achieving a mean of 3.5 or greater progressed to iteration 3 "Please rank in order of preference which of the following treatments you would employ in the treatment of sub-acute sciatica". The response rate at iteration 3 was 60%. This pilot study achieved consensus on five treatment approaches to be employed in the management of sub-acute sciatica. In order of preference these treatments were advice (regarding staying active, staying at work, reassurance, analgesia), advice (time scale of recovery, natural course of sciatica, self-limiting condition, hurt does not equal harm), lumbar joint mobilizations (rotations, PA's, ilial mobs [distractions], transverse glides), direction specific stretches and nerve mobilizations. This pilot study provides preliminary evidence of commonly used treatment approaches for sub acute sciatica amongst physiotherapists.

Group Experiences and Individual Differences in Stuttering

2019 ◽  
Vol 62 (12) ◽  
pp. 4335-4350 ◽  
Author(s):  
Seth E. Tichenor ◽  
J. Scott Yaruss
Keyword(s):  
Individual Differences ◽  
Support Groups ◽  
Support Group ◽  
Affective States ◽  
Life Outcomes ◽  
Self Help ◽  
Wide Range ◽  
Group Experiences ◽  
History Of ◽  
Adults Who Stutter

Purpose This study explored group experiences and individual differences in the behaviors, thoughts, and feelings perceived by adults who stutter. Respondents' goals when speaking and prior participation in self-help/support groups were used to predict individual differences in reported behaviors, thoughts, and feelings. Method In this study, 502 adults who stutter completed a survey examining their behaviors, thoughts, and feelings in and around moments of stuttering. Data were analyzed to determine distributions of group and individual experiences. Results Speakers reported experiencing a wide range of both overt behaviors (e.g., repetitions) and covert behaviors (e.g., remaining silent, choosing not to speak). Having the goal of not stuttering when speaking was significantly associated with more covert behaviors and more negative cognitive and affective states, whereas a history of self-help/support group participation was significantly associated with a decreased probability of these behaviors and states. Conclusion Data from this survey suggest that participating in self-help/support groups and having a goal of communicating freely (as opposed to trying not to stutter) are associated with less negative life outcomes due to stuttering. Results further indicate that the behaviors, thoughts, and experiences most commonly reported by speakers may not be those that are most readily observed by listeners.

Revisiting the Natural History of Chronic Scaphoid Nonunions: A Retrospective Study of 20 Cases

2021 ◽  
Author(s):  
J. Terrence Jose Jerome
Keyword(s):  
Retrospective Study ◽  
Natural History ◽  
Functional Outcome ◽  
Grip Strength ◽  
Scaphoid Nonunion ◽  
Proximal Pole ◽  
Degenerative Arthritis ◽  
Level Of Evidence ◽  
History Of ◽  
The Mean

Abstract Background The natural history of scaphoid nonunion is the development of degenerative arthritis. A lot of information is still unclear about this progression. The purpose of this study is to analyze patients with scaphoid nonunions who had not received any kind of treatment and to assess the functional outcome. Materials and Methods This is a retrospective study that analyzed the patients with chronic scaphoid nonunions between 2009 and 2019. None of the patients received any treatment. The age at the time of injury, examination, pattern of fracture, types of scaphoid nonunion, symptoms, and duration of nonunion were noted. Diagnosis was confirmed by radiographs, computed tomography (CT) scan, and magnetic resonance imaging (MRI). Scapholunate and radiolunate angles were recorded. Pain score, modified mayo wrist score, grip strength, range of movement, and the functional outcome of these scaphoid nonunions were analyzed. A statistical correlation between the scaphoid nonunion presentations and the functional outcome was assessed. Results The mean age of the patients was 62 years (range: 35–82 years.). There were 17 male and 3 female patients. There were 9 waist and 11 proximal pole scaphoid nonunions. The mean duration of scaphoid nonunion was 34 years (range: 10–62 years). None of the patients had avascular necrosis (AVN) of the proximal scaphoid. The age at examination, gender, side of injury, fracture pattern (waist/proximal pole), fracture displacement ≤ 1 mm or > 1 mm, nonunion duration, and radiographic arthritic parameters had no significant impact on the functional outcome. Conclusions Untreated chronic scaphoid nonunion leads to the development of degenerative arthritis over a period of years, which is still unpredictable. Most of the patients become aware of the nonunion following a precedent injury or other reasons. Most of the patients have fair/good functional outcome despite reduced range of movements and grip strength. Many do not favor surgical intervention in the course of nonunion. Chronic nonunions open a lot of unanswered questions. Clinical relevance There have been numerous studies on the treatment aspects of scaphoid nonunion, with little knowledge about certain people with nonunion who did not have any kind of treatment. The demographics, clinical findings, and radiological parameters do confirm the progression of these nonunion to arthritis, but most of them had fair-to-good outcome throughout their life. It opens our thinking about the real need of treatment in such nonunions and raises numerous questions about the disease. Level of evidence This is a Level IV study.

History of political and civil rights of women in the United Kingdom

2019 ◽  
Vol 2019 (11) ◽  
pp. 135-139
Author(s):  
Maria Zhukova ◽  
Elena Maystrovich ◽  
Elena Muratova ◽  
Aleksey Fedyakin
Keyword(s):  
United Kingdom ◽  
Civil Rights ◽  
The United Kingdom ◽  
History Of

Charles de Gaulle and European Community

2020 ◽  
Vol 2020 (10-3) ◽  
pp. 70-81
Author(s):  
David Ramiro Troitino ◽  
Tanel Kerikmae ◽  
Olga Shumilo
Keyword(s):  
World War Ii ◽  
European Community ◽  
World War ◽  
Charles De Gaulle ◽  
The United Kingdom ◽  
History Of ◽  
The Common ◽  
Post War ◽  
De Gaulle

This article highlights the role of Charles de Gaulle in the history of united post-war Europe, his approaches to the internal and foreign French policies, also vetoing the membership of the United Kingdom in the European Community. The authors describe the emergence of De Gaulle as a politician, his uneasy relationship with Roosevelt and Churchill during World War II, also the roots of developing a “nationalistic” approach to regional policy after the end of the war. The article also considers the emergence of the Common Agricultural Policy (hereinafter - CAP), one of Charles de Gaulle’s biggest achievements in foreign policy, and the reasons for the Fouchet Plan defeat.

Volunteering in hospice and palliative care in the United Kingdom

2018 ◽  
Author(s):  
Ros Scott
Keyword(s):  
Palliative Care ◽  
United Kingdom ◽  
Care Services ◽  
The United Kingdom ◽  
Strategic Direction ◽  
Palliative Care Services ◽  
History Of ◽  
The Uk ◽  
Hospice And Palliative Care ◽  
Changing Role

This chapter explores the history of volunteers in the founding and development of United Kingdom (UK) hospice services. It considers the changing role and influences of volunteering on services at different stages of development. Evidence suggests that voluntary sector hospice and palliative care services are dependent on volunteers for the range and quality of services delivered. Within such services, volunteer trustees carry significant responsibility for the strategic direction of the organiszation. Others are engaged in diverse roles ranging from the direct support of patient and families to public education and fundraising. The scope of these different roles is explored before considering the range of management models and approaches to training. This chapter also considers the direct and indirect impact on volunteering of changing palliative care, societal, political, and legislative contexts. It concludes by exploring how and why the sector is changing in the UK and considering the growing autonomy of volunteers within the sector.

Disability and Work in South Asia and the United Kingdom

2018 ◽  
Author(s):  
Jane Buckingham
Keyword(s):  
Low Socioeconomic Status ◽  
Industrial Revolution ◽  
Economic Status ◽  
Low Socioeconomic ◽  
Disability History ◽  
The United Kingdom ◽  
Indian Experience ◽  
The Social ◽  
History Of ◽  
Western View

Historical analyses, as well as more contemporary examples of disability and work, show that the experience of disability is always culturally and historically mediated, but that class—in the sense of economic status—plays a major role in the way impairment is experienced as disabling. Although there is little published on disability history in India, the history of the Indian experience of caste disability demonstrates the centrality of work in the social and economic expression of stigma and marginalization. An Indian perspective supports the challenge to the dominant Western view that modern concepts of disability have their origins in the Industrial Revolution. Linkage between disability, incapacity to work, and low socioeconomic status are evident in India, which did not undergo the workplace changes associated with industrialization in the West.

Elevation of pulse pressure in middle age is associated with the risk of dementia: data from a population-based cohort

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
D Kim ◽  
H Jung ◽  
P.S Yang ◽  
H.T Yu ◽  
T.H Kim ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Pulse Pressure ◽  
Middle Age ◽  
Population Based ◽  
Entire Cohort ◽  
Incident Dementia ◽  
Increased Risk ◽  
Diagnosis Of Dementia ◽  
History Of ◽  
The Mean

Abstract Aims Pulse pressure (PP) is a well-known risk factor for cardiovascular disease. However, the association between the PP and dementia is not well identified. This study aimed to determine the effect of PP on the risk of dementia development in different age subgroups using a longitudinal, population-based, and stroke-free cohort from the general population. Methods The association of PP with the development of incident dementia was assessed from January 1, 2005, to December 31, 2013, in 433,154 participants without a history of dementia or stroke from the Korea National Health Insurance Service-Health Screening cohort. The diagnosis of dementia was defined using the 10th revision of the International Classification of Disease codes. Results The mean age of the cohort was 55.7±9.2 years, 45.7% were women. Hypertension was 23.6%. The mean systolic and diastolic blood pressure of the entire cohort were 125.9±16.6 and 78.4±10.7 mmHg, respectively. Mean PP was 47.5±10.9 mmHg. In the middle-age group (40 to 50 year-old), increasing of 10 mmHg of PP was associated with incident dementia after adjusting mean blood pressure and clinical variables with a hazard ratio (HR) of 1.21 (95% confidence interval [CI]: 1.19–1.23, p<0.001). The association was still significant even after censoring for stroke (HR: 1.16, 95% CI: 1.08–1.22, p<0.001). In the older population, elevation of PP was not associated with dementia development (HR: 0.98, 95% CI: 0.95–1.01, p=0.247) Conclusion PP was associated with increased risk of dementia only in middle-aged population beyond that of mean arterial pressure. Funding Acknowledgement Type of funding source: None

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