The Efficacy and Effectiveness of Education for Preventing and Treating Non-Specific Low Back Pain in the Hispanic Cultural Setting: A Systematic Review

A systematic review was conducted to assess the efficacy and effectiveness of education programs to prevent and treat low back pain (LBP) in the Hispanic cultural setting. Electronic and manual searches identified 1148 unique references. Nine randomized clinical trials (RCTs) were included in this review. Methodological quality assessment and data extraction followed the recommendations from the Cochrane Back Pain Review Group. Education programs which were assessed focused on active management (3 studies), postural hygiene (7), exercise (4) and pain neurophysiology (1). Comparators were no intervention, usual care, exercise, other types of education, and different combinations of these procedures. Five RCTs had a low risk of bias. Results show that: (a) education programs in the school setting can transmit potentially useful knowledge for LBP prevention and (b) education programs for patients with LBP improve the outcomes of usual care, especially in terms of disability. Education on pain neurophysiology improves the results of education on exercise, and education on active management is more effective than “sham” education and education on postural hygiene. Future studies should assess the comparative or summatory effects of education on exercise, education on pain neurophysiology and education on active management, as well as explore their efficiency.

Therapeutic outcome of active management in male patients with detrusor underactivity based on clinical diagnosis and videourodynamic classification

Detrusor underactivity (DU) could be resulted from many different etiologies. Patients with DU might have reduced bladder sensation, low detrusor contractility, and large post-void residual volume. This study analyzed therapeutic outcome of active management for male DU patients, based on clinical and urodynamic characteristics. Male DU patients aged > 18 years old were retrospectively reviewed from the videourodynamic study (VUDS) records in recent 10 years. The patients’ demographics, VUDS results, treatment modalities, and treatment outcome were analyzed. The treatment outcomes were compared among patients with different DU subgroups, clinical diagnosis and treatment modalities. Patients with voiding efficiency of > 66.7% were considered having a successful treatment outcome. For comparison, 30 men with normal VUDS finding served as the control arm. Most of the DU patients had reduced bladder sensation. The reduced bladder sensation is closely associated with low detrusor contractility. After active treatment, a successful outcome was achieved in 68.4% of patients after bladder outlet surgery, 59.1% after urethral botulinum toxin A injection, and 57.6% after medical treatment, but only 18.2% after conservative treatment. A successful treatment outcome was achieved in patients with an intact detrusor contractility, either low (69.2%) or normal voiding pressure (81.8%), and in patients with a normal or increased bladder sensation (78.1%). However, patients with detrusor acontractile (41.3%) or absent bladder sensation (17.9%) had less favorable treatment outcome after any kind of urological management. This study revealed that active management can effectively improve voiding efficiency in patients with DU. The normal bladder sensation, presence of adequate detrusor contractility, and bladder outlet narrowing during VUDS provide effective treatment strategy for DU patients. Among all management, BOO surgery provides the best treatment outcome.

Applying Knowledge Graph to Analyze the Historical Landscape Based on CiteSpace

The theory of “urban historical landscape” is gradually emerging in cultural heritage protection and urban planning in recent years. It was first proposed and promoted by UNESCO. In this study, the identification and evaluation are taken as the prerequisite for the protection and management of historical landscape. This paper uses CiteSpace to analyze the map of knowledge data to collect and sort out the global research status of urban historical landscape. In addition, the clustering function of knowledge graph software VOSviewer is used to analyze the knowledge clustering in the research field of urban historical landscape, and the research process and interdisciplinary development of urban historical landscape are obtained, to make some guiding suggestions for the future study of urban historical landscape. The results show that the study of urban historical landscape has experienced three stages. The early stage is the introduction and tracing stage, the middle stage is the diversification and enrichment stage, and the recent stage is the practice and construction stage. At present, it has become a multidisciplinary and multiperspective international research. The in-depth study of urban historical landscape undoubtedly opens a door for the traditional thought of urban heritage protection. At the same time, it gradually turned to more active management of urban historical landscape and also promoted the intersection of city, architecture, landscape architecture, anthropology, sociology, economics, and other disciplines from the side, with far-reaching influence. Reviewing and looking forward to studying urban historical landscape is more conducive to sustainable construction of the future. CiteSpace, as an excellent bibliometrics software, can help researchers sort out and display past research tracks in a novel visual way, to conduct future research better.

Great egret (Ardea alba) habitat selection and foraging behavior in a temperate estuary: Comparing natural wetlands to areas with shellfish aquaculture

Movement by animals to obtain resources and avoid predation often depends on natural cycles, and human alteration of the landscape may disrupt or enhance the utility of different habitats or resources to animals through the phases of these cycles. We studied habitat selection by GPS/accelerometer-tagged great egrets (Ardea alba) foraging in areas with shellfish aquaculture infrastructure and adjacent natural wetlands, while accounting for tide-based changes in water depth. We used integrated step selection analysis to test the prediction that egrets would express stronger selection for natural wetlands (eelgrass, tidal marsh, and other tidal wetlands) than for shellfish aquaculture areas. We also evaluated differences in foraging behavior among shellfish aquaculture areas and natural wetlands by comparing speed travelled (estimated from distance between GPS locations) and energy expended (Overall Dynamic Body Acceleration) while foraging. We found evidence for stronger overall habitat selection for eelgrass than for shellfish aquaculture areas, with results conditional on water depth: egrets used shellfish aquaculture areas, but only within a much narrower range of water depths than they used eelgrass and other natural wetlands. We found only slight differences in our metrics of foraging behavior among shellfish aquaculture areas and natural wetlands. Our results suggest that although great egrets appear to perceive or experience shellfish aquaculture areas as suitable foraging habitat during some conditions, those areas provide less foraging opportunity throughout tidal cycles than natural wetlands. Thus, expanding the footprint of shellfish aquaculture into additional intertidal areas may reduce foraging opportunities for great egrets across the range of tidal cycles. Over longer time scales, the ways in which natural wetlands and shellfish aquaculture areas adapt to rising sea levels (either through passive processes or active management) may change the ratios of these wetland types and consequently change the overall value of Tomales Bay to foraging great egrets.

Active Management of Third Stage of Labor: Practice and Associated Factors among Obstetric Care Providers in North Wollo, Amhara Region, Ethiopia

Background. World Health Organization strongly recommends that every obstetrical provider at birth needs to have knowledge and skills on active management of the third stage of labor and use it routinely for all women. However, implementation of this lifesaver intervention by skilled birth attendants is questionable because 3% to 16.5% of women still experience postpartum hemorrhage. Even though coverage of giving births at health facilities in Ethiopia increases, postpartum hemorrhage accounts for 12.2% of all maternal deaths occurring in the country. Lack of the necessary skills of birth attendants is a major contributor to these adverse birth outcomes. Objectives. This study aimed to assess the active management of the third stage of labor practice and associated factors among obstetric care providers. Methods. An institution-based cross-sectional study design was applied from March 15 to April 15, 2020. Multistage sampling techniques were used to get 254 participants, and data were collected using self-administered structured questionnaires and an observation checklist. Data were entered into EpiData version 3.1 and exported to Statistical Package for the Social Sciences (SPSS) version 23.0 for analyses. The multivariable logistic regression model was used at 95% confidence interval with P value <0.05. Among the 232 providers participating in the study, only 75 (32.3%) of respondents had a good practice. The practice of the provider was significantly associated with work experience (adjusted odd ratio 0.206 (95% confidence interval, 0.06–0.63)), knowledge (adjusted odd ratio (2.98 (95% confidence interval, 1.45–6.14)), the presence of assistance (adjusted odd ratio 2.04 (95% confidence interval, 1.06–3.93)), and time of uterotonic drug preparation (adjusted odd ratio 4.69 (95% confidence interval, 2.31–9.53)). Conclusion. Only one-third of obstetric care providers had good practice during active management of third stage of labor. Practice was significantly associated with work experience, knowledge, the presence of assistance during third-stage management, and time of uterotonic drug preparation. Consistent and sustainable on job training and clinical audit should be applied in all facilities with regular supportive supervision and monitoring. Furthermore, team work and adequate preparation should be done to facilitate the management of active third stage of labor.

Good, Bad, and Ugly Leadership Patterns: Implications for Followers’ Work-Related and Context-Free Outcomes

This research responds to calls for a more integrative approach to leadership theory by identifying subpopulations of followers who share a common set of perceptions with respect to their leader's behaviors. Six commonly researched styles were investigated: abusive supervision, transformational leadership (TFL), contingent reward (CR), passive and active management-by-exception (MBE-P and MBE-A, respectively), and laissez faire/avoidant (LF/A). Study hypotheses were tested with data from four independent samples of working adults, three from followers ( N = 855) and a validation sample of leaders ( N = 505). Using latent profile analysis, three pattern cohorts emerged across all four samples. One subpopulation of followers exhibited a constructive pattern with higher scores on TFL and CR relative to other styles. Two cohorts exhibited destructive patterns, one where the passive styles of MBE-A, MBE- P and LF/A were high relative to the other styles (passive) and one where the passive styles co-occurred with abusive supervision (passive-abusive). Drawing on conservation of resources theory, we confirmed differential associations with work-related (i.e., burnout, vigor, perceived organizational support and affective organizational commitment) and context-free (i.e., physical health and psychological well-being) outcomes. The passive-abusive pattern was devastating for physical health, yet passiveness without abuse was damaging for psychological well-being. Interestingly, we find a clear demarcation between passiveness as “benign neglect” and passiveness as an intentional and deliberate form of leadership aimed at disrupting or undermining followers—hence, the two faces of passiveness: “bad” and “ugly.” We discuss the novel insights offered by a pattern (person)-oriented analytical strategy and the broader theoretical and practical implications for leadership research.

Winners and Losers: How Woody Encroachment Is Changing the Small Mammal Community Structure in a Neotropical Savanna

Years of fire suppression, decreases in herbivores, and global climate change have led to shifts in savannas worldwide. Natural open vegetation such as grasslands and shrublands is increasing in wood density, but the effects for small mammals are not well understood. While most of the mammal studies from the Brazilian Cerrado are concentrated in the core area of this large Neotropical savanna, its southern portions are suffering from biome shifting through woody encroachment. Herein, we surveyed a small mammal community from the southeastern boundary of Cerrado (Santa Bárbara Ecological Station) and evaluated the micro and macro environmental variables shaping community structure in order to investigate how the woody encroachment in the last 15 years may have influenced this assemblage. We recorded 17 species of marsupials and rodents along five distinct habitats in a gradient from grasslands to woodlands. Although richness was not affected by microhabitat variables, total and relative abundance varied according to habitat type and in relation to herbaceous, shrub, and tree density. Rodents such as Calomys tener and Clyomys laticeps were positively affected by increasing herb cover, Cerradomys scotti and Oligoryzomys nigripes by shrub cover, while the marsupial Didelphis albiventris had higher association with increasing tree cover. We detected an increase of 27.4% in vegetation density (EVI) between 2003 and 2018 in our study site, and this woody encroachment negatively affected the abundance of some small mammals. The open-area specialists Cryptonanus chacoensis and C. scotti had a decrease in abundance, while D. albiventris and O. nigripes were favored by woody encroachment. Our data suggest that woody encroachment is shifting community composition: small mammals often associated with grasslands and open savannas are likely to be negatively affected by woody encroachment; while species that rely on tree-covered habitats are likely to benefit from an increasing woody landscape. Therefore, forest-dwellers are gradually replacing open-vegetation inhabitants. Active management of open formations (e.g., with prescribed burning) may be needed to maintain Cerrado biodiversity, especially considering the open-area endemics.

Growth of Managed Older Douglas-fir Stands: Implications of the Black Rock Thinning Trial in the Coast Range of Western Oregon

The most recent remeasurement of growth (at approximate total stand age 100 years) from the Black Rock Thinning Trial in western Oregon provides useful information for forest owners interested in accelerating restoration of older forest characteristics in Douglas-fir stands of the Pacific Northwest. Thinnings at several intensities at total stand age of roughly 50 years effectively reset stand growth patterns. With quadratic mean diameters in thinned plots up to 40% higher than those of unthinned controls, thinned plot mean annual increments (MAIs) and periodic annual increments continue to rise 55 years after thinning, with the peak in board foot and cubic foot MAI apparently still decades in the future. Assuming repeatable future thinning responses similar to the Black Rock Trial, financial analysis of the opportunity costs of extending rotations to 100 years indicates that some thinning treatments can reduce opportunity costs by up to half at a 6% discount rate. Study Implications Active management through thinning may be a useful tool for public and private landowners interested in rapid development of stands with older forest characteristics to enhance output of some ecosystem services. Heavy thinning regimes, of the type described here, are compatible with growing trees with large diameter stems, large branches, and large crowns. They also reduce fuel accumulation by lowering mortality rates of stems less than 60 years old and slowing the rate of crown recession, branch mortality, and branch litterfall. Midrotation thinning revenues reduce opportunity costs of holding more rapidly growing stems to older ages, which may be a consideration for some owners.