Barriers and facilitators experienced by osteopaths in implementing a biopsychosocial (BPS) framework of care when managing people with musculoskeletal pain – a mixed methods systematic review

Background Clinical practice guidelines commonly recommend adopting a biopsychosocial (BPS) framework by practitioners managing musculoskeletal pain. However, it remains unclear how osteopaths implement a BPS framework in the management of musculoskeletal pain. Hence, the objective of this review was to systematically appraise the literature on the current practices, barriers and facilitators experienced by osteopaths in implementing a BPS framework of care when managing people with musculoskeletal pain. Methods The following electronic databases from January 2005 to August 2020 were searched: PubMed, CINAHL, Science Direct, Google Scholar, ProQuest Central and SCOPUS. Two independent reviewers reviewed the articles retrieved from the databases to assess for eligibility. Any studies (quantitative, qualitative and mixed methods) that investigated the use or application of the BPS approach in osteopathic practice were included in the review. The critical appraisal skills program (CASP) checklist was used to appraise the qualitative studies and the Mixed Methods Appraisal Tool (MMAT) was used to appraise quantitative or mixed methods studies. Advanced convergent meta-integration was used to synthesise data from quantitative, qualitative and mixed methods studies. Results A total of 6 studies (two quantitative, three qualitative and one mixed methods) were included in the final review. While two key concepts (current practice and embracing a BPS approach) were generated using advanced meta-integration synthesis, two concepts (barriers and enablers) were informed from qualitative only data. Discussion Our review finding showed that current osteopathic practice occurs within in the biomedical model of care. Although, osteopaths are aware of the theoretical underpinnings of the BPS model and identified the need to embrace it, various barriers exist that may prevent osteopaths from implementing the BPS model in clinical practice. Ongoing education and/or workshops may be necessary to enable osteopaths to implement a BPS approach.

Title: Barriers and facilitators experienced by osteopaths in implementing a biopsychosocial (BPS) framework of care when managing people with musculoskeletal pain – A mixed methods systematic review

Background: Clinical practice guidelines commonly recommend adopting a biopsychosocial (BPS) framework by practitioners managing musculoskeletal (MSK) pain. However, it remains unclear how osteopaths implement a BPS framework in the management of MSK pain. Hence, the objective of this review was to systematically appraise the literature on the current practices, barriers and facilitators experienced by osteopaths in implementing a BPS framework of care when managing people with MSK pain.Methods: The following electronic databases from January 2005 to August 2020 were searched: PubMed, CINAHL, Science Direct, Google Scholar, ProQuest Central and SCOPUS. Two independent reviewers reviewed the articles retrieved from the databases to assess for eligibility. Any studies (quantitative, qualitative and mixed methods) that investigated the use or application of the BPS approach in osteopathic practice were included in the review. The critical appraisal skills program (CASP) checklist was used to appraise the qualitative studies and the Mixed Methods Appraisal Tool (MMAT) was used to appraise quantitative or mixed methods studies. Advanced convergent meta-integration was used to synthesise data from quantitative, qualitative and mixed methods studies.Results: a total of 6 articles (two quantitative, three qualitative and one mixed methods) were included in the final review. While two key concepts (current practice and embracing a BPS approach) were generated using advanced meta-integration synthesis, two concepts (barriers and enablers) were informed from qualitative only data.Discussion: Our review finding showed that current osteopathic practice occurs within in the biomedical model of care. Although, osteopaths are aware of the theoretical underpinnings of the BPS model and identified the need to embrace the BPS model, various barriers exist that stop osteopaths BPS model use in osteopathic clinical practice. Ongoing education and/or workshops may be necessary to enable osteopaths to implement a BPS approach.

Microplastic pollution: Sources, fate, impacts and research gaps

The occurrence of microplastics into the ecosystem has become and eminent threat for the environment as well as gets extensive attention in recent times. Microplastic existence has severely affected lakes, rivers, oceans, coastal zones, and even polar zones biome. Microplastics (primary microplastics) mostly come from used products and by shattering of larger fragments. Through runoff, the microplastic enters into either aquatic or terrestrial environment where it can cause the devastating impacts not only to that ecosystem but also to the humans. Several studies professed that microplastics have a significant impact on marine and terrestrial communities. Microplastic particles are widespread in India, Asia, Southeast Asia, North America, Africa, South Africa, and Europe. The microplastic source and global distribution in the ecosystem, their effects on marine organisms, particularly in the food chain are illustrated in this review. Finding the principal sources of microplastic into the environment and raising the awareness among communities can significantly reduce the extent of microplastics pollution in the environment. This review article is an effort to create understanding about the microplastics pollution, sources and effects on environment. All the possible environmental friendly remediation strategies like bioremediation are also discussed in this article.

Prevalent posttraumatic stress disorder among emergency department personnel: rapid systematic review

This research review synthesized the evidence on the prevalence of posttraumatic stress disorder among emergency department personnel in Canada and the USA. No previous such synthesis, specific to this crucial aspect of North American health care had previously been published. Broad keyword searches of interdisciplinary research databases, both peer-reviewed and grey, retrieved 10 surveys published between 1996 and 2019. Their outcomes were synthesized with sample-weighted, pooled analyses. The most significant review finding was that one of every five such emergency care personnel met posttraumatic stress disorder diagnostic criteria; 18.6% (95% confidence interval 16.9, 20.4). However, this synthesis of generally small, nonprobability surveys with high nonparticipation rates, could only suggest that the prevalence of posttraumatic stress disorder is perhaps nearly two-fold greater among emergency department nurses (25.8%) than physicians (15.6%). Additionally, it seems that gender (being a woman) may play an important role in the relatively greater risk of nurses. Better controlled, more powerful probability surveys that examine the profession by gender interaction, are needed to affirm (or refute) these synthetic findings. Qualitative inquiries that tap into the key informing experiences of diverse emergency department personnel are also needed to best plan and implement their preventive and therapeutic care.