LOW BACK PAIN IN RUNNING: FROM PREVALENCE TO DIFFERENTIAL DIAGNOSIS

General organization of the research project The main goal of this PhD research project is to investigate the relevance of LBP in running, the specific risk factor for onset LBP on runners, the differential diagnosis in runners with LBP and the real impact of these data on therapeutic strategies to adopt in physiotherapy. Different studies were conducted during the 3-year period of PhD training (2016-2019). The results, relative discussions and implications are reported in the following chapters of the present dissertation as follows: \u2022 Chapter I: A brief overview on running and etiology of Running-Related Injury; \u2022 Chapter II: Analysis of The Prevalence and The Incidence of Low Back Pain in running; \u2022 Chapter III: The knowledge, attitude and behaviour of Italian physiotherapists specialized in manual therapy towards Low Back Pain as Related Running Injuries; \u2022 Chapter IV: The prevalence, behaviours and risk factors of Low back pain about Italian runners; \u2022 Chapter V: The Differential Diagnosis in Physical Therapy Practice, through two review: - The use of Red Flags in screening patients in physiotherapy. Narrative Review; - The diagnostic value of Red Flags in Thoracolumbar pain: A Systematic Review; \u2022 Chapter VI: The study of Red Flags identification as an important step to Screening for Referral Process in runners with Low Back Pain through four Cases Reports; \u2022 Chapter VII: General Discussion and Implication in physical therapy, and future research

Prevalence of Chronic Kidney Disease and Awareness Levels Among Young Adults in Imo and Anambra States, Nigeria

Chronic kidney disease (CKD) presents a significant public health concern, particularly in developing countries such as Nigeria, where health care resources are limited and awareness remains low. This quantitative study evaluated the prevalence of CKD and awareness levels among young adults in Imo and Anambra States, Nigeria. The relationship between health care access, medication adherence, and CKD diagnosis was also examined. The health belief model and the social ecological model provided the framework for the study. A sample of 800 participants was recruited from in- and outpatient facilities in Imo State and Anambra State, and sociodemographic information, awareness levels, and medication adherence were assessed. The prevalence of CKD in the two states was 30.02%. Imo State had a significantly higher prevalence (42.7%) than Anambra State (23.2%). The study revealed that most young adults with early CKD diagnoses faced challenges in accessing health care, and poor medication adherence was widespread. Additionally, a significant lack of awareness regarding CKD was observed among participants. These findings emphasize the pressing need for improved CKD awareness and prevention strategies in Nigeria to address this growing public health issue. Understanding factors contributing to the high CKD prevalence and limited awareness is crucial for formulating effective interventions and reducing the economic and health burdens associated with this condition

Long term health consequences of chronic spinal cord injury

BACKGROUND: A spinal cord injury (SCI) often results from a traumatic fracture or dislocation of the vertebral structures causing the spinal cord or surrounding nerves to become bruised, crushed or severed. Spinal cord injuries can leave an individual with a range of deficits from nerve impingement to life-threatening complete paralysis. There are hundreds of thousands of Americans living every day with various forms paralysis. Although advancements in acute care and rehabilitative medicine have transpired, individuals with chronic SCIs combat a number of secondary health complications and frequently encounter premature death. LITERATURE REVIEW FINDINGS: The neurologic dysfunction that ensues causes a vast number of secondary health complications including skin breakdown, osteoporosis, diabetes mellitus, dyslipidemia, blood pressure dysfunction, cardiovascular disease and frequently premature death. This comprehensive literature review focuses on these secondary health consequences of chronic spinal cord injuries. Current evidence has presented healthcare providers with guidelines to identify and manage health consequences in the general population. There is a lack of acknowledgement to the SCI population within these guidelines, yet, this subset of patients is, on average, found to have higher rates of osteoporotic fractures, infections, diabetes, dyslipidemia, cardiovascular events and depression due to their sedentary lifestyles. PROPOSED METHODS: The proposed hypothesis of this study states that Primary Healthcare providers will appropriately identify risk factors for secondary illness and proactively manage long-term care for patients with spinal cord injuries after completing CME training. CME seminars will be available for primary healthcare providers to attend at national AAFP, AAPA and AANP conferences. CONCLUSIONS: A SCI can be one of the most life altering experiences as one’s physical, social and psychological welfare are challenged. Beyond these discernible obstacles, lies a life of adverse health consequences linked with significantly reduced lifespans. By educating Physicians, Physician Assistants and Nurse Practitioners about health consequences in the chronic SCI population the care will become centralized and patient-provider relationships will be strengthened. CLINICAL SIGNIFICANCE: In the current medical model, there is a lack of provider education regarding SCI health consequences and subsequently care becomes fragmented to many different subspecialty providers. Educating the primary healthcare providers creates awareness and supports the need for further research in the field of chronic SCI

New Hampshire state health improvement plan 2013-2020, charting a course to improve the health of New Hampshire

Report using data and statistics to look at key health needs in N.H. including tobacco, obesity, heart disease, cancer prevention, asthma, and infectious diseases

Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective

This Report has a number of inter-related general purposes. One is to explore the extent to which food, nutrition, physical activity, and body composition modify the risk of cancer, and to specify which factors are most important. To the extent that environmental factors such as food, nutrition, and physical activity influence the risk of cancer, it is a preventable disease. The Report specifies recommendations based on solid evidence which, when followed, will be expected to reduce the incidence of cancer

The History and Practice of College Health

This volume is the first definitive reference and textbook in the one-hundred-fifty year history of college health. Written for professionals and for those working in student services and higher education administration, it covers the history of college health, administrative matters including financing and accreditation, and clinical issues such as women’s health, HIV/AIDS, and mental health. The book also focuses on prevention, including immunization and tuberculin testing. The contributors are well respected in the field and are actively working in the specific areas on which they write. H. Spencer Turner, MD, is director of the University Health Service and clinical professor of preventative medicine and environmental health at the University of Kentucky. Janet L. Hurley, Ph.D., is the Associate Director and Administrator of the University of Kentucky\u27s Health Service.https://uknowledge.uky.edu/upk_history_of_science_technology_and_medicine/1003/thumbnail.jp

Benefit Design in Health Care Reform: Clinical Preventive Services

This Report examines the evidence on the effectiveness and cost-effectiveness of selected clinical preventive services, and whether and how this information might be used to design insurance benefits

Assessing the Temporal Dynamics of the Lower Urinary Tract Microbiota and the Effects of Lifestyle

Urinary tract infections (UTIs) are among the most common bacterial infections in humans, accounting for $3.5 billion in health care expenditures yearly in the United States alone. Yet, treatments for UTI have seen little innovation over the past decade. As demonstrated in other body sites, such as the vagina and gastrointestinal (GI) tract, acute and infectious diseases often have indirect microbial contributions which serve as intriguing new targets for therapies. The recent discovery of the existence of a resident community of bacteria (i.e., microbiota) in the bladders of both women and men, represents a novel avenue for targeting UTIs. However, before targeted approaches aimed at modulating the urinary microbiota can be thoroughly investigated, it is first necessary to understand the normal modulations of these bacteria in the context of the host. Temporal dynamics in the vaginal and GI microbiota have been well described, and often linked to lifestyle factors or behaviors. Rigorous, longitudinal studies are required to study these trends. To date, few studies have assessed the urinary microbiota in such a manner -- none were comprehensive, and all were in the context of lower urinary tract symptoms. This is primarily due to the impracticality of collecting repeated transurethral catheterized urine specimens for analysis. I sought an extensive and in-depth analysis of the temporal dynamics of the lower urinary tract (LUT) microbiota in individuals without confounding urinary symptoms or disorders. Moreover, I intend to determine if any observed changes have correlations to participant-reported lifestyle factors. Through these analyses, I will aim to achieve three things. First, these data will provide the first description of the normal dynamics of the LUT microbiota. Second, our study design will serve as a framework for future research on this topic. Finally, our findings will increase our understanding of the development, risk, and prevention of UTIs by identifying patterns and potential causes of fluctuations within the LUT microbiota. In this thesis, I performed a clinical survey study as well as traditional mechanistic investigations to describe and understand the relationship between urinary microbiota dynamics and lifestyle. In the primary clinical study, I used next-generation sequencing and bacterial culture, as previously described and validated, to identify and taxonomically characterize the bacteria present in mid-stream voided urine (MSU) and peri-urethral swab specimens obtained daily from healthy, pre-menopausal women, for three months. Measures of microbiota temporal stability as well as changes in microbiota composition and alpha-diversity were obtained. I assessed for relationships between these values and various participant-reported lifestyle factors. Ultimately, I found that reporting of menstruation and sexual activity had significant impact on the microbiota of the MSU specimens in particular. The microbiota variability was observed across participants, while specific trends were very individualized but were consistent over time. I then sought to determine if the lifestyle factors were directly responsible for the observed microbiota changes. I chose to investigate sexual intercourse in particular because of the literature-documented epidemiological association with UTI risk in women. I first investigated the biological mechanism of these changes by analyzing specimens from male and female sexual partners. I determined that urinary Streptococcus isolates, which appear in elevated abundance in the MSU specimens of the female following sexual intercourse, are genomically related to isolates from the male\u27s oral flora. These data suggest that direct movement of bacteria between sexual partners results in altered female LUT microbiota following sexual intercourse. I then asked what the clinical significance of these changes were by studying the in vitro phenotypes of isolates from the normal LUT flora (i.e., Lactobacillus) as well as isolates from MSU specimens following sexual intercourse (i.e., Streptococcus). In relation to UTI risk, I found that urinary Lactobacillus isolates were bacteriostatic against strains of uropathogenic Escherichia coli (UPEC) while urinary Streptococcus isolates were not. These findings may directly relate to sexual intercourse and UTI risk, in which the normal LUT flora are protective against UTI, while the flora following sexual intercourse are not. Altogether, these data show that the LUT microbiota are dynamic and directly respond to lifestyle. Large clinical studies should be performed to further investigate the clinical significance of these findings

Appalachian Health and Well-Being

Appalachians have been characterized as a population with numerous disparities in health and limited access to medical services and infrastructures, leading to inaccurate generalizations that inhibit their healthcare progress. Appalachians face significant challenges in obtaining effective care, and the public lacks information about both their healthcare needs and about the resources communities have developed to meet those needs. In Appalachian Health and Well-Being, editors Robert L. Ludke and Phillip J. Obermiller bring together leading researchers and practitioners to provide a much-needed compilation of data- and research-driven perspectives, broadening our understanding of strategies to decrease the health inequalities affecting both rural and urban Appalachians. The contributors propose specific recommendations for necessary research, suggest practical solutions for health policy, and present best practices models for effective health intervention. This in-depth analysis offers new insights for students, health practitioners, and policy makers, promoting a greater understanding of the factors affecting Appalachian health and effective responses to those needs. Robert L. Ludke is a professor of family and community medicine at the University of Cincinnati. He is also a member of the Board of the Urban Appalachian Council. Phillip J. Obermiller is a Senior Visiting Scholar in the School of Planning at the University of Cincinnati and a past president of the Appalachian Studies Association. This volume pulls together an enormous amount of information that has been scattered in obscure publications in diverse fields. It synthesizes that information, puts it in context, and makes it available to the anyone interested in general health issues. It should be in the library of every postsecondary education institution with an Appalachian constituency. -- Wayne Meyers, M.D. A well-written, insightful work that encompasses the breadth of this important topic. -- Baretta R. Casey, M.D., M.P.H. Ludke and Obermiller\u27s work goes far beyond the borders of Appalachia to document the relationship between health and economic status. It particularly emphasizes the long-term effects of poverty on health. Its usefulness is not limited to Appalachia but to all those who believe that the opportunity for good health should not be defined by income and wealth. -- William W. Philliber, author of Appalachian Migrants in Urban America An important and much-needed book. Mountaineers, both those inside the region as well as those beyond it, will receive better care from health-care providers and more humane treatment by policy makers if both read carefully the multidisciplinary perspectives contained in this timely volume. -- Chad Berry, author of Southern Migrants, Northern Exiles An excellent introduction to the persisting health challenges of Appalachia, where health disparities are one of the continuing markers of inequality. In this volume some of the region\u27s leading health researchers examine the economic, environmental, behavioral and systemic causes of those disparities. -- Ronald D Eller, Distinguished Professor of History, author of Uneven Ground: Appalachia since 1945 Brings together researchers who present data addressing health disparities affecting urban and rural Appalachians and offers possible solutions. -- Kentucky Enquirer Ludke and Obermiller summarize the state of Appalachian health. . . . An important addition to the body of work documenting the state of Appalachia. -- Kentucky Libraries A truly exemplary book. . . . Surveys nine areas of health in the region and concludes with policy recommendations. -- Apalachian Heritage An important addition to the body of work documenting the state of Appalachia. -- Kentucky Libraries This medical text, the first of its kind, focuses on health of the region’s inhabitants as well as those who have moved away. -- Library Journal While the idea of geographically-based health disparities is still evolving, this engaging resource has greatly expanded the concept in what is a remarkable volume of well-organized, well-written, evidence-based studies on health in Appalachia presented from a host of critical perspectives. This book should become required reading for policy makers, health care providers, community activists, and students everywhere. -- Elke Jones Zschaebitz, David C. Gordon, Family and Community Health Appalachian Health and Well-being develops an enriched analytical framework for health care and creates a new, comprehensive source of knowledge that will benefit multidirectional efforts to improve Appalachian health. Authors offer informed recommendations for assessing and preventing disease and promoting health. This compilation is a pioneering work that will inform and guide readers and serve as a model for future Appalachian health research. -- Journal of Appalachian Studieshttps://uknowledge.uky.edu/upk_medicine_and_health_sciences/1013/thumbnail.jp