STarT Back Screening Tool als Prädiktor von chronischen Schmerzen in der Physiotherapie

Darstellung des Themas: Das „STarT Back Screening Tool“ (SBST) wurde ursprünglich für die Hausarztmedizin entwickelt. Es ist ein einfacher prognostischer Fragebogen, der Fachpersonen hilft, modifizierbare biomedizinische, psychologische und soziale Risikofaktoren für Kreuzschmerzen zu identifizieren und teilt die Patienten und Patientinnen in Low-, Medium- oder High-Risikokategorien ein. Die Nutzung des SBST in der Physiotherapie wurde bis anhin noch wenig untersucht. Ziel: Das Ziel dieser Arbeit ist, zu ermitteln, ob sich das „StarT Back Screening Tool“ als Prädiktor von chronischen Schmerzen in der Physiotherapie eignet. Ein weiteres Ziel ist es, die Validität und Reliabilität des „StarT Back Screening Tool“ in der Physiotherapie zu beschreiben. Methode: In Form eines systematischen Reviews werden vier Studien anhand definierter Ein- und Ausschlusskriterien aus den Datenbanken Medline, Pubmed und CINHAL ausgewählt. Die integrierten Studien werden mittels AICA bewertet. Relevante Ergebnisse: Das SBST ist ein geeignetes Instrument zur Einteilung von LBP Patienten und Patientinnen in verschieden Risikogruppen in der Physiotherapie. Jedoch sollte das SBST nicht als Prädiktor von chronischen Schmerzen angewendet werden. Im Verlauf der physiotherapeutischen Behandlung wechseln die Probanden oft früh die Risikokategorie.Introduction: The „Start back Screening Tools“ (SBST) was originally designed for use in primary care. It is a simple, brief and practical tool that helps qualified personnel to subgroup patients with nonspecific lower back pain. This process of subgrouping is achieved by identifying modifiable biometric, psychological and social risk factors for back pain. Patients are classified in low, medium- or high-risk categories. So far, the use of SBST in physiotherapy has not been researched. Aim: The purpose of this Thesis is to verify if the SBST is appropriate to predict chronic pain in physiotherapeutic settings. Furthermore, it aims to describe the validity and reliability of the SBST in physiotherapy. Method: Four studies were elected based on a systemic review regarding defined inandexcluding criteria. They were acquired from the databases Medline, Pubmed and CINHAL. The selected studies were rated by AICA. Relevant Results: The SBST is an appropriate tool to subgroup patients with low back pain in physiotherapeutic settings. However, it should not be used to predict chronic pain. Comparing the results of the first evaluation with following ones, different results were noticed early on in the subsequent sessions (during the physiotherapeutic treatment)

"Basal conditions of Kongsvegen at the onset of surge - revealed using seismic vibroseis surveys" in the IASC Workshop on the dynamics and mass budget of Arctic glaciers - Abstracts and program booklet.

Kongsvegen is a well-studied surge-type glacier in the Kongsfjord area of northwest Svalbard. Long-term monitoring has shown that the ice surface velocity has been increasing for the past 4 years; presenting a unique opportunity to study the internal ice structure, basal conditions and thermal regime that play a crucial role in initiating glacier surges. In April 2019, three-component seismic vibroseis surveys were conducted at two sites on the glacier, using a small Electrodynamic Vibrator source (ElViS). Site 1 is in the ablation area and site 2 near the equilibrium line, where the greatest increase in ice surface velocity has been observed. Initial analysis indicates the conditions at the two sites are significantly different. At site 1 the ice is around 220 m thick, sitting on a relatively flat and uniform bed, with no clear change in the bed reflection along the profile. There is a horizontally layered sediment package ∼60 m thick underlaying the bed. The ice column shows no internal layering. By contrast at site 2 (Fig. 1), where the ice is around 390 m thick, there is much more complex internal ice structure. Clear internal ice reflections are visible between 150-250 m depth – where we expect a transition from cold to temperate ice. Further reflections in the 100 m above the bed indicate there could be shearing or sediment entrainment in this area. Below the bed, cross-cutting layers are clearly visible and the bed reflection itself shows changing reflection polarity – suggesting water or very wet sediment is present in some areas. This suggests ice movement by basal sliding and shearing is likely

Assessment of Chronic Illness Care with the German version of the ACIC in different primary care settings in Switzerland

BACKGROUND: In Switzerland the extent to which patients with chronic illnesses receive care congruent with the Chronic Care Model (CCM) is unknown. METHODS: According to guidelines we translated the Assessment of Chronic Illness Care (ACIC) into German (G-ACIC). We tested the instrument in different primary care settings and compared subscales with the original testing. RESULTS: Difficulties encountered during the translation process consisted in the difference of health care settings in Switzerland and USA. However initial testing showed the G-ACIC to be a suitable instrument. The average ACIC subscale scores in Swiss managed care (MC)-, group (GP)- and single handed practices (SP) were higher for MC practices than for group- and single handed practices: Organization of the healthcare delivery system: MC mean (m) = 6.80 (SD 1.55), GP m = 5.42 (SD 0.99), SP m = 4.60 (SD 2.07); community linkages: MC m = 4.19 (SD 1.47), GP m = 4.83 (SD 1.81), SP m = 3.10 (SD 2.12); self-management support: MC m = 4.96 (SD 1.13), GP m = 4.73 (SD 1.40), SP m = 4.43 (SD 1.34); decision support: MC m = 4.75 (SD 1.06); GP m = 4.20 (SD 0.87), SP m = 3.25 (SD 1.59); delivery system design: MC m = 5.98 (SD 1.61), GP m = 5.05 (SD 2.05), SP m = 3.86 (SD 1.51) and clinical information systems: MC m = 4.34 (SD = 2.49), GP m = 2.06 (SD 1.35), SP m = 3.20 (SD 1.57). CONCLUSIONS: The G-ACIC is applicable and useful for comparing different health care settings in German speaking countries. Managed care organizations seem to implement the different components of the CCM in a greater extend than group and single handed practices. However, much room exists for further improvement

Basal settings control fast ice flow in the Recovery/Slessor/Bailey Region, East Antarctica

The region of Recovery Glacier, Slessor Glacier and Bailey Ice Stream, East Antarctica, has remained poorly explored, despite representing the largest potential contributor to future global sea level rise on a centennial to millennial timescale. Here, we use new airborne radar data to improve knowledge about the bed topography and investigate controls of fast ice flow. Recovery Glacier is underlain by an 800 km-long trough. Its fast flow is controlled by subglacial water in its upstream and topography in its downstream region. Fast flow of Slessor Glacier is controlled by the presence of subglacial water on a rough crystalline bed. Past ice flow of adjacent Recovery and Slessor Glaciers was likely connected via the newly-discovered Recovery-Slessor Gate. Changes in direction and speed of past fast flow likely occurred for upstream parts of Recovery Glacier, and between Slessor Glacier and Bailey Ice Stream. Similar changes could also reoccur here in future

Patchy lakes and topographic origin for fast flow in the Recovery Glacier system, East Antarctica

The Recovery subglacial basin, with its largest glacier Recovery Glacier, has been identified as potentially the biggest contributor to future sea level rise from East Antarctica. Subglacial lakes along the main trunk have been detected from satellite data, with four giant lakes (Recovery Lakes A, B, C and D) located at the onset of the fast ice flow (≥15 m/yr) and multiple smaller lakes along the glacier. The presence of subglacial water potentially plays a key role in the control of fast ice flow of Recovery Glacier. We present new insights on the Recovery Lakes from airborne radar data collected in 2013 and 2015. Using an adjusted classification scheme we show that a single large area consisting of smaller lakes connected by likely saturated sediment, referred to as Lake AB, exists in the originally proposed area of the Recovery Lakes A and B. We estimate that the current size of Lake AB is ∼4320 km2. Water likely leaks from the western shore of Lake AB lubricating the bed initiating fast ice flow at this location. The difference in the outlines of Lake AB and the Lakes A and B previously derived from surface features suggested that a larger paleo lake existed here in the past. From our data, we find Recovery Lake C to be dry; we attribute fast ice flow originating from this area to be due to a topographic step, and thus an increase in ice thickness rather than enhanced lubrication at the bed

Connexin-43 in the osteogenic BM niche regulates its cellular composition and the bidirectional traffic of hematopoietic stem cells and progenitors

Connexin-43 (Cx43), a gap junction protein involved in control of cell proliferation, differentiation and migration, has been suggested to have a role in hematopoiesis. Cx43 is highly expressed in osteoblasts and osteogenic progenitors (OB/P). To elucidate the biologic function of Cx43 in the hematopoietic microenvironment (HM) and its influence in hematopoietic stem cell (HSC) activity, we studied the hematopoietic function in an in vivo model of constitutive deficiency of Cx43 in OB/P. The deficiency of Cx43 in OB/P cells does not impair the steady state hematopoiesis, but disrupts the directional trafficking of HSC/progenitors (Ps) between the bone marrow (BM) and peripheral blood (PB). OB/P Cx43 is a crucial positive regulator of transstromal migration and homing of both HSCs and progenitors in an irradiated microenvironment. However, OB/P Cx43 deficiency in nonmyeloablated animals does not result in a homing defect but induces increased endosteal lodging and decreased mobilization of HSC/Ps associated with proliferation and expansion of Cxcl12-secreting mesenchymal/osteolineage cells in the BM HM in vivo. Cx43 controls the cellular content of the BM osteogenic microenvironment and is required for homing of HSC/Ps in myeloablated animal

High population frequencies of MICA copy number variations originate from independent recombination events

MICA is a stress-induced ligand of the NKG2D receptor that stimulates NK and T cell responses and was identified as a key determinant of anti-tumor immunity. The MICA gene is located inside the MHC complex and is in strong linkage disequilibrium with HLA-B. While an HLA-B*48-linked MICA deletion-haplotype was previously described in Asian populations, little is known about other MICA copy number variations. Here, we report the genotyping of more than two million individuals revealing high frequencies of MICA duplications (1%) and MICA deletions (0.4%). Their prevalence differs between ethnic groups and can rise to 2.8% (Croatia) and 9.2% (Mexico), respectively. Targeted sequencing of more than 70 samples indicates that these copy number variations originate from independent nonallelic homologous recombination events between segmental duplications upstream of MICA and MICB. Overall, our data warrant further investigation of disease associations and consideration of MICA copy number data in oncological study protocols