2015 recommendations for the management of polymyalgia rheumatica: a European League Against Rheumatism/American College of Rheumatology collaborative initiative

Therapy for polymyalgia rheumatica (PMR) varies widely in clinical practice as international recommendations for PMR treatment are not currently available. In this paper, we report the 2015 European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) recommendations for the management of PMR. We used the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) methodology as a framework for the project. Accordingly, the direction and strength of the recommendations are based on the quality of evidence, the balance between desirable and undesirable effects, patients'and clinicians'values and preferences, and resource use. Eight overarching principles and nine specific recommendations were developed covering several aspects of PMR, including basic and follow-up investigations of patients under treatment, risk factor assessment, medical access for patients and specialist referral, treatment strategies such as initial glucocorticoid (GC) doses and subsequent tapering regimens, use of intramuscular GCs and disease modifying anti-rheumatic drugs (DMARDs), as well as the roles of non-steroidal anti-rheumatic drugs and non-pharmacological interventions. These recommendations will inform primary, secondary and tertiary care physicians about an international consensus on the management of PMR. These recommendations should serve to inform clinicians about best practices in the care of patients with PMR

Selecting interventions to promote fruit and vegetable consumption: from policy to action, a planning framework case study in Western Australia

The Department of Health in Western Australia identified access to, and daily consumption of recommended amounts of fruit and vegetables, as priority health determinants. The numerous factors that influence supply and consumption of fruit and vegetables indicated that a comprehensive approach would be required. A government and non-government sector steering group was set up to select priority interventions using the National Public Health Partnership\u27s Framework for Implementing Public Health Strategies. This structured framework was used for developing strategies to improve fruit and vegetable consumption and supply, and to identify implementation priorities. After one year a desktop audit of progress on framework interventions was undertaken

Electronic Structure of Oxo-Bridged Iron(III) Dimers

Magnetic susceptibility results and extensive electronic, infrared, and Mi:issbauer spectral data are presented for enH_2[(FeHEDT A)_2O]· 6H_2O_3, Na_4[(FeEDTA)_2O]· 12H_2O, FeHEDTA· H_2O, and NaFeEDT A· 3H_2O (HEDTA = N-hydroxoethylethylenediaminetriacetate, EDTA = ethylenediaminetetraacetate, and enH_2^(2+) = ethylenediammonium cation). The magnetic and spectral data establish an electronic structural model for the oxo-bridged dimers in which pairs of S = 5/2 Fe(III) ions interact antiferromagnetically, with J ≃ -95 cm^(-1). The oxo-bridged dimers show marked intensity enhancement of the one-center Fe(III) ligand-field bands. There are also several uv bands which are interpreted as arising from simultaneous electronic excitations of Fe(III) pairs. A simple high-spin ligand-field model modified by spin-spin interaction is judged to be considerably more appropriate than the Dunitz-Orgel molecular orbital approach as a vehicle for describing oxo-bridged Fe(IIl) dimers

A Survey of Canadian Massage Therapists Experiences of Work-Related Pain

An investigation into the work-related pain (WRP) experienced by Massage Therapists (MTs) in Ontario, Canada was undertaken using voluntary completion of an online questionnaire following broad distribution of requests to take part in this study. Data from respondents were included for analysis if they provided informed consent and were a currently or previously registered MT in the region. With voluntary participation, self-selection respondent bias must be considered in evaluating reported results. Valid questionnaires (n=1103) were analyzed both quantitatively and qualitatively. Massage therapists ranged in age from 20 to 73 years, and 85% of respondents were female. The overwhelming majority (85%) of MTs had experienced, or were experiencing, WRP at one or more of five pre-identified, primary locations with the hand/wrist, the most common site (65.5%); followed by the fingers/thumb (60.3%), shoulder (55.0%), lower back (50.1%), and neck (49.2%). Females were significantly more likely to report neck and shoulder pain than males, and were significantly more likely to report WRP at a higher number of body locations, with approximately one in five female MTs reporting WRP at all (5) primary sites. On a 10-point pain-severity scale, females reported significantly higher perceived pain than males. Work-related pain was attributed to the gradual onset of musculoskeletal conditions by 60.3% of respondents, with no other choice of cause being reported by more than 11.1%. There was clear indication of WRP impacting the lives of MTs, with 48% reporting an impact on activities of daily living, 31% reporting a loss of income, 54.6% working in pain, and 30.5% considering changing (or having changed) their profession. Various work adjustments to WRP were reported, including altered biomechanics and greater rest between patient treatments. The reported data suggested that WRP was a limiting factor for MTs’ work capacity