Fencing the Flint Hills

Introduction: As the Chisholm trail became the thoroughfare for millions of Texas cattle coming to railheads in Kansas, it initiated economic opportunities in Kansas cattle towns and the countryside surround them. But the increased settlement it spawned only served as obstacles to trail drovers as homesteads with their fences were established

Building A Veterinary Practice

If you would like to meet a successful veterinarian, attend a local meeting of the Heart Association, United Way, or Junior Chamber of Commerce. Successful veterinarians know that giving of their time freely to charitable and civic associations is an excellent way to be of service to the community, and to help build the practice

Embedded motivational interviewing combined with a smartphone app to increase physical activity in people with sub-acute low back pain: study protocol of a cluster randomised control trial

Background: Motivational Interviewing is an evidence-based, client-centred counselling technique that has been used effectively to increase physical activity, including for people with low back pain. One barrier to implementing Motivational Interviewing in health care settings more broadly is the extra treatment time with therapists. The aim of this paper is to describe the design of a cluster randomised controlled trial evaluating the effect of an intervention that pairs Motivational Interviewing embedded into usual physiotherapy care with a specifically designed app to increase physical activity in people with sub-acute low back pain. Methods: The study is a cluster randomised controlled in which patients aged over 18 years who have sub-acute low back pain (3–12 weeks duration) are recruited from four public hospital outpatient clinics. Based on the recruitment site, participants either receive usual physiotherapy care or the Motivational Interviewing intervention over 6 consecutive weekly outpatient sessions with a specifically designed app designed to facilitate participant-led physical activity behaviour change in between sessions. Outcome measures assessed at baseline and 7 weeks are: physical activity as measured by accelerometer (primary outcome), and pain-related activity restriction and pain self-efficacy (secondary outcomes). Postintervention interviews with physiotherapists and participants will be conducted as part of a process evaluation. Discussion: This intervention, which comprises trained physiotherapists conducting conversations about increasing physical activity with their patients in a manner consistent with Motivational Interviewing as part of usual care combined with a specifically designed app, has potential to facilitate behaviour change with minimal extra therapist time

Couplings and Alignment

Discussion Grou

Embedded motivational interviewing combined with a smartphone application to increase physical activity in people with sub-acute low back pain: a cluster randomised controlled trial

BackgroundModerately vigorous physical activity (PA) may be beneficial for people with sub-acute low back pain (LBP), but may initially be painful for patients and challenging for physical therapists to facilitate.ObjectivesThis study investigated motivational interviewing (MI) delivered by physical therapists and a smartphone app for increasing PA in people with LBP.MethodsA mixed methods cluster randomised controlled trial involving 46 adults with LBP in Melbourne, Australia. Participants attended weekly 30-min physical therapy consultations for 6 weeks. Experimental group physical therapists were taught to embed MI into consultations and patients were provided with a self-directed app. The primary outcome was accelerometer-derived moderately vigorous PA. Secondary outcomes were LBP disability (Oswestry Disability Index), functional capacity (Patient Specific Functional Scale), and self-efficacy (Pain Self-Efficacy Questionnaire). Between-group differences were analysed by ANCOVA post-intervention.ResultsThere was no statistically significant difference between the experimental group and control group for PA. Between-group differences in LBP disability (MD= 19.4 units, 95% CI: 8.5, 30.3), functional capacity (primary MD= −4.1 units, 95% CI: −6.9, −1.3; average MD= −3.1, 95% CI: −4.9, −1.2) and self-efficacy (MD −11.3 units, 95%CI −20.2 to −2.5) favoured the control group with small to moderate effect sizes. There were low levels of overall engagement with the app.ConclusionThe embedded MI intervention was no more beneficial than physical therapy alone for PA and was associated with poorer LBP disability, function, and self-efficacy. The effectiveness of embedding MI and a smartphone app into usual care for LBP was not supported.Keywords: Low back pain; Motivational interviewing; Randomised controlled trial; Smartphone application, app<br/

AN ANALYSIS OF SIZE, WEIGHT AND POWER (SWAP) FOR EMP SHIELDING OF THE RAAD SYSTEM

In 2019, the U.S. Army’s Future Study Program designed and led the Unified Quest Multinational Seminar Wargame. This wargame examined U.S. forces, partners, and allies’ interoperability requirements to defeat a near-peer threat in a future operational environment. As part of the seminar wargame, Army forces executed a critical air assault operation in adversary-controlled terrain to support a river crossing. This task covers multiple aspects of operational planning and coordination for an assault operation as outlined in AFC Pamphlet 71 20-1. An air assault execution revealed the challenges of performing a complex forcible entry operation in a contested, anti-access/aerial denial (A2/AD) environment. Even with future aircraft, the air assault operation was vulnerable to enemy air defense capabilities. Landing zone restrictions reduce the number of areas the multinational forces could conduct air assault operations, providing a marked advantage to near-peer adversaries in planning likely counterattack operations and increasing the risk to forces. Through a combination of integrated air defense systems (IADS), indirect fires, direct fires, and reserve formations specifically tasked with contesting air assault operations, threat forces are expected to contest the air assault force during insertion. As the report stated, the wargame demonstrated the need for new Army air assault capabilities.Major, United States ArmyMajor, United States ArmyCaptain, United States ArmyMajor, United States ArmyMajor, United States ArmyApproved for public release. Distribution is unlimited