Does inter-vertebral range of motion increase after spinal manipulation? A prospective cohort study.

Background: Spinal manipulation for nonspecific neck pain is thought to work in part by improving inter-vertebral range of motion (IV-RoM), but it is difficult to measure this or determine whether it is related to clinical outcomes. Objectives: This study undertook to determine whether cervical spine flexion and extension IV-RoM increases after a course of spinal manipulation, to explore relationships between any IV-RoM increases and clinical outcomes and to compare palpation with objective measurement in the detection of hypo-mobile segments. Method: Thirty patients with nonspecific neck pain and 30 healthy controls matched for age and gender received quantitative fluoroscopy (QF) screenings to measure flexion and extension IV-RoM (C1-C6) at baseline and 4-week follow-up between September 2012-13. Patients received up to 12 neck manipulations and completed NRS, NDI and Euroqol 5D-5L at baseline, plus PGIC and satisfaction questionnaires at follow-up. IV-RoM accuracy, repeatability and hypo-mobility cut-offs were determined. Minimal detectable changes (MDC) over 4 weeks were calculated from controls. Patients and control IV-RoMs were compared at baseline as well as changes in patients over 4 weeks. Correlations between outcomes and the number of manipulations received and the agreement (Kappa) between palpated and QF-detected of hypo-mobile segments were calculated. Results: QF had high accuracy (worst RMS error 0.5o) and repeatability (highest SEM 1.1o, lowest ICC 0.90) for IV-RoM measurement. Hypo-mobility cut offs ranged from 0.8o to 3.5o. No outcome was significantly correlated with increased IV-RoM above MDC and there was no significant difference between the number of hypo-mobile segments in patients and controls at baseline or significant increases in IV-RoMs in patients. However, there was a modest and significant correlation between the number of manipulations received and the number of levels and directions whose IV-RoM increased beyond MDC (Rho=0.39, p=0.043). There was also no agreement between palpation and QF in identifying hypo-mobile segments (Kappa 0.04-0.06). Conclusions: This study found no differences in cervical sagittal IV-RoM between patients with non-specific neck pain and matched controls. There was a modest dose-response relationship between the number of manipulations given and number of levels increasing IV-RoM - providing evidence that neck manipulation has a mechanical effect at segmental levels. However, patient-reported outcomes were not related to this

Assessment of motor functioning in the preschool period

The assessment of motor functioning in young children has become increasingly important in recent years with the acknowledgement that motor impairment is linked with cognitive, language, social and emotional difficulties. However, there is no one gold standard assessment tool to investigate motor ability in children. The aim of the current paper was to discuss the issues related to the assessment of motor ability in young pre-school children and to provide guidelines on the best approach for motor assessment. The paper discusses the maturational changes in brain development at the preschool level in relation to motor ability. Other issues include sex differences in motor ability at this young age, and evidence for this in relation to sociological versus biological influences. From the previous literature it is unclear what needs to be assessed in relation to motor functioning. Should the focus be underlying motor processes or movement skill assessment? Several key assessment tools are discussed that produce a general measure of motor performance followed by a description of tools that assess specific skills, such as fine and gross motor, ball and graphomotor skills. The paper concludes with recommendations on the best approach in assessing motor function in pre-school children

Using social and behavioural science to support COVID-19 pandemic response

The COVID-19 pandemic represents a massive global health crisis. Because the crisis requires large-scale behaviour change and places significant psychological burdens on individuals, insights from the social and behavioural sciences can be used to help align human behavior with the recommendations of epidemiologists and public health experts. Here we discuss evidence from a selection of research topics relevant to pandemics, including work on navigating threats, social and cultural influences on behaviour, science communication, moral decision-making, leadership, and stress and coping. In each section, we note the nature and quality of prior research, including uncertainty and unsettled issues. We identify several insights for effective response to the COVID-19 pandemic, and also highlight important gaps researchers should move quickly to fill in the coming weeks and months

Agile Manufacturing: an evolutionary review of practices

Academics and practitioners have long acknowledged the importance of agile manufacturing and related supply chains in achieving firm sustainable competitiveness. However, limited, if any, research has focused on the evolution of practices within agile manufacturing supply chains and how these are related to competitive performance objectives. To address this gap, we reviewed the literature on agile manufacturing drawing on evolution of manufacturing agility, attributes of agile manufacturing, the drivers of agile manufacturing, and the identification of the enabling competencies deployable for agile manufacturing. Our thesis is that agile manufacturing is at the centre of achieving sustainable competitive advantage, especially in light of current unprecedented market instability coupled with complex customer requirements. In this regard, the emphasis which agile manufacturing places on responsive adaptability would counter the destabilising influence of competitive pressures on organisations performance criteria. We have identified five enabling competencies as the agility enablers and practices of agile manufacturing, that is, transparent customisation, agile supply chains, intelligent automation, total employee empowerment and technology integration, and further explored their joint deployment to create positive multiplier effects. Future research directions were also provided with respect to operationalisation of the five identified enablers and the potential for emergent technologies of big data, blockchain, and Internet of Things to shape future agile manufacturing practices

Narrative approach to understand people's comprehension of acquaintance rape: The role of Sex Role Stereotyping

One of the most unreported crimes is acquaintance rape. This may be the result of people's understanding of what rape is because of their rape script and their stereotypes of victim characteristics. These judgements may be moderated by sex role stereotyping (SRS). We utilised a narrative approach to understand low and high SRS participants' rape scripts. Young-adult participants described what they believed a typical rape was, followed by describing an acquaintance rape and then what they believed the stereotypical victim of each crime would be. A narrative analysis was conducted on the data. We found that the blitz script is still held by 44% of low SRS and 47% of high SRS people despite 90% of rapes being committed by an acquaintance. While acquaintance rape scripts existed, the emotional imagery and content of these depended on participants level of SRS. Stereotypical victim characteristics also depended on SRS: those with high SRS were more likely to endorse rape myth ideals in describing victims than those with low SRS. These results have implications for educating people about what rape is so that victims might feel more confident in reporting rape