Understanding the biomechanical “spread” of joint pain: knee pain predicts subsequent shoulder pain and this is mediated by leg weakness. Data from the osteoarthritis initiative

Joint pain is common in older adults; typically multiple joints are involved. A greater number of painful sites is associated with higher levels of pain intensity in affected joints, more functional impairment and poorer quality of life. However, little is known about the pattern of multi-site joint pain development. We aimed to assess whether the number of painful joints increases over time, whether pain in certain joints precedes pain in others, and to assess whether the association is mediated by weakness in a cohort of older adults with painful knee osteoarthritis or at risk of knee osteoarthritis in the NIH Osteoarthritis Initiative (OAI)

Physical examination for lumbar radiculopathy due to disc herniation in patients with low-back pain (Protocol)

This is the protocol for a review and there is no abstract. The objectives are as follows: The general aim of our review is to provide information that may assist the clinician in making decisions about appropriate management in patients with low-back pain and leg pain suspected of having radicular pain and radiculopathy due to disc herniation. More specifically, the objective of this systematic review is to assess the diagnostic performance of tests performed during physical examination in the identification of radicular pain and radiculopathy due to lumbar disc herniation in patients with low-back and leg pain. The secondary objective of this review is to assess the influence of sources of heterogeneity on the diagnostic accuracy of tests performed during physical examination, in particular the type of reference standard, health care setting, spectrum of disease, and study design

Finite temperature stability and dimensional crossover of exotic superfluidity in lattices

We investigate exotic paired states of spin-imbalanced Fermi gases in anisotropic lattices, tuning the dimension between one and three. We calculate the finite temperature phase diagram of the system using real-space dynamical mean-field theory in combination with the quantum Monte Carlo method. We find that regardless of the intermediate dimensions examined, the Fulde-Ferrell-Larkin-Ovchinnikov (FFLO) state survives to reach about one third of the BCS critical temperature of the spin-density balanced case. We show how the gapless nature of the state found is reflected in the local spectral function. While the FFLO state is found at a wide range of polarizations at low temperatures across the dimensional crossover, with increasing temperature we find out strongly dimensionality-dependent melting characteristics of shell structures related to harmonic confinement. Moreover, we show that intermediate dimension can help to stabilize an extremely uniform finite temperature FFLO state despite the presence of harmonic confinement.Comment: 5 pages, 3 figure

Education and older adults at the University of the Third Age

This article reports a critical analysis of older adult education in Malta. In educational gerontology, a critical perspective demands the exposure of how relations of power and inequality, in their myriad forms, combinations, and complexities, are manifest in late-life learning initiatives. Fieldwork conducted at the University of the Third Age (UTA) in Malta uncovered the political nature of elder-learning, especially with respect to three intersecting lines of inequality - namely, positive aging, elitism, and gender. A cautionary note is, therefore, warranted at the dominant positive interpretations of UTAs since late-life learning, as any other education activity, is not politically neutral.peer-reviewe

Understanding the management of osteoarthritis in Australia: a qualitative study of GPs and orthopaedic surgeons in Tasmania, Australia

ObjectiveUsing a qualitative design this study aimed to 1) explore the attitudes towards and understanding of osteoarthritis (OA) held by Tasmanian general practitioners (GPs) and orthopaedic surgeons, 2) gain a deeper understanding of conservative and surgical management and 3) identify key barriers and challenges.DesignPurposive sampling was used to recruit 17 ​GPs and 10 surgeons from Tasmania, Australia. Semi-structured interviews were audio-recorded, transcribed, coded, and thematically analysed to document understanding of OA, management and treatment decision making.ResultsGPs and surgeons had a shared understanding of the cause and management of OA which aligned well with evidence-based best practice. Most GPs acknowledged that severity of disease on an X-Ray does not correlate well with symptoms, although some GPs reported always using imaging to support their diagnosis. Conservative management was highly supported by all interviewees, focussing on exercise and/or physiotherapy. Key treatment barriers included managing poor patient understanding of OA, unrealistic expectations for treatment, lack of patient motivation and scepticism towards exercise, and cost and accessibility of conservative treatment options. Surgery was considered a suitable option when conservative management options had been exhausted.ConclusionThis study uniquely interviewed GPs and surgeons from the same population, capturing two crucial areas of OA management. Some key barriers to treatment were identified and options for improving treatment include creating opportunities for increased patient education about OA, enhanced accessibility to OA conservative management programs along with improved reimbursement models supporting conservative management as first-line OA treatment

Are bisphosphonates effective in the treatment of osteoarthritis pain? A meta-analysis and systematic review.

Osteoarthritis (OA) is the most common form of arthritis worldwide. Pain and reduced function are the main symptoms in this prevalent disease. There are currently no treatments for OA that modify disease progression; therefore analgesic drugs and joint replacement for larger joints are the standard of care. In light of several recent studies reporting the use of bisphosphonates for OA treatment, our work aimed to evaluate published literature to assess the effectiveness of bisphosphonates in OA treatment