Low back pain and the post-laminectomy pain syndrome

Back pain is one of the most common disorders seen in general practice. Patients with chronic low back pain form a large proportion of the work of any pain relief unit. The aetiology of low back pain and the post-laminectomy pain syndrome are briefly presented and treatment of the 'failed back surgery patient' and the patient with arachnoiditis are discussed

Books

NEUROLOGY AND MEDICINE Ed by RAC Hughes and G D Perkin. Pp. xiv + 415. £45. 1999.BM]. ISBNO-7279-1224--D.EPIDEMIOLOGY OF PAIN. TASK FORCE ON EPIDEMIOLOGY Edited by lain K Crombie, Peter R Croft, Steven J Linton, Linda LeResche and Michael Von Korff Pp. xi + 321.US$61. IASP 1999.ISBN 0-931092-25-6.LET'S TALK ABOUT LIFE: AN EDUCATIONAL BOOK TO END THE AIDS CRISISCollard, Wand Ncayiyana, DJ. Pp 242. R40. Illustrated. 1999 S A Medical Press. ISBN 0-620-24165-

HRM and innovation: the mediating role of market-sensing capability and the moderating role of national power distance

This paper examines the mechanism through which human resource management (HRM) practices promote firms’ innovation and how this relationship differs across cultures. Based on a dataset of 3,755 firms from 13 countries, this study finds that in most countries employee-oriented HRM practices that dedicate attention to employee needs and interests are positively related to firms’ market-sensing capability, which is the capability to continuously learn about their markets. Market-sensing capability is in turn significantly related to firms’ product and process innovation. Cross-country examination further reveals that in high power distance countries employee- oriented HRM practices have a stronger positive effect than in low power distance countries. This study highlights the importance of HRM in supporting the use organizations make of external knowledge, which is critical for organizational innovation. Bringing an external perspective, we complement existing literature that emphasizes the role of HRM in integrating internal knowledge. Our cross-cultural findings contribute to the understanding of cultural contingency in HRM theories

Leaf yellowing of the wheat cultivar Mace in the absence of yellowspot disease

The wheat variety Mace is currently dominating the southern wheat growing regions of Australia. It is high yielding in most environments and resistant to many diseases including yellow spot (also known as tan spot). However, observations of foliar yellowing of Mace have recently been reported in the field. This has raised concerns over a possible breakdown of resistance to yellow spot, which is caused by the necrotrophic fungal pathogen Pyrenophora triticirepentis. West Australian field samples of yellowing Mace leaves were evaluated for P. triticirepentis infection, and this pathogen was determined to be absent. Instead, Alternaria spp. were isolated from the wheat leaves. Pathogenicity assays showed that the recovered Alternaria spp. were unable to cause disease symptoms on Mace. Furthermore, spontaneous foliar lesions were observed in Mace grown in the absence of pathogens. It is therefore likely that such yellowing is a physiological trait, which will not respond to fungicide application. A marginal impact on yield cannot be excluded

Incidence and Risk Factors of Serious Adverse Events during Antituberculous Treatment in Rwanda: A Prospective Cohort Study

BACKGROUND: Tuberculosis (TB) and TB-human immunodeficiency virus infection (HIV) coinfection is a major public health concern in resource-limited settings. Although TB treatment is challenging in HIV-infected patients because of treatment interactions, immunopathological reactions, and concurrent infections, few prospective studies have addressed this in sub-Saharan Africa. In this study we aimed to determine incidence, causes of, and risk factors for serious adverse events among patients on first-line antituberculous treatment, as well as its impact on antituberculous treatment outcome. METHODS AND FINDINGS: Prospective observational cohort study of adults treated for TB at the Internal Medicine department of the Kigali University Hospital from May 2008 through August 2009. Of 263 patients enrolled, 253 were retained for analysis: median age 35 (Interquartile range, IQR 28-40), 55% male, 66% HIV-positive with a median CD4 count 104 cells/mm(3) (IQR 44-248 cells/mm(3)). Forty percent had pulmonary TB, 43% extrapulmonary TB and 17% a mixed form. Sixty-four (26%) developed a serious adverse event; 58/167 (35%) HIV-infected vs. 6/86 (7%) HIV-uninfected individuals. Commonest events were concurrent infection (n = 32), drug-induced hepatitis (n = 24) and paradoxical reactions/TB-IRIS (n = 23). HIV-infection (adjusted Hazard Ratio, aHR 3.4, 95% Confidence Interval, CI 1.4-8.7) and extrapulmonary TB (aHR 2, 95%CI 1.1-3.7) were associated with an increased risk of serious adverse events. For TB/HIV co-infected patients, extrapulmonary TB (aHR 2.0, 95%CI 1.1-3.9) and CD4 count <100 cells/mm3 at TB diagnosis (aHR 1.7, 95%CI 1.0-2.9) were independent predictors. Adverse events were associated with an almost two-fold higher risk of unsuccessful treatment outcome at 6 months (HR 1.89, 95%CI 1.3-3.0). CONCLUSION: Adverse events frequently complicate the course of antituberculous treatment and worsen treatment outcome, particularly in patients with extrapulmonary TB and advanced immunodeficiency. Concurrent infection accounts for most events. Our data suggest that deterioration in a patient already receiving antituberculous treatment should prompt an aggressive search for additional infections

Reconstructing Asian faunal introductions to eastern Africa from multi-proxy biomolecular and archaeological datasets

Human-mediated biological exchange has had global social and ecological impacts. In subS-aharan Africa, several domestic and commensal animals were introduced from Asia in the pre-modern period; however, the timing and nature of these introductions remain contentious. One model supports introduction to the eastern African coast after the mid-first millennium CE, while another posits introduction dating back to 3000 BCE. These distinct scenarios have implications for understanding the emergence of long-distance maritime connectivity, and the ecological and economic impacts of introduced species. Resolution of this longstanding debate requires new efforts, given the lack of well-dated fauna from high-precision excavations, and ambiguous osteomorphological identifications. We analysed faunal remains from 22 eastern African sites spanning a wide geographic and chronological range, and applied biomolecular techniques to confirm identifications of two Asian taxa: domestic chicken (Gallus gallus) and black rat (Rattus rattus). Our approach included ancient DNA (aDNA) analysis aided by BLAST-based bioinformatics, Zooarchaeology by Mass Spectrometry (ZooMS) collagen fingerprinting, and direct AMS (accelerator mass spectrometry) radiocarbon dating. Our results support a late, mid-first millennium CE introduction of these species. We discuss the implications of our findings for models of biological exchange, and emphasize the applicability of our approach to tropical areas with poor bone preservation

The meaning of compassion fatigue to student nurses: an interpretive phenomenological study

Background: Compassion fatigue is a form of occupational stress which occurs when individuals are exposed to suffering and trauma on an ongoing basis. The purpose of this study was to explore the experiences of compassion fatigue among student nurses following their first clinical placement in a UK health care setting during 2015. Methods: The aim of this study was to explore students’ thoughts and feelings about compassion fatigue using reflective poems as a source of data. An interpretive phenomenological approach was taken using a purposeful sampling strategy which aimed to explore in depth meaning of the concept as experienced by the students. Results: From this study it is clear that students experience compassion fatigue and this has a psychological effect on their wellbeing and ability to learn in the clinical practice setting. Reflective poetry writing enabled articulation of feelings which were at times negative and linked to the student’s status as a novice nurse. Conclusions: Students experience compassion fatigue and educators need to find ways to provide support in both clinical and university settings. Positive practices such as shared reflection and the use of creative teaching methods might be beneficial, to support exploration of feelings, build resilience and effective ways of coping