Spinal pain: Current understanding, trends, and the future of care

© 2015 Trainor et al. This commissioned review paper offers a summary of our current understanding of nonmalignant spinal pain, particularly persistent pain. Spinal pain can be a complex problem, requiring management that addresses both the physical and psychosocial components of the pain experience. We propose a model of care that includes the necessary components of care services that would address the multidimensional nature of spinal pain. Emerging care services that tailor care to the individual person with pain seems to achieve better outcomes and greater consumer satisfaction with care, while most likely containing costs. However, we recommend that any model of care and care framework should be developed on the basis of a multidisciplinary approach to care, with the scaffold being the principles of evidence-based practice. Importantly, we propose that any care services recommended in new models or frameworks be matched with available resources and services-this matching we promote as the fourth principle of evidence-based practice. Ongoing research will be necessary to offer insight into clinical outcomes of complex interventions, while practice-based research would uncover consumer needs and workforce capacity. This kind of research data is essential to inform health care policy and practice

Aquaponics: alternative types and approaches

Whilst aquaponics may be considered in the mid-stage of development, there are a number of allied, novel methods of food production that are aligning alongside aquaponics and also which can be merged with aquaponics to deliver food efficiently and productively. These technologies include algaeponics, aeroponics, aeroaquaponics, maraponics, haloponics, biofloc technology and vertical aquaponics. Although some of these systems have undergone many years of trials and research, in most cases, much more scientific research is required to understand intrinsic processes within the systems, efficiency, design aspects, etc., apart from the capacity, capabilities and benefits of conjoining these systems with aquaponics

Diabetic ketoacidosis

Diabetic ketoacidosis (DKA) is the most common acute hyperglycaemic emergency in people with diabetes mellitus. A diagnosis of DKA is confirmed when all of the three criteria are present — ‘D’, either elevated blood glucose levels or a family history of diabetes mellitus; ‘K’, the presence of high urinary or blood ketoacids; and ‘A’, a high anion gap metabolic acidosis. Early diagnosis and management are paramount to improve patient outcomes. The mainstays of treatment include restoration of circulating volume, insulin therapy, electrolyte replacement and treatment of any underlying precipitating event. Without optimal treatment, DKA remains a condition with appreciable, although largely preventable, morbidity and mortality. In this Primer, we discuss the epidemiology, pathogenesis, risk factors and diagnosis of DKA and provide practical recommendations for the management of DKA in adults and children

Spinal pain: current understanding, trends, and the future of care

Gregory F Parkin-Smith,1 Lyndon G Amorin-Woods,2–4 Stephanie J Davies,5–7 Barrett E Losco,8 Jon Adams9,10 1General Practice, Surgery 82, Busselton, WA, Australia; 2School of Health Professions, Murdoch University, Murdoch, WA, Australia; 3Chiropractors’ Association of Australia, Nedlands, WA, Australia; 4ACORN Project, 5WA Specialist Pain Services, WA, Australia; 6School of Physiotherapy, Curtin University, Bentley, WA, Australia; 7School of Medicine and Pharmacology, University of Western Australia, Crawley, WA, Australia; 8Murdoch University, Murdoch, WA, Australia; 9Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia; 10Australian Research Centre in Complementary and Integrative Medicine, University of Technology Sydney, Ultimo, NSW, Australia Abstract: This commissioned review paper offers a summary of our current understanding of nonmalignant spinal pain, particularly persistent pain. Spinal pain can be a complex problem, requiring management that addresses both the physical and psychosocial components of the pain experience. We propose a model of care that includes the necessary components of care services that would address the multidimensional nature of spinal pain. Emerging care services that tailor care to the individual person with pain seems to achieve better outcomes and greater consumer satisfaction with care, while most likely containing costs. However, we recommend that any model of care and care framework should be developed on the basis of a multidisciplinary approach to care, with the scaffold being the principles of evidence-based practice. Importantly, we propose that any care services recommended in new models or frameworks be matched with available resources and services – this matching we promote as the fourth principle of evidence-based practice. Ongoing research will be necessary to offer insight into clinical outcomes of complex interventions, while practice-based research would uncover consumer needs and workforce capacity. This kind of research data is essential to inform health care policy and practice. Keywords: back pain, pain management, combined modality therapy, patient care tea