The Nordic back pain subpopulation program: predicting outcome among chiropractic patients in Finland

<p>Abstract</p> <p>Background</p> <p>In a previous Swedish study it was shown that it is possible to predict which chiropractic patients with persistent LBP will not report definite improvement early in the course of treatment, namely those with LBP for altogether at least 30 days in the past year, who had leg pain, and who did not report definite general improvement by the second treatment. The objectives of this study were to investigate if the predictive value of this set of variables could be reproduced among chiropractic patients in Finland, and if the model could be improved by adding some new potential predictor variables.</p> <p>Methods</p> <p>The study was a multi-centre prospective outcome study with internal control groups, carried out in private chiropractic practices in Finland. Chiropractors collected data at the 1st, 2^ndand 4^thvisits using standardized questionnaires on new patients with LBP and/or radiating leg pain. Status at base-line was identified in relation to pain and disability, at the 2^ndvisit in relation to disability, and "definitely better" at the 4^thvisit in relation to a global assessment. The Swedish questionnaire was used including three new questions on general health, pain in other parts of the spine, and body mass index.</p> <p>Results</p> <p>The Swedish model was reproduced in this study sample. An alternative model including leg pain (yes/no), improvement at 2^ndvisit (yes/no) and BMI (underweight/normal/overweight or obese) was also identified with similar predictive values. Common throughout the testing of various models was that improvement at the 2^ndvisit had an odds ratio of approximately 5. Additional analyses revealed a dose-response in that 84% of those patients who fulfilled none of these (bad) criteria were classified as "definitely better" at the 4^thvisit, vs. 75%, 60% and 34% of those who fulfilled 1, 2 or all 3 of the criteria, respectively.</p> <p>Conclusion</p> <p>When treating patients with LBP, at the first visits, the treatment strategy should be different for overweight/obese patients with leg pain as it should be for all patients who fail to improve by the 2^ndvisit. The number of predictors is also important.</p

Lihavuus (lapset, nuoret ja aikuiset) : KÄYPÄ-HOITO -SUOSITUS (Tiivistelmä)

Suositus koskee lasten, nuorten ja aikuisten lihavuuden ehkäisyä ja hoitoa. Koko suositus luettavissa: www.kaypahoito.f

Yläpohjan ja vesikatteen rakentaminen sekä niiden yleisimmät rakennusvirheet

Käsittelemme opinnäytetyössämme rakennuksen yläpohjan ja vesikatteen rakentamista sekä niissä tehtäviä rakennusvirheitä. Tavoitteenamme oli tehdä opinnäytetyö, jonka avulla lukija pystyy tunnistamaan tehdyt rakennusvirheet ja niistä aiheutuvat ongelmat. Yläpohjassa tehdyt rakennusvirheet on vaikea havaita ja niistä johtuvat ongelmat tulevat esiin vasta usean vuoden kuluttua rakennuksen valmistumisesta. Rakennuksen yläpohjan ja vesikatteen toimivuudella on suuri merkitys rakennuksen käyttöikään. Toimiva ja hyvin huollettu kattorakenne lisää raken-nuksen käyttöikää huomattavasti. Ajoissa havaitut rakennusvirheet sekä syntyneet viat ovat vielä edullisia korjata. Havaitsematta jääneet pienetkin viat voivat pahimmillaan aiheuttaa koko kattorakenteen uusimisen. Käymme opinnäytetyössämme läpi yläpohjan ja vesikatteen osalta sellaiset rakennuskohdat, mitkä ovat katon toimivuuden kannalta tärkeitä, ja missä tehdään yleensä virheitä. Keräsimme tietoa opinnäytetyötämme varten alan kirjallisuudesta. Kävimme myös tarkastamassa neljän kiinteistön yläpohjan ja vesikatteen. Tarkastamistamme kiinteistöistä löytämämme ongelmat johtuivat pääasiassa rakennusaikana tehdyistä virheistä. Tarkastuksista laadimme tutkimustuloksen parannusehdotuksineen jokaiselle kiinteistölle. Tutkimustulokset paran-nusehdotuksineen toimitimme kiinteistöjen isännöitsijöille.This final year project discussed the construction of the roof and the roofing as well as the defects in them. The aim of this final year project was to ena-ble the reader to identify the errors made in the construction and the resulting problems. Roof problems are difficult to detect, and the resulting problems appear several years after the completion of the building. The functionality of the roof and the roofing is of great importance for the lifetime of the building. The functional and the well maintained roof structure of the building increases the lifetime of the building. Timely identified construction errors and the resulting problems are cheap to fix. Undetected, even small faults can at worst case cause the renewal of the entire roof structure. This thesis also discussed how to build the most important building elements of the roof and the roofing and the most common construction errors. Information for the study was mainly gathered from literature. Information was also gathered from four buildings the roof and roofing of which were inspected for this thesis. The result of the inspections shows that most of the roof and roofing problems were caused by construction defects. Reports with improvement pro-posals were made for each building. The reports with improvement proposal were also sent to all the building managers

Long-Term Effect of Gastric Bypass and Sleeve Gastrectomy on Severe Obesity : Do Preoperative Weight Loss and Binge Eating Behavior Predict the Outcome of Bariatric Surgery?

Few studies have examined weight loss sustainability after sleeve gastrectomy (SG). The purpose of this study was to determine long-term outcome after SG and gastric bypass (GBP) and learn whether preoperative weight loss and binge eating behavior can be used to predict outcome. Together, 257 patients (64 % women) were operated, 163 by GBP and 94 by SG. Binge eating was assessed by binge eating scale (BES) and preoperative weight loss was advised to all, including very low-calorie diet for 5 weeks. Postoperative visits took place at 1 and 2 years, and long-term outcome was at median 5 years (range 2.29-6.85). Multivariate linear regression analysis was used to predict outcome at 2-year and long-term control. Median age was 48 years, weight 141.1 kg, and BMI 48.2 kg/m(2). Preoperative weight loss was median 4.9 % before GBP and 3.8 % before SG, P = 0.04. Total weight loss at year one was 24.1 % in GBP and 23.7 % in SG (P = 0.40), at year two 24.4 and 23.4 % (P = 0.26), and at long-term control 23.0 and 20.2 % (P = 0.006), respectively. Weight was analyzed in 93, 88, and 89 % of those alive, respectively. BES did not predict weight outcome, but larger preoperative weight loss predicted less postoperative weight loss at 2 years. On long term, weight loss was better maintained after GBP compared with SG. Binge eating behavior was not a significant predictor, but larger preoperative weight loss predicted less postoperative weight loss for the next 2 years.Peer reviewe

Chiropractic &amp; Osteopathy BioMed Central

The Nordic back pain subpopulation program: predicting outcome among chiropractic patients in Finlan