Behavioural treatment for chronic low-back pain

Background Behavioural treatment is commonly used in the management of chronic low-back pain (CLBP) to reduce disability through modification of maladaptive pain behaviours and cognitive processes. Three behavioural approaches are generally distinguished: operant, cognitive, and respondent; but are often combined as a treatment package. Objectives To determine the effects of behavioural therapy for CLBP and the most effective behavioural approach. Search strategy The Cochrane Back Review Group Trials Register, CENTRAL, MEDLINE, EMBASE, and PsycINFO were searched up to February 2009. Reference lists and citations of identified trials and relevant systematic reviews were screened. Selection criteria Randomised trials on behavioural treatments for non-specific CLBP were included. Data collection and analysis Two review authors independently assessed the risk of bias in each study and extracted the data. If sufficient homogeneity existed among studies in the pre-defined comparisons, a meta-analysis was performed. We determined the quality of the evidence for each comparison with the GRADE approach.Public Health and primary careDisease managementPrevention, Population and Disease management (PrePoD

The current understanding of precision medicine and personalised medicine in selected research disciplines: study protocol of a systematic concept analysis

Introduction The terms ‘precision medicine’ and ‘personalised medicine’ have become key terms in health-related research and in science-related public communication. However, the application of these two concepts and their interpretation in various disciplines are heterogeneous, which also affects research translation and public awareness. This leads to confusion regarding the use and distinction of the two concepts. Our aim is to provide a snapshot of the current understanding of these concepts.Methods and analysis Our study will use Rodgers’ evolutionary concept analysis to systematically examine the current understanding of the concepts ‘precision medicine’ and ‘personalised medicine’ in clinical medicine, biomedicine (incorporating genomics and bioinformatics), health services research, physics, chemistry, engineering, machine learning and artificial intelligence, and to identify their respective attributes (clusters of characteristics) and surrogate and related terms. A systematic search of the literature will be conducted for 2016–2022 using databases relevant to each of these disciplines: ACM Digital Library, CINAHL, Cochrane Library, F1000Research, IEEE Xplore, PubMed/Medline, Science Direct, Scopus and Web of Science. These are among the most representative databases for the included disciplines. We will examine similarities and differences in definitions of ‘precision medicine’ and ‘personalised medicine’ in the respective disciplines and across (sub)disciplines, including attributes of each term. This will enable us to determine how these two concepts are distinguished.Ethics and dissemination Following ethical and research standards, we will comprehensively report the methodology for a systematic analysis following Rodgers’ concept analysis method. Our systematic concept analysis will contribute to the clarification of the two concepts and distinction in their application in given settings and circumstances. Such a broad concept analysis will contribute to non-systematic syntheses of the concepts, or occasional systematic reviews on one of the concepts that have been published in specific disciplines, in order to facilitate interdisciplinary communication, translational medical research and implementation science.</p

The effect of powdery mildew infection of grape berries on juice and wine composition and on sensory properties of Chardonnay wines

The composition of juice and wine made from Chardonnay, Shiraz and Cabernet Sauvignon grapes with increasing levels of powdery mildew infection was assessed over two vintages (2000 and 2001). Chardonnay juice and wine made from grape lots with 0 %, 1-5 %, 10-30 % and 31-100 % of bunches visually infected with powdery mildew showed an increase in titratable acidity, total phenolics, hydroxycinnamates and flavonoids with increasing level of infection. In vintage 2001, Chardonnay bunches with greater than 30% powdery mildew infection had lower total soluble solids (TSS) than lower infection categories and healthy grapes. Powdery mildew infection of Cabernet Sauvignon bunches (1-20%) also resulted in lower TSS, and in lower wine phenolic concentration and spectral colour values compared with healthy grapes. The total microbial population was higher on powdery mildew affected Chardonnay, Shiraz and Cabernet Sauvignon grapes than on healthy grapes. Sensory descriptive analysis of Chardonnay wines from the 2001 vintage showed that wines made from grapes with powdery mildew infection were rated higher in 'oily' and 'viscosity' attributes than wines made from disease-free grapes. Other sensory attribute differences were also apparent, but these were likely to be related to differences in fermentation rate or secondary compositional effects of the powdery mildew infection, notably differing TSS and acidity in the juice. No mouldy or 'off aromas' were associated with wine made from infected grapes. Nevertheless, the study indicated that even very low levels of infection appear to be detrimental to wine sensory characteristics.Belinda E. Stummer, I. Leigh Francis, Andrew J. Markides and Eileen S. Scot