Effectiveness of manual therapies: the UK evidence report

<p>Abstract</p> <p>Background</p> <p>The purpose of this report is to provide a succinct but comprehensive summary of the scientific evidence regarding the effectiveness of manual treatment for the management of a variety of musculoskeletal and non-musculoskeletal conditions.</p> <p>Methods</p> <p>The conclusions are based on the results of systematic reviews of randomized clinical trials (RCTs), widely accepted and primarily UK and United States evidence-based clinical guidelines, plus the results of all RCTs not yet included in the first three categories. The strength/quality of the evidence regarding effectiveness was based on an adapted version of the grading system developed by the US Preventive Services Task Force and a study risk of bias assessment tool for the recent RCTs.</p> <p>Results</p> <p>By September 2009, 26 categories of conditions were located containing RCT evidence for the use of manual therapy: 13 musculoskeletal conditions, four types of chronic headache and nine non-musculoskeletal conditions. We identified 49 recent relevant systematic reviews and 16 evidence-based clinical guidelines plus an additional 46 RCTs not yet included in systematic reviews and guidelines.</p> <p>Additionally, brief references are made to other effective non-pharmacological, non-invasive physical treatments.</p> <p>Conclusions</p> <p>Spinal manipulation/mobilization is effective in adults for: acute, subacute, and chronic low back pain; migraine and cervicogenic headache; cervicogenic dizziness; manipulation/mobilization is effective for several extremity joint conditions; and thoracic manipulation/mobilization is effective for acute/subacute neck pain. The evidence is inconclusive for cervical manipulation/mobilization alone for neck pain of any duration, and for manipulation/mobilization for mid back pain, sciatica, tension-type headache, coccydynia, temporomandibular joint disorders, fibromyalgia, premenstrual syndrome, and pneumonia in older adults. Spinal manipulation is not effective for asthma and dysmenorrhea when compared to sham manipulation, or for Stage 1 hypertension when added to an antihypertensive diet. In children, the evidence is inconclusive regarding the effectiveness for otitis media and enuresis, and it is not effective for infantile colic and asthma when compared to sham manipulation.</p> <p>Massage is effective in adults for chronic low back pain and chronic neck pain. The evidence is inconclusive for knee osteoarthritis, fibromyalgia, myofascial pain syndrome, migraine headache, and premenstrual syndrome. In children, the evidence is inconclusive for asthma and infantile colic.</p

Reproductive inequality in humans and other mammals

Data, Materials, and Software Availability: All study data are included in the article and/or supporting information available online at https://www.pnas.org/lookup/doi/10.1073/pnas.2220124120#supplementary-materials .Copyright © 2023 the Author(s). To address claims of human exceptionalism, we determine where humans fit within the greater mammalian distribution of reproductive inequality. We show that humans exhibit lower reproductive skew (i.e., inequality in the number of surviving offspring) among males and smaller sex differences in reproductive skew than most other mammals, while nevertheless falling within the mammalian range. Additionally, female reproductive skew is higher in polygynous human populations than in polygynous nonhumans mammals on average. This patterning of skew can be attributed in part to the prevalence of monogamy in humans compared to the predominance of polygyny in nonhuman mammals, to the limited degree of polygyny in the human societies that practice it, and to the importance of unequally held rival resources to women’s fitness. The muted reproductive inequality observed in humans appears to be linked to several unusual characteristics of our species—including high levels of cooperation among males, high dependence on unequally held rival resources, complementarities between maternal and paternal investment, as well as social and legal institutions that enforce monogamous norms.This work was conducted as a part of the “Emergence of Hierarchy and Leadership in Mammalian Societies” group at the National Institute for Mathematical and Biological Synthesis, supported by NSF Award DBI-1300426 and the University of Tennessee, Knoxville. It was supported by NSF awards SMA-1329089 and SMA-1743019, and the Santa Fe Institute, as well as the Max Planck Institute for Evolutionary Anthropology, Department of Human Behavior, Ecology and Culture. S.G. was supported by the US Army Research Office grants W911NF-14-1-0637, W911NF-17-1-0150, and the Office of Naval Research grant W911NF-18-1-0138. Additional funding for data collection was provided by the Wenner-Gren Foundation for Anthropological Research awards: 8913 and 7970, by NSF awards: BCS-0924630, BCS-0925910, BCS-0848360, BCS-0514559, BCS-0613226, BCS-0827277, SES-9870429, and DDRIG-1357209, by the National Geographic Society awards: HJ-099R-17, 20113909, 8671-09, and 7968-06, by the Kone Foundation awards: 086809, 088423, and 088423, and by the Jacobs Foundation, the UCSB Broom Center for Demography, and the UCSB Department of Anthropology

Staying Well on the Margins of the Formal Economy: Exploring Occupational Health and Treatment among Peruvian Vendors in the Urban Marketplace

With a growing percentage of the world's population living in urban areas, many people in cities are increasingly participating in economic activities on the margins of the formal economy. Many such workers generate income by vending goods on a small-scale level in and around traditional open-aired marketplaces. As a setting for health, marketplaces have been studied largely in the interest of consumer safety but less in terms of occupational health. This study explores the health of market vendors with a health promotion lens. It assumes health to be a holistic concept that considers the physical and psychosocial affects that vendors experience as a result of their work. Situated in the Andes, I describe how traditional concepts of health and well-being related to social reciprocity and ritual payments to the natural surroundings inform vendors' everyday health practices in a market located in the city of Arequipa, in the southern Andes of Peru. Data interpreted through socio- economic frameworks describes how one's social status, inside and outside the market, as well as social networks, affect health and rationale of treatment choices, largely in terms of biomedical and traditional methods. It was found that the nature of vendor's work represents a challenge to maintaining health in relation to both biomedical and traditional health practices. Findings suggest that treatment decisions may be motivated by demands of work, but also made as a means to re-enforce social relationships that go on to support one's economic well-being

Reproductive inequality in humans and other mammals.

To address claims of human exceptionalism, we determine where humans fit within the greater mammalian distribution of reproductive inequality. We show that humans exhibit lower reproductive skew (i.e., inequality in the number of surviving offspring) among males and smaller sex differences in reproductive skew than most other mammals, while nevertheless falling within the mammalian range. Additionally, female reproductive skew is higher in polygynous human populations than in polygynous nonhumans mammals on average. This patterning of skew can be attributed in part to the prevalence of monogamy in humans compared to the predominance of polygyny in nonhuman mammals, to the limited degree of polygyny in the human societies that practice it, and to the importance of unequally held rival resources to women's fitness. The muted reproductive inequality observed in humans appears to be linked to several unusual characteristics of our species-including high levels of cooperation among males, high dependence on unequally held rival resources, complementarities between maternal and paternal investment, as well as social and legal institutions that enforce monogamous norms

Reproductive inequality in humans and other mammals

To address claims of human exceptionalism, we determine where humans fit within the greater mammalian distribution of reproductive inequality. We show that humans exhibit lower reproductive skew (i.e., inequality in the number of surviving offspring) among males and smaller sex differences in reproductive skew than most other mammals, while nevertheless falling within the mammalian range. Additionally, female reproductive skew is higher in polygynous human populations than in polygynous nonhumans mammals on average. This patterning of skew can be attributed in part to the prevalence of monogamy in humans compared to the predominance of polygyny in nonhuman mammals, to the limited degree of polygyny in the human societies that practice it, and to the importance of unequally held rival resources to women's fitness. The muted reproductive inequality observed in humans appears to be linked to several unusual characteristics of our species-including high levels of cooperation among males, high dependence on unequally held rival resources, complementarities between maternal and paternal investment, as well as social and legal institutions that enforce monogamous norms