Intensive spa and exercise therapy program for returning to work for low back pain patients: a randomized controlled trial

Abstract We aimed to determine whether a 5-day intensive inpatient spa and exercise therapy and educational program is more effective than usual care in improving the rate of returning to work at 1 year for patients with subacute and chronic low back pain (LBP) on sick leave for 4 to 24 weeks. We conducted a 12-month randomized controlled trial. LBP patients were assigned to 5-day spa (2 hr/day), exercise (30 min/day) and education (45 min/day) or to usual care. The primary outcome was the percentage of patients returning to work at 1 year after randomization. Secondary outcomes were pain, disability and health-related quality of life at 1 year and number of sick leave days from 6 to 12 months. The projected recruitment was not achieved. Only 88/700 (12.6%) patients planned were enrolled: 45 in the spa therapy group and 43 in the usual care group. At 1 year, returning to work was 56.3% versus 41.9% (OR 1.69 [95% CI 0.60–4.73], p = 0.32) respectively. There was no significant difference for any of the secondary outcomes. However, our study lacked power

Ectopic calcification in the Azores - Clinical and radiological manifestations of Diffuse Idiopathic Skeletal Hypertosis and Chondrocalcinosis families

Objective. Twelve families that were multiply affected with diffuse idiopathic skeletal hyperostosis (DISH) and/or chondrocalcinosis, were identified on the island of Terceira, The Azores, potentially supporting the hypothesis that the 2 disorders share common etiopathogenic factors. The present study was undertaken to investigate this hypothesis. Methods. One hundred three individuals from 12 unrelated families were assessed. Probands were identified from patients attending the Rheumatic Diseases Clinic, Hospital de Santo Espirito, in The Azores. Family members were assessed by rheumatologists and radiologists. Radiographs of all family members were obtained, including radiographs of the dorsolumbar spine, pelvis, knees, elbows, and wrists, and all cases were screened for known features of chondrocalcinosis. Results. Ectopic calcifications were identified in 70 patients. The most frequent symptoms or findings were as follows: axial pain, elbow, knee and metacarpophalangeal (MCP) joint pain, swelling, and/or deformity, and radiographic enthesopathic changes. Elbow and MCP joint periarticular calcifications were observed in 35 and 5 patients, respectively, and chondrocalcinosis was identified in 12 patients. Fifteen patients had sacroiliac disease (ankylosis or sclerosis) on computed tomography scans. Fifty-two patients could be classified as having definite (17%), probable (26%), or possible (31%) DISH. Concomitant DISH and chondrocalcinosis was diagnosed in 12 patients. Pyrophosphate crystals were identified from knee effusions in 13 patients. The pattern of disease transmission was compatible with an autosomal-dominant monogenic disease. The mean age at which symptoms developed was 38 years. Conclusion. These families may represent a familial type of pyrophosphate arthropathy with a phenotype that includes peripheral and axial enthesopathic calcifications. The concurrence of DISH and chondrocalcinosis suggests a shared pathogenic mechanism in the 2 conditions

Where and With Whom Does a Brief Social-Belonging Intervention Promote Progress in College?

A promising way to mitigate inequality is by addressing students’ worries about belonging. But where and with whom is this social-belonging intervention effective? Here we report a team-science randomized controlled experiment with 26,911 students at 22 diverse institutions. Results showed that the social-belonging intervention, administered online before college (in under 30 minutes), increased the rate at which students completed the first year as full-time students, especially among students in groups that had historically progressed at lower rates. The college context also mattered: The intervention was effective only when students’ groups were afforded opportunities to belong. This study develops methods for understanding how student identities and contexts interact with interventions. It also shows that a low-cost, scalable intervention generalizes its effects to 749 4-year institutions in the United States

L’âge du Fer en Basse-Normandie. Gestes funéraires en Gaule au Second-Âge du Fer. Volumes I et II

Cet ouvrage est la publication des actes du 33e colloque international de l’AFEAF, qui s’est tenu à Caen, du 20 au 24 mai 2009. De même que le colloque, il comprend deux parties. La première, qui contient dix-sept contributions, traite de l’actualité des recherches sur l’Âge du fer en Basse-Normandie, une région qui a connu un renouvellement important de la documentation permettant d’appréhender les dynamiques d’occupation et les formes d’organisation territoriale durant la Protohistoire. Plusieurs bilans synthétiques concernant l’habitat rural, les sites fortifiés et la culture matérielle, sont, entre autres, proposés ici. La seconde partie de l’ouvrage traite du thème de la mort et des pratiques funéraires durant la période Ve-Ier siècles avant J.-C. ; elle contient vingt-deux contributions. Ce sujet a été abordé en privilégiant quelques axes de réflexion, de façon à faciliter les comparaisons entre régions. À travers des bilans synthétiques, le thème spécialisé du colloque est traité à l’échelle de la Gaule, avec les éclairages de plusieurs régions de l’Europe celtique.This is the publication of the proceedings of the 33rd AFEAF symposium held in Caen from the 20th to the 24th of May 2009. Like the symposium, this book is divided in two parts. The first part, with its 17 contributions, deals with the current knowledge about the Iron Age in Lower Normandy. An important renewal of the documentation concerning this region allows a better understanding of the occupational processes and territorial organization existing throughout Protohistory. This first part also includes several summary reports on rural settlements, fortified sites as well as finds. The second part of the book, with 22 contributions, deals with the subject of death and funerary practices during the 5th to 1st centuries BC. The subject was discussed focussing on a chosen number of thoughts as to make it easier to compare between different regions. Various summary reports allow an overview of this specialized topic throughout Gaul with perspectives from other regions of Celtic Europe