The effects of the McKenzie Method and strengthening/stabilization exercises in patients with chronic nonspecific low back pain.

Background & objective: Low back pain is a frequent problem that the majority of people will face at some point in their lifetime. Exercise has been advocated as an effective treatment for chronic nonspecific low back pain; however, there is a lack of consensus on the best form of exercise treatment. This review was designed to compare the effectiveness of the McKenzie Method against stabilization/strengthening exercises in patients with chronic nonspecific low back pain. Methods: A literature review examining McKenzie and stabilization exercises for chronic nonspecific low back pain were identified from three databases. Results: A total of nine articles were selected to be included in this review. Included in this review was one systematic review, one literature review with meta-analysis, two reviews, four randomized controlled trials (RCT), and one test-retest design. Each study included McKenzie Method and/or stabilization exercises. Pain and functional disability were reported as outcome measures. Conclusion: Each of the studies reported improvements in the form of decreased pain and/or functional disability with the use of the McKenzie Method and/or stabilization/strengthening techniques. The selection of the treatment intervention should be individualized based on patient presentation and examination findings. Key Words: McKenzie Method, MDT, Chronic Nonspecific Low back pain, Stabilization exercise

Tolerance Equivalency between ΔE*ab and ΔE00 Metrics

In order to be competitive and to meet global brand’s printing requirements, conventional printing is increasingly moving toward standardization. The principal international standard for offset printing is defined ISO 12647-2. The latest revision of ISO 12647-2 (2013) includes ∆E00 as the tolerance metric for deviation assessment, as the traditionally utilized ∆E*ab lacks visual uniformity. However, the tolerance value for ∆E00 from ISO 12647-2 (2013) is informative only. In addition, there is no justification given for how the published ∆E00 values were derived. This research devised a method that uses the %Pass approach in a database to determine the equivalent tolerances between ∆E*ab and ∆E00 and to examine the merit of setting equal or unequal ∆E00 tolerances among CMYK solids. The findings indicate that (1) equal %Pass will result in unequal ∆E*ab-to-∆E00 tolerances, (2) ∆E00 tolerance for K solid does not have to be larger than Cyan and Magenta solids, and (3) ∆E00 tolerance for Yellow solid can be smaller than Cyan and Magenta solids. Printing standardization and certification bodies are encouraged to apply the methodology with larger databases, including non-conforming jobs, to assess the performance of current printing specifications in the graphic arts industry. Their findings are the best impetus for future revision of printing standards

Foreign cash holdings and credit rating: Evidence from U.S. multinationals

Using a sample of listed U.S. multinationals in 1999-2016, we document a positive correlation between foreign cash holdings and credit ratings, suggesting that firms may credibly signal their liquidity by accumulating large foreign cash reserves and pledging not to repatriate “in the foreseeable future”. Also, we find that this positive correlation is stronger in financially distressed firms, suggesting that the escalated signaling costs (e.g., an increased penalty in the case of cash shortages) in financially distressed firms amplify the signaling effect of foreign cash holdings, and thus, strengthen its positive impact on credit rating assessments. These two findings hold for an instrumental variable approach, reducing the likelihood of our results being purely driven by endogeneity bias. In additional analyses, we find that rating agencies are more conservative in discounting the value of foreign cash holdings when multinational firms are at the investment-grade cutoff and/or are subject to higher repatriation costs

My bitterness is deeper than the ocean : understanding internalized stigma from the perspectives of persons with schizophrenia and their family caregivers.

Background: It is estimated that 8 million of the Chinese adult population had a diagnosis of schizophrenia. Stigma associated with mental illness, which is pervasive in the Chinese cultural context, impacts both persons with schizophrenia and their family caregivers. However, a review of the literature found a dearth of research that explored internalized stigma from the perspectives of both patients and their caregivers. Methods: We integrated data from standardized scales and narratives from semi-structured interviews obtained from eight family-dyads. Interview narratives about stigma were analyzed using directed content analysis and compared with responses from Chinese versions of the Internalized Stigma of Mental Illness Scale and Affiliated Stigma Scale. Scores from the two scales and number of text fragments were compared to identify consistency of responses using the two methods. Profiles from three family-dyads were analyzed to highlight the interactive aspect of stigma in a dyadic relationship. Results: Our analyses suggested that persons with schizophrenia and their caregivers both internalized negative valuation from their social networks and reduced engagement in the community. Participants with schizophrenia expressed a sense of shame and inferiority, spoke about being a burden to their family, and expressed self-disappointment as a result of having a psychiatric diagnosis. Caregivers expressed high level of emotional distress because of mental illness in the family. Family dyads varied in the extent that internalized stigma were experienced by patients and caregivers. Conclusions: Family plays a central role in caring for persons with mental illness in China. Given the increasingly community-based nature of mental health services delivery, understanding internalized stigma as a family unit is important to guide the development of cultural-informed treatments. This pilot study provides a method that can be used to collect data that take into consideration the cultural nuances of Chinese societies

Promoting self-management through adherence among heart failure patients discharged from rural hospitals: a study protocol.

UNLABELLED: Background Heart failure is one of the most prevalent chronic conditions in adults, leading to prolonged morbidity, repeated hospitalizations, and placing tremendous economic burden on the healthcare system. Heart failure patients discharged from rural hospitals, or primarily critical access hospitals, have higher 30-day readmission and mortality rates compared to patients discharged from urban hospitals. Self-management improves heart failure patients\u27 health outcomes and reduces re-hospitalizations, but adherence to self-management guidelines is low. We propose a home based post-acute care service managed by advanced practice nurses to enhance patient activation and lead to the improvement of self-management adherence in heart failure patients discharged from rural hospitals. Objective This article describes the study design and research methods used to implement and evaluate the intervention. Method Our intervention is a 12-week patient activation (Patient AcTivated Care at Home [PATCH]) to improve self-management adherence. Patients were randomized into two parallel groups (12-week PATCH intervention + usual care vs. usual care only) to evaluate the effectiveness of this intervention. Outcomes were measured at baseline, 3 and 6 months. Discussion This study aimed to examine the effectiveness of a rural theory based, advance practice nurse led, activation enhancing intervention on the self-management adherence in heart failure patients residing in rural areas. Our expectation is to facilitate adherence to self-management behaviors in heart failure patients following discharge from rural hospitals and decrease complications and hospital readmissions, leading to the reduction of economic burden. CLINICAL TRIAL REGISTRATION INFORMATION: ClinicalTrials.gov; https://register.clinicaltrials.gov/ NCT01964053

Review Strategies to Recruit and Retain Rural Patient Participating Self-management Behavioral Trials

Self-management plays a vital role in improving health outcomes and reducing costs in patient with cardiovascular disease (CVD) and associated risk factors. Based on existing studies, rural residents with CVD and/or risk factors show low engagement in self-management behaviors. Due to low participation in behavioral intervention trials, the most promising mechanism to promote self-management among rural populations is unknown. In turn, the purpose of this article is to review the evidence that supports strategies to recruit and retain rural patients to participate in behavioral intervention trials aimed to promote self-management of CVD and its risk factors. This review is expected to assist researchers in identifying effective solutions to overcome barriers in the recruitment and retention processes when conducting intervention research studies on the self-management of CVD in rural communities

An Investigation of Factors Influencing Color Tolerances

Tolerance is the permissible difference between sample measurement and the aim and is used to determine the acceptability of a product. A well-known example is the color tolerance of printed solids in ISO 12647-2. The first edition of ISO 12647-2 was published in 1996. It has gone through two major revisions. In the 2004 revision, the magnitude of the color tolerance (∆E*ab) was changed. In the 2013 revision, a new color tolerance metric (∆E00) was included. No justification was found regarding the ISO 12647-2 revisions. In this research, %Pass is used to study the effect of color tolerance in a database. Recognizing that tolerance is a man-made decision, if the tolerance is too tight, the %Pass will be low; and vice versa. This research also examines the use of the equal %Pass to determine the tolerance equivalency between the old (∆E*ab) and the new (∆E00) parameter. The results show that there is no convergence between ∆E*ab and ∆E00 when using the boundary data approach. However, there is an equivalent tolerance between ∆E*ab and ∆E00 using the equal %Pass approach. The current ISO 12647-2 standard, using 3.5 ∆E00 for CMY and 5 ∆E00 for black, resulted in unequal %Pass. By using the equal %Pass approach, the black solid tolerance does not need to be different than cyan and magenta solids, but the yellow solid tolerance can be smaller than cyan and magenta solids