Efficacy of behavioural graded activity compared with conventional exercise therapy in chronic nonspecific low back pain: Implication for direct health care cost

Background: The relative efficacy of conventional exercise therapy (CET) and behavioural graded activity (BGA) has not been fully established to inform the preference in clinical practice.Objective: To compare CET and BGA on the treatment outcome of chronic non-specific low back pain (LBP).Methodology: Participants were assigned into either BGA or CET group in this randomized feasibility intervention. The CET group received supervised exercise therapy while BGA group engaged in individually prescribed sub-maximal activities based on timecontingent principles. Interventions were carried out twice weekly and over a period of 12 weeks. Outcome measures were numerical rating scale and RAND 36- item health survey which were administered at baseline, week 4 and week 12. Health care cost questionnaire was also administered to evaluate physiotherapy cost after 12 weeks. Mixed design two-way ANOVA with level of significance set as priori at p<0.05 was used to compare both groups.Results: Seventy-seven and half percent (62) participants (CET=29 and BGA=33) with mean ages 45.0±12.2 and 43.1±13.2years respectively, completed the study. Both groups improved significantly (p<0.001) during the intervention. However, there were no significant differences (p>0.05) between the treatment groups at any time points and for any measures assessed. Therapeutic benefits in both groups have bearing on direct health care costs.Conclusion: The results indicate that CET and BGA have similar outcomes in patients with chronic nonspecific LBP with regard to the pain and quality of life. Effective application may however be hampered by the cost-related factors thus suggesting evaluation of health care system in Ghana.Key words: Pain; Cognitive Therapy; Exercise Therapy; Quality of life; direct cost

How safe are school and bus environments? Parents’ perception of risks and hazards in the emirate of Dubai

© 2020 Institution of Occupational Safety and Health. The increasing numbers of school bus injuries in the United Arab Emirates have generated concerns over children’s safety on school buses and around school premises. A survey was administered on 550 parents or guardians, whose children use the school bus in public and private schools of Dubai. The main objective was to assess parental perceptions of the school bus and school environments. Parents identified several factors that pose a threat to bus safety including speeding cars, poor driving, lack of seat belt use enforcement, lack of supervision, motorists’ lack of understanding of school bus stop law, and children behaviour. Results suggest a deficiency in the communication of information regarding bus safety and behavioural policies. The study also highlights parents’ concerns over safety in relation to the school bus transport and around school premises, and emphasizes the need for safety education, as well as proper provision and communication of safety policies

Coinfection of cutaneous leishmaniasis and hiv infection

Cutaneous leishmaniasis has recently been discovered in some parts of Ghana. The case of an HIV infected patient presenting with cutaneous leishmaniasis at the Korle-Bu Teaching Hospital is discussed. The diagnosis of leishmaniasis was con-firmed by histology. Also highlighted is the fact that this is the first reported case of dual infection of HIV and Leishmaniasis in Ghana. The possibility of rapid spread to other members of the community, both immunecompetent and immunesuppressed in view of the large numbers of organisms present in the lesion is discussed

Cutaneous Involvement of Hodgkin Lymphoma in a Child – Case Report

Specific cutaneous involvement in Hodgkin Lymphoma is rare and has not been reported in the younger paediatric age group. We report a case of a ten year old girl who presented with specific cutaneous involvement, confirmed using immunohistochemical stains. Treatment with combination chemotherapy resulted in rapid disappearance of the lesions and contrary to the generally poor prognosis associated with most other such reported cases in adults, she has clinically remained disease free two and a half years post treatment. Obtaining an accurate pathological diagnosis is essential to ensure appropriate treatment even in resource limited settings as illustrated by this case

Second-Hand Smoke in a University Campus: Attitudes and Perceptions of Faculty, Staff and Students

Purpose: To examine the attitudes and perceptions of faculty, staff and students concerning tobacco policies at a university campus in a tobacco producing state. Methods: A questionnaire was administered to faculty, staff and students to assess knowledge, attitudes and beliefs related to smoking and exposure to second-hand smoke on campus. A 3-wave e-mailing was used to send the questionnaire. Results: A total of 2,914 individuals responded to the questionnaire. Majority (60%) of the participants believed a smoke free policy would be a positive move and could possibly improve the quality of life for the campus community, while not negatively affecting student enrollment status. Conclusion: Implementing a smoke free policy in university campuses in North America could be acceptable to faculty, staff and students and is unlikely to reduce students enrolment. Our findings have the potential to support efforts to implement smoke free policies on university campuses in North America