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

Influência das avós na alimentação de lactentes: o que dizem suas filhas e noras Influencia de las abuelas en la alimentación de lactantes Influence of grandmothers on infant feeding: what they say to their daughters and granddaughters

OBJETIVO: Identificar as práticas de primíparas sobre a alimentação de crianças lactentes aprendidas com a mãe e/ou sogra. MÉTODOS: Trata-se de pesquisa qualitativa, do tipo descritiva. Os sujeitos foram 11 primíparas, usuárias do Sistema Único de Saúde de Palmeira das Missões/RS. Os dados foram coletados por entrevista semiestruturada e analisados por meio da análise temática. RESULTADOS: Emergiram três temas: práticas de alimentação transmitidas pelas avós; influência das avós na alimentação do lactente; sentimentos das primíparas em relação às ações das avós relativas à alimentação do lactente. CONCLUSÕES: As avós são importantes no que diz respeito à transmissão de conhecimentos, saberes e experiências relativas à alimentação do lactente. Para que a assistência de enfermagem priviligie a autonomia dos sujeitos que envolve corresponsabilidade e congruência cultural, o enfermeiro deve considerar as interações do grupo familiar que, em seu movimento dialético, modulam e são moduladas pela cultura.<br>OBJETIVO: Identificar las prácticas de primigestas sobre la alimentación de niños lactantes aprendidas con la madre y/o suegra. MÉTODOS: Se trata de una investigación cualitativa, de tipo descriptiva. Los sujetos fueron 11 primigestas, usuarias del Sistema Único de Salud de Palmeira das Missões/RS. Los datos fueron recolectados por entrevista semiestructurada y analizados por medio del análisis temático. RESULTADOS: Emergieron tres temas: prácticas de alimentación transmitidas por las abuelas; influencia de las abuelas en la alimentación del lactante; sentimientos de las primigestas en relación a las acciones de las abuelas relativas a la alimentación del lactante. CONCLUSIONES: Las abuelas son importantes en lo referente a la transmisión de conocimientos, saberes y experiencias relativas a la alimentación del lactante. Para que la asistencia de enfermería privilegie la autonomía de los sujetos que involucra corresponsabilidad y congruencia cultural, el enfermero debe considerar las interacciones del grupo familiar que, en su movimiento dialéctico, modulan y son moduladas por la cultura.<br>OBJECTIVE: To identify practices of primiparas about infant feeding of infants learned from the mother and/or grandmother. METHODS: This was a qualitative, descriptive research study. The subjects were 11 primiparas, who used the Unified Health System of Palmeira das Missões/ RS. Data were collected through semi-structured interviews and analyzed using thematic analysis. RESULTS: Three themes emerged: practices of infant feeding transmitted by grandmothers; influence of grandmothers on infant feeding; feelings of primiparas in regard to the actions of grandmothers on infant feeding. CONCLUSIONS: The grandmothers are important with regard to the transmission of knowledge, wisdom and experiences related to infant feeding. For nursing care focused on the subjects' autonomy and responsibility that involves cultural congruence, the nurse should consider that the interactions of the family group, in its dialectical movement, modulate and are modulated by their culture

Archaea on human skin

The recent era of exploring the human microbiome has provided valuable information on microbial inhabitants, beneficials and pathogens. Screening efforts based on DNA sequencing identified thousands of bacterial lineages associated with human skin but provided only incomplete and crude information on Archaea. Here, we report for the first time the quantification and visualization of Archaea from human skin. Based on 16 S rRNA gene copies Archaea comprised up to 4.2% of the prokaryotic skin microbiome. Most of the gene signatures analyzed belonged to the Thaumarchaeota, a group of Archaea we also found in hospitals and clean room facilities. The metabolic potential for ammonia oxidation of the skin-associated Archaea was supported by the successful detection of thaumarchaeal amoA genes in human skin samples. However, the activity and possible interaction with human epithelial cells of these associated Archaea remains an open question. Nevertheless, in this study we provide evidence that Archaea are part of the human skin microbiome and discuss their potential for ammonia turnover on human skin

Fatores interferentes no comportamento das parturientes: enfoque na etnoenfermagem Factores que interfieren en el comportamiento de las parturientas: enfoque en la etnoenfermería Factors that interfere in the parturient women's behavior: focus on etnonursing

O estudo objetivou compreender o comportamento das gestantes em trabalho de parto e parto. Participaram sete parturientes que tiveram filhos por parto normal, em uma maternidade pública de Fortaleza-Ceará. A coleta de dados ocorreu nos meses de junho, julho e agosto de 2003. O método de pesquisa utilizado para a coleta e análise dos dados foi a etnoenfermagem. Os dados investigados nos mostraram através das categorias: vivenciando uma gravidez e assistência na maternidade. Concluímos que são vários os fatores que subsidiam o comportamento da mulher na vivência do trabalho de parto e parto e que a assistência dos profissionais de saúde deve estar sempre voltada para o cuidado humanístico unindo o saber cultural ao científico.<br>El estudio objetivó comprender el comportamiento de las embarazadas en trabajo de parto y parto. Participaron siete parturientas que tuvieron hijos por parto normal, en una maternidad pública de Fortaleza-Ceará. La colecta de datos ocurrió en los meses de junio, julio y agosto de 2003. El método de investigación utilizado para la colecta y análisis de los datos fue la etnoenfermería. Los datos investigados nos mostraron a través de las categorías: viviendo un embarazo y asistencia en la maternidad. Concluimos que son varios los factores que subsidian el comportamiento de la mujer en la vivencia del trabajo de parto y parto y que la asistencia de los profesionales de salud debe estar siempre vuelta para el cuidado humanístico añadiendo el saber cultural al científico.<br>This study aimed to understand the behavior of pregnant women in labor and delivery. Seven parturient women who had their children through normal delivery in a public maternity in Fortaleza, Ceará. Data collection was carried out in June to August, 2003. The research method used for the collection and analysis of data was the ethnonursing. The data studied showed us through the categories: experiencing pregnancy and assistance in the maternity. We concluded that there are several factors that justify the woman's behavior during the experience of labor and delivery and that the health professionals' assistance should be always aimed at the humanistic care linking cultural and scientific knowledge