98 research outputs found

    Pelvic girdle pain - associations between risk factors in early pregnancy and disability or pain intensity in late pregnancy: a prospective cohort study

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    <p>Abstract</p> <p>Background</p> <p>Recent studies have shown high prevalence rates for pelvic girdle pain (PGP) in pregnancy. Some risk factors for developing PGP have been suggested, but the evidence is weak. Furthermore there is almost no data on how findings from clinical examinations are related to subsequent PGP. The main purpose for this study was to study the associations between socio-demographical, psychological and clinical factors measured at inclusion in early pregnancy and disability or pain intensity in gestation week 30.</p> <p>Methods</p> <p>This is a prospective cohort study following women from early to late pregnancy. Eligible women were recruited at their first attendance at the maternity care unit. 268 pregnant women answered questionnaires and underwent clinical examinations in early pregnancy and in gestation week 30. We used scores on disability and pain intensity in gestation week 30 as outcome measures to capture the affliction level of PGP. Multiple linear regression analysis was used to study the associations between potential risk factors measured in early pregnancy and disability or pain intensity in gestation week 30.</p> <p>Results</p> <p>Self-reported pain locations in the pelvis, positive posterior pelvic pain provocation (P4) test and a sum of pain provocation tests in early pregnancy were significantly associated with disability and pain intensity in gestation week 30 in a multivariable statistic model. In addition, distress was significantly associated with disability. The functional active straight leg raise (ASLR) test, fear avoidance beliefs and the number of pain sites were not significantly associated with either disability or pain intensity.</p> <p>Conclusions</p> <p>The results suggest that a clinical examination, including a few tests, performed in early pregnancy may identify women at risk of a more severe PGP late in pregnancy. The identification of clinical risk factors may provide a foundation for development of targeted prevention strategies.</p

    Pregnancy related back pain, is it related to aerobic fitness? A longitudinal cohort study

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    <p>Abstract</p> <p>Background</p> <p>Low back pain with onset during pregnancy is common and approximately one out of three women have disabling pain. The pathogenesis of the pain condition is uncertain and there is no information on the role of physical fitness. Whether poorer physical conditioning is a cause or effect of back pain is also disputed and information from prospective studies needed.</p> <p>Methods</p> <p>A cohort of pregnant women, recruited from maternal health care centers in central Sweden, were examined regarding estimated peak oxygen uptake by cycle ergometer test in early pregnancy, reported physical activity prior to pregnancy, basic characteristics, back pain during pregnancy and back pain postpartum.</p> <p>Results</p> <p>Back pain during the current pregnancy was reported by nearly 80% of the women. At the postpartum appointment this prevalence was 40%. No association was displayed between estimated peak oxygen uptake and incidence of back pain during and after pregnancy, adjusted for physical activity, back pain before present pregnancy, previous deliveries, age and weight. A significant inverse association was found between estimated peak oxygen uptake and back pain intensity during pregnancy and a direct association post partum, in a fully adjusted multiple linear regression analysis.</p> <p>Conclusions</p> <p>Estimated peak oxygen uptake and reported physical activity in early pregnancy displayed no influence on the onset of subsequent back pain during or after pregnancy, where the time sequence support the hypothesis that poorer physical deconditioning is not a cause but a consequence of the back pain condition. The mechanism for the attenuating effect of increased oxygen uptake on back pain intensity is uncertain.</p

    Simple word of mouth or complex resource orchestration for overcoming liabilities of outsidership

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    Drawing on the resource orchestration literature, we explore the processes by which transnational entrepreneurs offset the liabilities of outsidership they face in their host country. We show how these entrepreneurs’ outsidership with respect to domestic business networks of the host country is compensated by their involvement in diaspora networks. Our second contribution lies in an extension of the resource orchestration framework, as we show that sequencing of resource orchestration processes is important for the implementation of the entrepreneurs’ strategy for using their embeddedness within the diaspora network for enhancing their competitiveness, and can lead to lead to groupings of activities that differ from the groupings found in the original version of the framework

    Diet in irritable bowel syndrome

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    Alfven: magnetosphere-ionosphere connection explorers

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    The aurorae are dynamic, luminous displays that grace the night skies of Earth’s high latitude regions. The solar wind emanating from the Sun is their ultimate energy source, but the chain of plasma physical processes leading to auroral displays is complex. The special conditions at the interface between the solar wind-driven magnetosphere and the ionospheric environment at the top of Earth’s atmosphere play a central role. In this Auroral Acceleration Region (AAR) persistent electric fields directed along the magnetic field accelerate magnetospheric electrons to the high energies needed to excite luminosity when they hit the atmosphere. The “ideal magnetohydrodynamics” description of space plasmas which is useful in much of the magnetosphere cannot be used to understand the AAR. The AAR has been studied by a small number of single spacecraft missions which revealed an environment rich in wave-particle interactions, plasma turbulence, and nonlinear acceleration processes, acting on a variety of spatio-temporal scales. The pioneering 4-spacecraft Cluster magnetospheric research mission is now fortuitously visiting the AAR, but its particle instruments are too slow to allow resolve many of the key plasma physics phenomena. The AlfvĂ©n concept is designed specifically to take the next step in studying the aurora, by making the crucial high-time resolution, multi-scale measurements in the AAR, needed to address the key science questions of auroral plasma physics. The new knowledge that the mission will produce will find application in studies of the Sun, the processes that accelerate the solar wind and that produce aurora on other planet

    Posterior pelvic pain provocation test is negative in patients with lumbar herniated discs

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    The classification of pelvic girdle pain can only be reached after lumbar causes have been excluded by a clinical examination. During clinical examination, the posterior pelvic pain provocation test is a well-established method for verifying pelvic girdle pain. However, a criticism of pelvic pain provocation tests is that they may have an effect on lumbar structures, thus yielding false-positive results. The posterior pelvic pain provocation test was performed with four groups of patients: patients with computed tomography-verified disc herniations (1) on the waiting list for surgery (14 women; 9 men); (2) 6 weeks after disc surgery (18 women, 12 men); (3) pregnant women seeking care for pelvic girdle pain (n = 25); and (4) women with persistent pelvic girdle pain after delivery (n = 32). The sensitivity of the posterior pelvic pain provocation test was 0.88 and the specificity was 0.89. The positive predictive value was 0.89 and the negative predictive value was 0.87. Analysis of only women showed similar results. In our study, the posterior pelvic pain provocation test was negative in patients with a well-defined lumbar diagnosis of lumbar disc herniation, both before and after disc surgery. Our results are an important step toward the more accurate classification of lumbopelvic pain

    Does caesarean section negatively influence the post-partum prognosis of low back pain and pelvic pain during pregnancy?

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    Low back and pelvic pain (LBPP) is prevalent during pregnancy and also post-partum. The aetiology is poorly understood. The aim of this study was to investigate possible associations between epidural or spinal anaesthesia and caesarean section (CS) with persistent LBPP half a year after pregnancy. In a previous questionnaire study (n=891) altogether 639 (72%) women had reported LBPP during pregnancy. We sent these respondents a second questionnaire at approximately 6 months post-delivery. The response rate was 72.6% (n=464). The respondents were divided into three groups reporting ‘no pain’, ‘recurrent pain’ and ‘continuous pain’ in relation to LBPP 6 months after delivery. Pearson’s chi-square test was used to test the difference between groups and logistic regression analysis was performed. Forty percent of the respondents had received epidural anaesthesia (EDA) or spinal anaesthesia during delivery and 18.5% of women had been delivered by CS. Epidural or spinal anaesthesia was not associated with persistent LBPP. There was no significant difference in CS rates between different sub-groups. The risk of persistent LBPP was increased three- to fourfold in women delivered by elective CS compared with women delivered by emergency CS. Epidural or spinal anaesthesia was not associated with risk of persistent LBPP. Elective CS was associated with an increased risk of persistent LBPP. However, the results must be interpreted with caution because of a relatively small study sample

    Auroral Small-and Meso-Scale Structures, Origin and Function

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    International audienceDiscrete auroral arcs regularly display small- and meso-scale distortions that can appear suddenly and move with speeds that are not related to plasma speeds in the ionosphere but rather represent properties of the acceleration processes in the magnetosphere. The temporal and spatial structure of each small-scale structure is thus evidence for its distinct dynamic role in the interaction between the hot magnetospheric and the cold, dense ionospheric plasmas. We analyzed passes of Reimei and FAST over the network of THEMIS Ground-Based Observatories (GBO) with all-sky cameras to combine small- and medium-scale auroral imaging with in-situ measurements of the precipitating particles in order to determine the properties and characteristics of auroral arcs and embedded small-scale structures. The THEMIS or Cluster spacecraft provided additional measurements of magnetospheric plasma and the GBO magnetometers allowed for the determination of ionospheric currents and their dynamic changes. The combination of in-situ and remotely determined auroral arc properties allowed for the complete characterization of a substorm breakup arc and embedded small-scale structures. We find consistency between theoretical expectations and observed values for arc and fold speeds and dimensions. The leading edge of the breakup arc with Alfvenic accelerated electrons exhibits the fastest fold speeds while the wider inverted-V arc shows less structure and internal speeds. Twin vortex shear flows observed by two of the THEMIS spacecraft are related to the poleward expansion of the breakup arc, the development of the substorm current wedge, and the appearance of a strong upward/downward current system. The scale size and motion of the small-scale structures signifies the dynamics of the magnetospheric plasma and the acceleration processes responsible for their generation
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