Lifting capacity is associated with central sensitization and non-organic signs in patients with chronic back pain

Purpose: To analyze the associations between lifting capacity, and central sensitization (CS) and non-organic signs (NOS) in patients with chronic back pain (CBP) attending vocational rehabilitation. Materials and methods: Cross-sectional observational multicenter study among patients with CBP undergoing a return to work assessment within care as usual. Main analyses: step 1: partial correlation between lifting capacity, and CS, NOS, and additional variables; step 2: multiple regression in stepwise forward method for dependent variable lifting capacity, and for independent variables CS and NOS, and additional variables significant (p < 0.05) at step 1. All analyses were controlled for sex. Results: Fifty-six patients of mean age 42.5 years and 59% women participated in the study. Correlations between lifting capacity and CS and NOS were r = –0.53 and r = –0.50, respectively. CS and NOS, as well as age and sex, contributed significantly to the final regression model, which explained 57.6% of variance. Conclusions: After controlling for confounders, CS and NOS were negatively associated with lifting capacity in patients with CBP. Explained variance was substantially higher than previously reported studies.Implications for Rehabilitation The identification of central sensitization and non-organic signs (NOS) in patients with chronic back pain can alert clinicians about central nervous system being in a hypersensitive state and about pain behavior. Central sensitization and NOS are relevant determinants of lifting capacity. Better understanding of the factors affecting lifting capacity lead to better design and tailoring of interventions, resulting in optimized vocational rehabilitation programs and faster return to work

A pilot study in the association between Waddell Non-organic Signs and Central Sensitization

Study design: A cross-sectional observational multicenter pilot-study was performed within care as usual in three rehabilitation centers in the Netherlands. Objective: To explore the relationship between Waddell Non-organic Signs (NOS) and Central Sensitization (CS) in patients with chronic back pain. Summary of background data: A possible relationship between NOS and CS is theoretically plausible, but it has never been tested. Methods: A cross-sectional observational multicenter pilot-study was performed in three rehabilitation centers in the Netherlands. Patients with chronic back pain were included. Main measures were Waddell's NOS, a battery of eight clinical tests performed during a physical examination, and Central Sensitization Inventory (CSI), a questionnaire measuring symptoms originating from CS. Analyses included Spearman correlation and univariate multiple regression analysis with NOS as dependent variable, CSI as independent, and controlled for confounders (psychosocial variables). Results: Data of n = 56 patients (59% female, mean age 42.6 years) were obtained. Correlation between NOS and CSI was rs = 0.34 (p = 0.01). After controlling for confounders, CSI did not independently predict NOS. Conclusion: In this pilot study, CS was moderately related to NOS, but CS did not independently contribute to NOS after controlling for confounders. The results suggest that NOS may not exclusively be non-organic tests, although questions remain. The results of this pilot study can help to develop larger studies to allow replication and more detailed analyses

Schools, teachers and community: cultivating the conditions for engaged student learning

This paper reveals the nature of the actions, discussions and relationships which characterised teachers' and associated school personnel's efforts to engage poor and refugee students through a community garden located in a school in a low socio-economic urban area in south-east Queensland, Australia. These actions, discussions and relationships are described as both revealing and producing particular 'practice architectures' which help constitute conditions for practice-in this case, conditions for beneficial student learning. The paper draws upon interview data with teachers, other school staff and community members working in the school to reveal the interrelating actions, discussions and relationships involved in developing and using the garden for academic and non-academic purposes. By better understanding such interrelationships as practice architectures, the paper reveals how teachers and those in schooling settings learn to facilitate student learning practices that likely to assist some of the most marginalised students in schooling settings

Extramuscular myofascial force transmission alters substantially the acute effects of surgical aponeurotomy: assessment by finite element modeling

Effects of extramuscular myofascial force transmission on the acute effects of aponeurotomy were studied using finite element modeling and implications of such effects on surgery were discussed. Aponeurotomized EDL muscle of the rat was modeled in two conditions: (1) fully isolated (2) with intact extramuscular connections. The specific goal was to assess the alterations in muscle length-force characteristics in relation to sarcomere length distributions and to investigate how the mechanical mechanism of the intervention is affected if the muscle is not isolated. Major effects of extramuscular myofascial force transmission were shown on muscle length-force characteristics. In contrast to the identical proximal and distal forces of the aponeurotomized isolated muscle, substantial proximo-distal force differences were shown for aponeurotomized muscle with extramuscular connections (for all muscle lengths F dist > F prox after distal muscle lengthening). Proximal optimal length did not change whereas distal optimal length was lower (by 0.5 mm). The optimal forces of the aponeurotomized muscle with extramuscular connections exerted at both proximal and distal tendons were lower than that of isolated muscle (by 15 and 7%, respectively). The length of the gap separating the two cut ends of the intervened aponeurosis decreases substantially due to extramuscular myofascial force transmission. The amplitude of the difference in gap length was muscle length dependent (maximally 11.6% of the gap length of the extramuscularly connected muscle). Extramuscular myofascial force transmission has substantial effects on distributions of lengths of sarcomeres within the muscle fiber populations distal and proximal to the location of intervention: (a) Within the distal population, the substantial sarcomere shortening at the proximal ends of muscle fibers due to the intervention remained unaffected however, extramuscular myofascial force transmission caused a more pronounced serial distribution towards the distal ends of muscle fibers. (b) In contrast, extramuscular myofascial force transmission limits the serial distribution of sarcomere lengths shown for the aponeurotomized isolated muscle in the proximal population. Fiber stress distributions showed that extramuscular myofascial force transmission causes most sarcomeres within the aponeurotomized muscle to attain lengths favorable for higher force exertion. It is concluded that acute effects of aponeurotomy on muscular mechanics are affected greatly by extramuscular myofascial force transmission. Such effects have important implications for the outcome of surgery performed to improve impeded function since muscle in vivo is not isolated both anatomically and mechanically

Appraisal for quality learning

Educational quality is a concern for the New Zealand community and there are various views about how it can be achieved. There is significant support for the view that excellence in teaching is the key to quality education, and therefore teacher appraisal has become an increasingly important issue. Two broad schools of thought on teacher appraisal can be identified, and they are based on different assumptions about teachers and the nature of the teaching task. In this article I have called these two perspectives the bureaucratic managerial perspective, and the professional perspective. In reviewing teacher appraisal from these differing viewpoints, issues emerged around the themes of foundational issues, ethical issues, and affective issues. In concluding this article, the implications of these issues are explored for educational leadership, particularly in the context of the recent educational reforms in New Zealand

Middle leading and influence in two Australian schools

Increasingly, educational systems are appreciating the importance of middle leaders leading educational improvement in schools. Schools depend on middle leaders to lead site-based educational development in areas including curriculum development, teacher professional learning and student learning improvement. Middle leaders are in a unique but complex position where they influence both executive leadership and teachers within the school organisation. Adopting case study methodology to investigate the practices and influence of middle leaders leading a school-based educational development project, three semi-structured interviews and artefacts from two middle leaders were collected over eight months. The theory of practice architectures afforded an examination of data to explain the conditions and arrangements enabling and constraining the middle leaders\u27 practices of influence. The findings showed middle leaders\u27 influence was dependent on executive leadership support, time, formal role descriptions and trusting relationship. Furthermore, the results reveal middle leaders can influence educational development at the school level through advocating for, collaborating with, and empowering colleagues to support teacher ownership of site-based projects. Of interest, this study showed influence can be reciprocal, between middle leaders and colleagues, and between middle leaders and executive leadership

Cultivating community: detailing school and community engagement under complex conditions

This article reveals the nature of actions, discussions and relationships which helped forge school-community partnerships for engaged student learning and wider community participation for students and families living under difficult socio-economic circumstances. Specifically, the article draws upon interviews with key personnel and staff involved in the establishment and enactment of a ‘Community Partnerships’ programme to help improve the opportunities for students attending a primary school serving a low socio-economic urban community in south-east Queensland, Australia. Drawing upon the notion of educational practice as a product of ongoing interactions between particular actions (doings), discussions (sayings) and relationships (relatings), which both constitute and are responsive to particular conditions or ‘architectures’ for practice, the article reveals how the conceptualisation, establishment and consolidation of the community partnerships programme was dependent upon specific ‘relatings’ between key district and school personnel, the actions/‘doings’ of these personnel and ongoing ‘sayings’/dialogue about their work. Collectively, these ‘doings’, ‘sayings’ and ‘relatings’ all helped to stimulate new conditions – ‘practice architectures’ – for improved opportunities for students and their families. Teacher education informed by such theorising of community partnerships as the product of specific actions, dialogue and relationship-building is vital for developing improved understandings of such interactions and partnerships over time

Student engagement and educational rapport in higher education

Comprend des références bibliographiques et un index.This book outlines a range of innovative methods to gather student feedback, and explores the complex relation between student engagement, student satisfaction, and student success. Drawing on results from a set of numerous case-studies carried out at a school of education, the book reports on a range of theoretically-informed teaching innovations, including focus groups, learning analytics data, collegial conversations and insights from student researchers, that have been designed to create respectful, student-centred, and engaging learning environments. In the current climate of ever-increasing pressure on delivering high student satisfaction rates, these results are invaluable for university students and teachers across the globe.With its unique thematic focus on educational rapport and relationship-centred education, the book is an excellent reference point for staff with a commitment to the scholarship of learning and teaching. It will be of great interest to students, practitioners, teachers and policy makers in higher education.

Contextualizing, orchestrating and learning for leading: The praxis and particularity of educational leadership practices

The importance of leadership for improving educational outcomes in schools has been widely promoted. However, the nature of leadership practices, in context, has received less attention in the educational leadership literature. In this article, we present a case study of the specific leadership practices that developed in one school site serving the learning needs of students in a complex, diverse, low socio-economic community in south-east Queensland, Australia. Rather than focusing on the person/role of ‘the leader’, or various leadership qualities/traits, we examine the nature and particularity of the leadership practices as praxis, across a variety of roles and dispositions, as developed within the school. To help make sense of the praxis and particularity of educational leadership practices, we draw upon recent neo-Aristotelian practice theory to reveal the specific actions (‘doings’), dialogue (‘sayings’) and relationships (‘relatings’), which constituted leadership-in-practice, as praxis. These ‘doing’, ‘sayings’ and ‘relatings’ for praxis were evident in: formal leadership practices responsive to the context and history of the particular school site; formal and informal leadership practices involved in establishing a ‘leadership group’ within the school to address students’ needs, and; and informal leadership practices focused on cultivating teacher learning for student learning. Such an approach does not simply reinforce sedimented notions of what constitutes ‘educational leadership’, but sheds new light upon the nature of ‘leading practices for praxis’

Learning practices: Financial literacy in an Aboriginal community

In this chapter, we focus on the financial literacy education (FLE) practices in an Aboriginal community in Canada. We discuss the role of FLE in this Community and describe how a form of site-based education development occurred. The importance of praxis, the moral and ethical aspect of teaching by FLE practitioners is also explored. Next, we identify the ecological arrangements of FLE practices and Community members' financial practices. The enabling and constraining practice architectures encountered in the site are identified and explained. It is important to point out that the first named author of this paper is a member of this Aboriginal community and so in conjunction with fellow Community members, the approaches to learning and their felt needs were explored. Last, we will outline the implications for FLE practitioners/educators we identified working in this site