Rehabilitation following surgery for lumbar spinal stenosis: a Cochrane review

Study Design A systematic review of randomised controlled trials (RCTs) Objective To determine the effects of active rehabilitation on functional outcome following lumbar spinal stenosis surgery when compared with 'usual postoperative care'. Summary of background data Surgery rates for lumbar spinal stenosis have risen, yet outcomes remain suboptimal. Post-operative rehabilitation has been suggested as a tool to improve post-operative function but, to date, there is limited evidence to support its use. Methods CENTRAL (The Cochrane Library), the Cochrane Back Review Group Trials Register, MEDLINE, EMBASE, CINAHL and PEDro electronic databases were searched. Randomised controlled trials (RCTs) comparing the effectiveness of active rehabilitation with usual care in adults with lumbar spinal stenosis who had undergone primary spinal decompression surgery were included. Two authors independently selected studies, assessed the risk of bias, and extracted the data in line with the recommendations of the Cochrane Back Review Group. Study results were pooled in a meta-analysis when appropriate using functional status as the primary outcome, with secondary outcomes including measures of leg pain, low back pain, and global improvement/general health. The GRADE approach was used to assess the quality of the evidence. Results Our searches yielded 1,726 articles, of which three studies (N = 373 participants) were suitable for inclusion in meta-analysis. All included studies were deemed to have low risk of bias; no study had unacceptably high dropout rates. There was moderate evidence suggesting that active rehabilitation was more effective than usual care in improving both short- and long-term functional status following surgery. Similar findings were noted for secondary outcomes, including short-term improvement in low back pain and long-term improvement in both low back pain and leg pain. Conclusions We obtained moderate-quality evidence indicating that postoperative active rehabilitation after decompression surgery for lumbar spinal stenosis is more effective than usual care. Further work is required particularly with respect to the cost effectiveness of such interventions

Colonialism and conservation: restoration, killing and tourism on Jabugay Yanooa/Pelorus Island

This article describes and analyses the Pelorus experiment, a recent restoration project in which dingoes were used to eradicate goats on a Great Barrier Reef Island. Before they were taken to the island, the dingoes were implanted with a poison capsule that was intended to kill them after they had killed the goats; they were both pest and ‘pesticide’ (Mavhunga 2011). Subsequently, freehold land on the island was marketed as a tourism development site. We contextualise the Pelorus Island goat eradication program within the cultural–political history of carceral colonialism in Australia and show how this experiment relates to ideas about the special role that islands play in conservation. We also piece together the story of what happened to the goats and dingoes involved. Our analysis reveals the ways notions of animal pesthood and ecological restoration are co-opted by conservation and tourism interests. The Pelorus experiment illustrates how illusions of idyllic island sanctuaries, which appeal to contemporary tourism tropes of seclusion within a ‘pristine’ environment, are predicated on the violence inherent to, but obfuscated within, settler-colonialist visions of land for the taking and remaking

The Anthropomorphic Application of Gender Stereotypes to Horses

Gender stereotypes shape human social interaction, often to the detriment of women and those who do not comply with normative expectations of gender. So far, little research has assessed the extent to which people apply gender stereotypes to animals, and the implications this may have for individuals and groups, particularly female animals. The current study investigated survey respondents’ preference for horses to perform in different sport and leisure practices, based solely on ideas about the sex of the animal. An anonymous online survey explored the preferences of riders for mares, geldings and stallions for dressage, show-jumping and trail-riding, and reasons for their choice. A total of 1032 responses were received. Geldings were the preferred choice, being perceived as safe and reliable, followed by stallions who were valued for their supposed power, presence and good looks. Overall, mares were the least popular choice, and were discussed in ambivalent terms reflecting broad gender stereotypes which depict females as moody, flighty and unpredictable. Respondents appeared to draw on gender stereotypes to make judgements about horses and justify their choices. The anthropomorphic application of gender stereotypes to animals may have negative consequences for female animals, shaping human-animal interactions and expectations

Prognostic factors for chronic headache: A systematic review

OBJECTIVE: To identify predictors of prognosis and trial outcomes in prospective studies of people with chronic headache. METHODS: This was a systematic review of published literature in peer-reviewed journals. We included (1) randomized controlled trials (RCTs) of interventions for chronic headache that reported subgroup analyses and (2) prospective cohort studies, published in English, since 1980. Participants included adults with chronic headache (including chronic headache, chronic migraine, and chronic tension-type headache with or without medication overuse headache). We searched key databases using free text and MeSH terms. Two reviewers independently extracted data and assessed the methodologic quality of studies and overall quality of evidence identified using appropriate published checklists. RESULTS: We identified 16,556 titles, removed 663 duplicates, and reviewed 199 articles, of which 27 were included in the review-17 prospective cohorts and 10 RCTs with subgroup analyses reported. There was moderate-quality evidence indicating that depression, anxiety, poor sleep and stress, medication overuse, and poor self-efficacy for managing headaches are potential prognostic factors for poor prognosis and unfavorable outcomes from preventive treatment in chronic headache. There was inconclusive evidence about treatment expectations, age, age at onset, body mass index, employment, and several headache features. CONCLUSIONS: This review identified several potential predictors of poor prognosis and worse outcome postinterventions in people with chronic headache. The majority of these are modifiable. The findings also highlight the need for more longitudinal high-quality research of prognostic factors in chronic headache

Non-pharmacological self-management for people living with migraine or tension-type headache:a systematic review including analysis of intervention components

OBJECTIVES: To assess the effect of non-pharmacological self-management interventions against usual care, and to explore different components and delivery methods within those interventions PARTICIPANTS: People living with migraine and/or tension-type headache INTERVENTIONS: Non-pharmacological educational or psychological self-management interventions; excluding biofeedback and physical therapy.We assessed the overall effectiveness against usual care on headache frequency, pain intensity, mood, headache-related disability, quality of life and medication consumption in meta-analysis.We also provide preliminary evidence on the effectiveness of intervention components and delivery methods. RESULTS: We found a small overall effect for the superiority of self-management interventions over usual care, with a standardised mean difference (SMD) of -0.36 (-0.45 to -0.26) for pain intensity; -0.32 (-0.42 to -0.22) for headache-related disability, 0.32 (0.20 to 0.45) for quality of life and a moderate effect on mood (SMD=0.53 (-0.66 to -0.40)). We did not find an effect on headache frequency (SMD=-0.07 (-0.22 to 0.08)).Assessment of components and characteristics suggests a larger effect on pain intensity in interventions that included explicit educational components (-0.51 (-0.68 to -0.34) vs -0.28 (-0.40 to -0.16)); mindfulness components (-0.50 (-0.82 to -0.18) vs 0.34 (-0.44 to -0.24)) and in interventions delivered in groups vs one-to-one delivery (0.56 (-0.72 to -0.40) vs -0.39 (-0.52 to -0.27)) and larger effects on mood in interventions including a cognitive-behavioural therapy (CBT) component with an SMD of -0.72 (-0.93 to -0.51) compared with those without CBT -0.41 (-0.58 to -0.24). CONCLUSION: Overall we found that self-management interventions for migraine and tension-type headache are more effective than usual care in reducing pain intensity, mood and headache-related disability, but have no effect on headache frequency. Preliminary findings also suggest that including CBT, mindfulness and educational components in interventions, and delivery in groups may increase effectiveness. TRIAL REGISTRATION NUMBER: PROSPERO 2016:CRD42016041291

Long-Term Trends in Phytoplankton Chlorophyll a and Size Structure in the Benguela Upwelling System

This is the final version. Available from American Geophysical Union (AGU) via the DOI in this record.The Benguela Upwelling System (BUS) is among the most productive ecosystems globally, supporting numerous fisheries and ecosystem services in Southern Africa. Sea-viewing Wide Field-of-view Sensor and Moderate-resolution Imaging Spectroradiometer-Aqua chlorophyll a (Chla) concentrations between September 1997 and February 2018 were used to investigate long-term trends in phytoplankton biomass and size structure (microphytoplankton [>20 μm], nanophytoplankton [2–20 μm], and picophytoplankton [<2 μm]) in the Northern Benguela, Southern Benguela (SB), and Agulhas Bank (AB) shelf and open ocean regions of the BUS. Trends in upwelling and correlations with Chla and size structure were examined. Increasing Chla and microphytoplankton trends occurred in the Northern Benguela shelf and open ocean, while decreases were evident on the SB shelf in all seasons. In the SB open ocean, small increases occurred during austral winter, with a decrease in spring. On the AB shelf, increases in Chla and microphytoplankton occurred in summer with decreases during the other seasons. Patterns differed in the AB open ocean, with increases in winter and spring and decreases in summer and autumn. Although R 2 values indicated that linear trends accounted for a reasonable portion of the variance, and most trends were statistically significant, they showed only small changes on the shelf domains and little to no change in the open ocean. Strong correlations between upwelling, Chla, and the size classes were observed, but distinct seasonal differences occurred in each region. This is the first 20-year analysis of phytoplankton biomass and community structure in the BUS and provides a baseline against which future changes can be monitored.NERC National Centre for Earth ObservationSouth African National Research Foundation (NRF)South African Department of Environmental Affair

It's all about the sex, or is it? Humans, horses and temperament

We propose that the anthropomorphic application of gender stereotypes to animals influences human-animal interactions and human expectations, often with negative consequences for female animals. An online survey was conducted to explore riders’ perceptions of horse temperament and suitability for ridden work, based on horse sex. The questionnaire asked respondents to allocate three hypothetical horses (a mare, gelding and stallion) to four riders compromising a woman, man, girl and boy. Riders were described as equally capable of riding each horse and each horse was described as suitable for all riders. Participants were also asked which horses (mares, geldings or stallions) were most suitable for the three equestrian disciplines of showjumping, dressage and trail-riding. Logistic regression analyses were conducted to investigate people’s perceptions about suitability of horse types for particular riders, to evaluate if age, strength or gender were important in rider choice and to investigate riders’allocation of various descriptors to a gelding, stallion or mare. There were 1,233 survey respondents, 94% of whom were female and 75% of whom were riders with at least eight years of experience. Binomial logistic regression revealed the girl had 2.5 times the odds of being allocated the gelding compared to the boy (p < 0.001). Respondents were significantly more likely to allocate the stallion to the man and nearly 50% of respondents did not allocate a horse to the boy, even though they ranked rider gender as least important to their choice (p < 0.001). In a forced choice selection of a positive or negative descriptor from a series of nine paired terms to describe horse temperament, a greater proportion of respondents assigned geldings positive ratings on terms such as calm, trainable, reliable and predictable. In terms of suitability for the three equestrian disciplines of show-jumping, dressage and trail-riding, participants overwhelmingly chose geldings for trail-riding, with mares being least preferred for both dressage and show-jumping. The results suggest that female riders are entering the horse-human dyad with gendered ideas about horse temperament and view horse-riding as an activity primarily for women and girls. This could have far-reaching implications for equine training and welfare

A sustainable campus: The Sydney Declaration on interspecies sustainability

Under the remit of an expanded definition of sustainability – one that acknowledges animal agriculture as a key carbon intensive industry, and one that includes interspecies ethics as an integral part of social justice – institutions such as Universities can and should play a role in supporting a wider agenda for sustainable food practices on campus. By drawing out clear connections between sustainability objectives on campus and the shift away from animal based products, the objective of this article is to advocate for a more consistent understanding and implementation of sustainability measures as championed by university campuses at large. We will draw out clear connections between sustainability objectives on campus and the shift away from animal based products. Overall, our arguments are contextualised within broader debates on the relationship between sustainability, social justice and interspecies ethics. We envisage that such discussion will contribute to an enriched, more robust sense of sustainability—one in which food justice refers not only to justice for human consumers and producers of food and the land used by them, but also to justice for the nonhuman animals considered as potential sources of food themselves

Early biomarkers and potential mediators of ventilation-induced lung injury in very preterm lambs

BACKGROUND: Bronchopulmonary dysplasia (BPD) is closely associated with ventilator-induced lung injury (VILI) in very preterm infants. The greatest risk of VILI may be in the immediate period after birth, when the lungs are surfactant deficient, still partially filled with liquid and not uniformly aerated. However, there have been very few studies that have examined this immediate post-birth period and identified the initial injury-related pathways that are activated. We aimed to determine if the early response genes; connective tissue growth factor (CTGF), cysteine rich-61 (CYR61) and early growth response 1 (EGR1), were rapidly induced by VILI in preterm lambs and whether ventilation with different tidal volumes caused different inflammatory cytokine and early response gene expression. METHODS: To identify early markers of VILI, preterm lambs (132 d gestational age; GA, term approximately 147 d) were resuscitated with an injurious ventilation strategy (V(T) 20 mL/kg for 15 min) then gently ventilated (5 mL/kg) for 15, 30, 60 or 120 min (n = 4 in each). To determine if early response genes and inflammatory cytokines were differentially regulated by different ventilation strategies, separate groups of preterm lambs (125 d GA; n = 5 in each) were ventilated from birth with a V(T) of 5 (VG5) or 10 mL/kg (VG10) for 135 minutes. Lung gene expression levels were compared to levels prior to ventilation in age-matched control fetuses. RESULTS: CTGF, CYR61 and EGR1 lung mRNA levels were increased approximately 25, 50 and 120-fold respectively (p < 0.05), within 30 minutes of injurious ventilation. VG5 and VG10 caused significant increases in CTGF, CYR61, EGR1, IL1- , IL-6 and IL-8 mRNA levels compared to control levels. CTGF, CYR61, IL-6 and IL-8 expression levels were higher in VG10 than VG5 lambs; although only the IL-6 and CYR61 mRNA levels reached significance. CONCLUSION: CTGF, CYR61 and EGR1 may be novel early markers of lung injury and mechanical ventilation from birth using relatively low tidal volumes may be less injurious than using higher tidal volumes