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

Rare and low-frequency coding variants alter human adult height

Height is a highly heritable, classic polygenic trait with ~700 common associated variants identified so far through genome - wide association studies . Here , we report 83 height - associated coding variants with lower minor allele frequenc ies ( range of 0.1 - 4.8% ) and effects of up to 2 16 cm /allele ( e.g. in IHH , STC2 , AR and CRISPLD2 ) , >10 times the average effect of common variants . In functional follow - up studies, rare height - increasing alleles of STC2 (+1 - 2 cm/allele) compromise d proteolytic inhibition of PAPP - A and increased cleavage of IGFBP - 4 in vitro , resulting in higher bioavailability of insulin - like growth factors . The se 83 height - associated variants overlap genes mutated in monogenic growth disorders and highlight new biological candidates ( e.g. ADAMTS3, IL11RA, NOX4 ) and pathways ( e.g . proteoglycan/ glycosaminoglycan synthesis ) involved in growth . Our results demonstrate that sufficiently large sample sizes can uncover rare and low - frequency variants of moderate to large effect associated with polygenic human phenotypes , and that these variants implicate relevant genes and pathways

Factors Associated with Revision Surgery after Internal Fixation of Hip Fractures

Background: Femoral neck fractures are associated with high rates of revision surgery after management with internal fixation. Using data from the Fixation using Alternative Implants for the Treatment of Hip fractures (FAITH) trial evaluating methods of internal fixation in patients with femoral neck fractures, we investigated associations between baseline and surgical factors and the need for revision surgery to promote healing, relieve pain, treat infection or improve function over 24 months postsurgery. Additionally, we investigated factors associated with (1) hardware removal and (2) implant exchange from cancellous screws (CS) or sliding hip screw (SHS) to total hip arthroplasty, hemiarthroplasty, or another internal fixation device. Methods: We identified 15 potential factors a priori that may be associated with revision surgery, 7 with hardware removal, and 14 with implant exchange. We used multivariable Cox proportional hazards analyses in our investigation. Results: Factors associated with increased risk of revision surgery included: female sex, [hazard ratio (HR) 1.79, 95% confidence interval (CI) 1.25-2.50; P = 0.001], higher body mass index (fo

Parliament in gross human rights violations: the case of Darfur

Based on a study of three European parliaments, the article analyses parliamentary oversight on government policy towards gross human rights violations in third countries using the case of Darfur in Sudan (2003–2005). We find that parliaments with greater constitutional rights in foreign policy are more active in the scrutiny of executive action. Scrutiny is stronger in parliaments with developed and strong foreign affairs committees. Media and public awareness correlate with greater oversight activities in all the three chambers considered. In their oversight, MPs do not deter governments to consider the use of armed forces. Rather than revealing party differences, conflicts involving gross human rights violations such as Darfur are venues for the manifestation of division between the executive and legislature

Success And Failures Of SWFS On The Macroeconomic Performance, Time-Varying Objectives And First Liquidations Of Sovereign Wealth Funds

There are now more than 100 Sovereign Wealth Funds around the world and some exist for more than 50 years. Currently, they face headwinds due to the end of the commodity supercycle and to gradual reduction of the global imbalances. We review what remains from their original definitions and discuss the SWFs’ alternative institutional design for reaching their objectives (saving, stabilization and development). We find that SWFs are more heterogenous than ever. We then review the available literature on the assessment of their effectiveness in stabilizing the economy, economic development and long-term savings. We find that this is a severely understudied area. By extension, not all SWF have had a successful track-record and the world has moved into a period with regular SWF liquidations, which may be a new area research

Policy Options for Labour Market Challenges in Amsterdam and Other Dutch Cities

Labour markets across the Netherlands recovered quickly from the COVID-19 shock and Dutch cities are now facing an unprecedented level of labour market tightness. The high demand for workers presents a unique opportunity for Dutch municipalities to find pathways into employment for those with the lowest labour market attachment and alleviate the pressure faced by local employers that struggle to find suitable workers. Supporting the diverse population in Dutch cities in finding their way into the labour market requires the efficient use of existing labour market instruments, advancing innovative methods of skills-based job matching and improving the cooperation between national, regional and local labour market institutions. This OECD report analyses current and future bottlenecks that could hamper the effective provision of local labour market services. It highlights policy options for strengthening the capacity of municipalities to support different population groups in making the transition from social welfare recipients to workers.<br/

The imperial roots of global trade

Throughout history empires facilitated trade within their territories by building and securing trade and migration routes, and by imposing common norms, languages, religions, and legal systems, all of which led to the accumulation of imperial capital. In this paper, we collect novel data on the rise and fall of empires over the last 5000 years, construct a measure of accumulated imperial capital between countries, and estimate its relationship with trade patterns today. Our measure of imperial capital has a positive and significant effect on trade beyond potential historical legacies such as sharing a language, a religion, a legal system, or links via natural trade and invasion routes. This suggests a persistent and previously unexplored influence of long-gone empires on current trade

The imperial roots of global trade

Throughout history empires facilitated trade within their territories by building and securing trade and migration routes, and by imposing common norms, languages, religions, and legal systems, all of which led to the accumulation of imperial capital. In this paper, we collect novel data on the rise and fall of empires over the last 5000 years, construct a measure of accumulated imperial capital between countries, and estimate its relationship with trade patterns today. Our measure of imperial capital has a positive and significant effect on trade beyond potential historical legacies such as sharing a language, a religion, a legal system, or links via natural trade and invasion routes. This suggests a persistent and previously unexplored influence of long-gone empires on current trade

A Service of zbw Leibniz-Informationszentrum Wirtschaft Leibniz Information Centre for Economics Dutch disease and the mitigation effect of migration: Evidence from Canadian provinces Dutch Disease and the Mitigation Effect of Migration: Evidence from Can

Standard-Nutzungsbedingungen: Die Dokumente auf EconStor dürfen zu eigenen wissenschaftlichen Zwecken und zum Privatgebrauch gespeichert und kopiert werden. Sie dürfen die Dokumente nicht für öffentliche oder kommerzielle Zwecke vervielfältigen, öffentlich ausstellen, öffentlich zugänglich machen, vertreiben oder anderweitig nutzen. Sofern die Verfasser die Dokumente unter Open-Content-Lizenzen (insbesondere CC-Lizenzen) zur Verfügung gestellt haben sollten, gelten abweichend von diesen Nutzungsbedingungen die in der dort genannten Lizenz gewährten Nutzungsrechte. This paper looks at whether immigration can mitigate the Dutch disease effects associated with booms in natural resource sectors. We first derive predicted changes in the size of the non-tradable sector from a small general-equilibrium model à la Obstfeld-Rogoff, supplemented by a resource income and a varying labour supply. Using data for Canadian provinces, we test for the existence of a mitigating effect of immigration in terms of an increase in the size of the non-tradable sector triggered by the positive resource shock in booming regions. We find evidence of such an effect for the aggregate inflow of migrants. Disentangling those flows by type of migrants, we find that the mitigation effect is due mostly to interprovincial migration and temporary international migration. There is no evidence of such an effect for permanent international immigration. Nevertheless, interprovincial migration also results in a spreading effect of Dutch disease from booming to non-booming provinces. Terms of use: Documents in JEL-Code: F220, O150, R110, R150