758 research outputs found

    Understanding how patients' pain beliefs influence chronic low back pain management in Ghana: a grounded theory approach.

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    Chronic low back pain (CLBP) is associated with negative consequences in high and low/middle-income countries. Pain beliefs are important psychosocial factors that affect the occurrence and progression of CLBP and may be influenced by the sociocultural context and interactions with healthcare professionals (HCPs). The pain beliefs of Ghanaian patients with CLBP are unknown and the factors influencing pain beliefs in African contexts are unclear. To explore the pain beliefs of Ghanaian patients with CLBP, how they influence CLBP management/coping and to identify the mechanisms influencing them. Qualitative study using individual semistructured face-to-face interviews, situated within Straussian grounded theory principles and critical realist philosophy. Thirty patients with CLBP accessing physiotherapy at two teaching hospitals in Ghana. Participants suggested dominant biomedical/mechanical beliefs (related to CLBP causes, posture and activity, and the belief of an endpoint/cure for CLBP). Maladaptive beliefs and practices, in particular fear-avoidance beliefs, and dependence on passive management and coping, were common among participants. These beliefs and practices were mostly influenced by HCPs and sociocultural expectations/norms. Although spirituality, pacing activity and prescribed exercises were commonly mentioned by participants, other active strategies and positive beliefs were expressed by a few participants and influenced by patients' themselves. Limited physiotherapy involvement, knowledge and awareness were also reported by participants, and this appeared to be influenced by the limited physiotherapy visibility in Ghana. Participants' narratives suggested the dominant influence of HCPs and the sociocultural environment on their biomedical/mechanical beliefs. These facilitated maladaptive beliefs and adoption of passive coping and management practices. Therefore, incorporation of more positive beliefs and holistic/active strategies by Ghanaian patients and HCPs may be beneficial. Furthermore, patient empowerment and health literacy opportunities to address unhelpful CLBP/sociocultural beliefs and equip patients with management options for CLBP could be beneficial. [Abstract copyright: Ā© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

    Chronic Low Back Pain Beliefs and Management Practices in Africa: Time for a Re-think?

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    Background: Chronic low back pain (CLBP) beliefs are important psychosocial risk factors affecting the occurrence and progression of CLBP. To address pain beliefs and implement recommended biopsychosocial approaches for CLBP management, an understanding of the beliefs of patients and healthcare professionals (HCPs), and also CLBP management practices, is necessary. A narrative review was conducted to explore CLBP beliefs and practices in African countries. Methods: Two systematic searches were conducted using seven databases (MEDLINE, Embase, PsychInfo, CINAHL Plus, AMED, PubMed and Web of Science) with combined variations of the terms ā€œManagementā€, ā€œGuidelinesā€, ā€œChronic Low Back Painā€, ā€œBeliefsā€, ā€œPatientsā€, ā€œHealthcare Professionalsā€ and ā€œAfricaā€. Results: Five studies and one standard treatment guideline document were included. No systematically developed African CLBP treatment guideline was found, although CLBP practices were identified in two African countries. CLBP management in African countries appears to be biomedically orientated. Only three research articles investigated the CLBP beliefs of patients in Africa, with none assessing HCP beliefs. Unhelpful CLBP beliefs (catastrophizing and fear avoidance) and biomedical thoughts about the causes of CLBP were identified. Unhelpful CLBP beliefs were associated with increased disability. Conclusions: Management practices for CLBP in African countries appear to contradict recommended biopsychosocial management guidelines by developed countries and are not sufficiently documented. Research on CLBP beliefs and CLBP management practices in Africa is lacking. To enhance the uptake of biopsychosocial approach in Africa, research around CLBP beliefs in African CLBP patients and HCPs is required

    Gas-plasma compressional wave coupling by momentum transfer

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    Pressure disturbances in a gas-plasma mixed fluid will result in a hybrid response, with magnetosonic plasma waves coupled to acoustic waves in the neutral gas. In the analytical and numerical treatment presented here, we demonstrate the evolution of the total fluid medium response under a variety of conditions, with the gas-plasma linkage achieved by additional coupling terms in the momentum equations of each species. The significance of this treatment lies in the consideration of density perturbations in such fluids: there is no 'pure' mode response, only a collective one in which elements of the characteristics of each component are present. For example, an initially isotropic gas sound wave can trigger an anisotropic magnetic response in the plasma, with the character of each being blended in the global evolution. Hence sound waves do not remain wholly isotropic, and magnetic responses are less constrained by pure magnetoplasma dynamics

    A Qualitative Investigation of the Psychosocial Impact of Chronic Low Back Pain in Ghana

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    Introduction: Chronic low back pain (CLBP) is a global health concern associated with multidimensional/biopsychosocial levels of affectation in developed countries, with holistic management requiring consideration of these factors. There has been minimal research exploring the psychosocial impact of CLBP, and the factors influencing it, in African contexts, with none in Ghana. Objectives: To explore the psychosocial impact of CLBP among patients with CLBP in Ghana. Design: Qualitative study using individual semistructured face-to-face interviews, underpinned by Straussian grounded theory principles and critical realist philosophy. Participants: Thirty patients with CLBP attending physiotherapy at two hospitals in Ghana. Results: Five categories: loss of self and roles, emotional distress, fear, stigmatisation and marginalisation, financial burden, and social support and three mechanisms: acquired biomedical/mechanical beliefs from healthcare professionals (HCPs), sociocultural beliefs and the socioeconomic impact of CLBP were derived. Conclusion: CLBP adversely affects multidimensional/biopsychosocial aspects of individuals experiencing CLBP in Ghana. This delineates the need for a biopsychosocial approach to care. There is the need for HCPs in Ghana to reassess current CLBP management strategies to address the influence of adverse HCPs biomedical inclinations on patientsā€™ psychosocial consequences. Population-based education strategies and consideration of formal support systems for persons with disabling CLBP may also be beneficial

    Systematic review of published studies on aquatic exercise for balance in patients with multiple sclerosis, Parkinson's disease, and hemiplegia

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    AbstractBackgroundMultiple sclerosis, Parkinson's disease, and hemiplegia are common disorders that directly cause impairment of balance and gait. Aquatic exercises are used for neurological rehabilitation. It is suggested that the contributing factors of the water setting such as buoyancy, viscosity, and hydrostatic pressure offer an ideal environment for rehabilitative programmes.ObjectiveTo conduct a systematic review of studies that assess the effect of aquatic exercises on balance in neurological patients (i.e., patients with multiple sclerosis, Parkinson's disease, and hemiplegia).MethodsA systematic literature search of six databases (MEDLINE, PEDro, AMED, CINAHL, Embase, SPORTDiscus) for randomized controlled trials and quasi-experimental trials on aquatic exercises in three different neurological disorders, namely, multiple sclerosis, Parkinson's disease, and hemiplegia, was performed. Reference lists from identified studies were manually searched for additional studies. Methodological quality was assessed using the Downs and Black checklist. The data were analyzed and synthesized by two independent reviewers. Disagreements in extracted data were resolved by discussion among the reviewers.ResultsThe methodological quality of eight studies included in this review ranged from fair to good. The findings illustrated that there were statistically significant improvements in static and dynamic balance in patients with multiple sclerosis and hemiplegia. The statistically significant improvements in gait ability were only found in the studies conducted on multiple sclerosis. No conclusions can be drawn in Parkinson's populations as only two trials conducted with a small sample size were available.ConclusionAquatic exercises may be effective at improving balance impairment in patients with hemiplegia and multiple sclerosis. There is a need for further research investigating its effect on Parkinson's disease before encouraging the use of aquatic exercises

    Ultra-relativistic electrostatic Bernstein waves

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    A new general form of the dispersion relation for electrostatic Bernstein waves in ultra-relativistic pair plasmas, characterized by aāˆ’1Ā =Ā kBT/(mec2)Ā Ā 1, is derived in this paper. The parameter SpĀ =Ā aĪ©0/Ļ‰p, where Ī©0 is the rest cyclotron frequency for electrons or positrons and Ļ‰p is the electron (or positron) plasma frequency, plays a crucial role in characterizing these waves. In particular, Sp has a restricted range for permitted wave solutions; this range is effectively unlimited for classical plasmas, but is significant for the ultra-relativistic case. The characterization of these waves is applied in particular to the presence of such plasmas in pulsar atmospheres
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