The Use of Manual Therapy In The Treatment Of A Patient With Chronic Low Back Pain And Sciatica: A Case Report

Low back pain (LBP) is the second most common cause of disability in adults with total costs estimated to be between $100 and$200 billion annually on the US economy. The prevalence of chronic LBP rose significantly over a 14-year interval (1992 to 2006), from 3.9% to 10.2%. Treatment of LBP may be conservative or surgical, with conservative being the mainstream initial treatment before a consideration of a surgical option. A surgical option is usually recommended when there is evidence of worsening nerve damage. In a physical therapy (PT) outpatient setting, chronic LBP is one of the most common conditions encountered. Primary evidence-based treatment options include exercise therapy and manual therapy; both have been shown to benefit many patients. The purpose of this case report is to report the effects of a short-course manual therapy intervention for a patient who presented with chronic LBP and sciatica.https://dune.une.edu/pt_studcrposter/1091/thumbnail.jp

Benefit and risk of intrathecal morphine without local anaesthetic in patients undergoing major surgery: meta-analysis of randomized trials

Intrathecal morphine without local anaesthetic is often added to a general anaesthetic to prevent pain after major surgery. Quantification of benefit and harm and assessment of dose-response are needed. We performed a meta-analysis of randomized trials testing intrathecal morphine alone (without local anaesthetic) in adults undergoing major surgery under general anaesthesia. Twenty-seven studies (15 cardiac-thoracic, nine abdominal, and three spine surgery) were included; 645 patients received intrathecal morphine (dose-range, 100-4000 µg). Pain intensity at rest was decreased by 2 cm on the 10 cm visual analogue scale up to 4 h after operation and by about 1 cm at 12 and 24 h. Pain intensity on movement was decreased by 2 cm at 12 and 24 h. Opioid requirement was decreased intraoperatively, and up to 48 h after operation. Morphine-sparing at 24 h was significantly greater after abdominal surgery {weighted mean difference, −24.2 mg [95% confidence interval (CI) −29.5 to −19.0]}, compared with cardiac-thoracic surgery [−9.7 mg (95% CI −17.6 to −1.80)]. The incidence of respiratory depression was increased with intrathecal morphine [odds ratio (OR) 7.86 (95% CI 1.54-40.3)], as was the incidence of pruritus [OR 3.85 (95% CI 2.40-6.15)]. There was no evidence of linear dose-responsiveness for any of the beneficial or harmful outcomes. In conclusion, intrathecal morphine decreases pain intensity at rest and on movement up to 24 h after major surgery. Morphine-sparing is more pronounced after abdominal than after cardiac-thoracic surgery. Respiratory depression remains a major safety concer

Optimalisasi Kinerja Upt Balai Latihan Kerja Dinas Sosial Tenaga Kerja dan Transmigrasi Kabupaten Kudus

Kudus Job Training Center (BLK) is a Technical Unit The Social Departement Of Manpower and Transmigration Kudus District. BLK is expected to be a forum for candidates for employment to become entrepreneurs and to get a job. But the fact is largely BLK graduate entrepreneurship or getting a job.This study aims to describe and optimize the performance of BLK and identify dimensionsthat support and hinder the performance of UPT Training Center Social Service Manpower Holy District, so as to know what needs to be improved and sustained performance. Kudus Job Training Center performance can be seen on the productivity, quality of service, responsiveness of organizations, organizational responsibility, and accountability.The results showed that the optimal performance of BLK yet. To optimize performance by improving BLK inhibit dimensions. Dimensions that support the resources (human, financial, time sarpras), participation, cooperation, motivation and organizational structure. Dimensions that inhibit is Human Resources, Financial Resources, and Communications

Improving Grade VIII Students' Vocabulary Achievement by Using Personal Vocabulary Notes in SMP SANTA MARIA MEDAN

This study attempts to improve students' vocabulary achievement by using Personal Vocabulary Notes. This research was conducted by using classroom action research. The subject of this study was VIII-B class SMP Santa Maria Medan which consisted of 46 students. The research was conducted in two cycles and each cycle consisted of three meetings. The result showed that the improvement of the students' scores from the first test in orientation test to the third test in cycle-II test. In the first test in orientation test, the mean was 46.95, in the second test in cycle-I test, the mean was 64.86, and the third test in cycle-II test, it was improved to be 80.45. Based on the diary notes, observation sheet, and questionnaire, it was found that the teaching learning activities ran well. Students were active and enthusiastic during the teaching learning process in the second cycle than the first one. The result of the researcher showed that the use of personal vocabulary notes significantly improved students' vocabulary

Kajian Kuat Tekan Beton Pasca Bakar Dengan Dan Tanpa Perendaman Berdasarkan Variasi Mutu Beton

Penelitian ini dilakukan terhadap mutu beton 15 MPa, 20 MPa, 22 MPa dan 25 MPa dengan sampel berupa kubus 15 cm × 15 cm × 15 cm. Jumlah sampel penelitian pada masing-masing mutu beton sebanyak 9 buah sehingga total keseluruhan sampel penelitian sebanyak 36 buah. Pembakaran dilakukan pada suhu 400oC dan lamanya pembakaran selama 3 jam.Perendaman beton pasca bakar dilakukan selama 14 hari.Hasil dari penelitian ini menunjukkan bahwa berdasarkan variasi mutu beton (15 MPa, 20 MPa, 22 MPa, dan 25 MPa) didapatkan nilai kuat tekan rata-rata pada pada perlakuan standar menghasikan kuat tekan rata-rata sebesar 26,00 MPa, 26,67 MPa, 28,44 MPa dan 29,48 MPa. Pada perlakuan beton pasca bakar dengan perendaman menghasilkan kuat tekan rata-rata sebesar 19,41 MPa, 22,37 MPa, 24,15 MPa dan 25,85 MPa. Sedangkan pada perlakuan beton pasca bakar tanpa perendaman menghasilkan kuat tekan rata-rata sebesar 24,89 MPa, 25,78 MPa, 28,67 MPa dan 30,52 MPa. Penurunan kekuatan beton pasca bakar tanpa perendaman pada mutu beton 15 MPa dan 20 MPa sebesar 4,274% dan 3,333% dan peningkatan pada mutu beton 22 MPa dan 25 MPa sebesar 0,781% dan 3,518%. Penurunan kekuatan beton pasca bakar dengan perendaman sebesar 25,356%, 16,111%, 15,104% dan 12,312%

How do authors of systematic reviews deal with research malpractice and misconduct in original studies? A cross-sectional analysis of systematic reviews and survey of their authors.

OBJECTIVES: To study whether systematic reviewers apply procedures to counter-balance some common forms of research malpractice such as not publishing completed research, duplicate publications, or selective reporting of outcomes, and to see whether they identify and report misconduct. DESIGN: Cross-sectional analysis of systematic reviews and survey of their authors. PARTICIPANTS: 118 systematic reviews published in four journals (Ann Int Med, BMJ, JAMA, Lancet), and the Cochrane Library, in 2013. MAIN OUTCOMES AND MEASURES: Number (%) of reviews that applied procedures to reduce the impact of: (1) publication bias (through searching of unpublished trials), (2) selective outcome reporting (by contacting the authors of the original studies), (3) duplicate publications, (4) sponsors' and (5) authors' conflicts of interest, on the conclusions of the review, and (6) looked for ethical approval of the studies. Number (%) of reviewers who suspected misconduct are reported. The procedures applied were compared across journals. RESULTS: 80 (68%) reviewers confirmed their data. 59 (50%) reviews applied three or more procedures; 11 (9%) applied none. Unpublished trials were searched in 79 (66%) reviews. Authors of original studies were contacted in 73 (62%). Duplicate publications were searched in 81 (69%). 27 reviews (23%) reported sponsors of the included studies; 6 (5%) analysed their impact on the conclusions of the review. Five reviews (4%) looked at conflicts of interest of study authors; none of them analysed their impact. Three reviews (2.5%) looked at ethical approval of the studies. Seven reviews (6%) suspected misconduct; only 2 (2%) reported it explicitly. Procedures applied differed across the journals. CONCLUSIONS: Only half of the systematic reviews applied three or more of the six procedures examined. Sponsors, conflicts of interest of authors and ethical approval remain overlooked. Research misconduct is sometimes identified, but rarely reported. Guidance on when, and how, to report suspected misconduct is needed

Ventilation strategies in obese patients undergoing surgery: a quantitative systematic review and meta-analysis†

Background Pathophysiological changes due to obesity may complicate mechanical ventilation during general anaesthesia. The ideal ventilation strategy is expected to optimize gas exchange and pulmonary mechanics and to reduce the risk of respiratory complications. Methods Systematic search (databases, bibliographies, to March 2012, all languages) was performed for randomized trials testing intraoperative ventilation strategies in obese patients (BMI ≥30 kg m−2), and reporting on gas exchange, pulmonary mechanics, or pulmonary complications. Meta-analyses were performed when data from at least three studies or 100 patients could be combined. Results Thirteen studies (505 obese surgical patients) reported on a variety of ventilation strategies: pressure- or volume-controlled ventilation (PCV, VCV), various tidal volumes, and different PEEP or recruitment manoeuvres (RM), and combinations thereof. Definitions and reporting of endpoints were inconsistent. In five trials (182 patients), RM added to PEEP compared with PEEP alone improved intraoperative ratio [weighted mean difference (WMD), 16.2 kPa; 95% confidence interval (CI), 8.0-24.4] and increased respiratory system compliance (WMD, 14 ml cm H2O−1; 95% CI, 8-20). Arterial pressure remained unchanged. In four trials (100 patients) comparing PCV with VCV, there was no difference in ratio, tidal volume, or arterial pressure. Comparison of further ventilation strategies or combination of other outcomes was not feasible. Data on postoperative complications were seldom reported. Conclusions The ideal intraoperative ventilation strategy in obese patients remains obscure. There is some evidence that RM added to PEEP compared with PEEP alone improves intraoperative oxygenation and compliance without adverse effects. There is no evidence of any difference between PCV and VC

Plasmonic Nanogels with Robustly Tunable Optical Properties

Low viscosity fluids with tunable optical properties can be processed to manufacture thin film and interfaces for molecular detection, light trapping in photovoltaics and reconfigurable optofluidic devices. In this work, self-assembly in wormlike micelle solutions is used to uniformly distribute various metallic nanoparticles to produce stable suspensions with localized, multiple wavelength or broad-band optical properties. Their spectral response can be robustly modified by varying the species, concentration, size and/or shape of the nanoparticles. Structure, rheology and optical properties of these plasmonic nanogels as well as their potential applications to efficient photovoltaics design are discussed