Effectiveness of Treatments for Low Back Pain

Low back pain with or without radiculopathy symptoms is increasingly becoming a common complaint for patients. The purpose of this study is to evaluate the most effective treatment for patients experiencing low back pain with or without radiculopathy symptoms with the goal of pain reduction/elimination and positive long term results. The review of literature explores studies that discuss treatment options of surgical intervention or conventional treatment such as physical therapy. This information supplies health care providers with the tools to educate patients on treatment options and possible outcomes in hopes to offer the best treatment for the individual. Results show that patients can have pain reduction or relief and return to normal activity level in a shorter time frame with treatment of conventional methods versus surgical interventions. The findings indicate treatment alternatives that may not have been considered as beneficial before. In addition, the findings may provide guidance to when a patient should be referred to a surgeon for treatment versus starting with physical therapy or other non-surgical treatment options. This information should help health care providers reduce a patient’s low back pain and improve their quality of life.https://commons.und.edu/pas-grad-posters/1140/thumbnail.jp

Loving Comrades: Lancashire\u27s Links to Walt Whitman

Offers the history of a group of Whitman\u27s advocates living in the late 19th and early 20th centuries in Bolton, Lancashire, England, known as the Bolton group or Bolton college, and emphasizes Whitman\u27s role upon the socialist politics and lifestyles of these individuals, including J.W. Wallace, Fred Wild, Dr. J. Johnston, Edward Carpenter, Katherine Conway, Bruce Glasier, Robert Blatchford, Caroline Martyn, Keir Hardie, John Addington Symonds, George Russell, and Wallace and Katherine Glasier

Outcomes following PDA surgery in extremely preterm born subjects. Focusing on left vocal cord paralysis and associated short- and long-tem outcomes

Background: Extremely preterm born (EPB) infants are at risk of a range of complications, among them a patent ductus arteriosus (PDA). If a conservative approach does not reduce the cardiopulmonary compromise imposed by the PDA, pharmacological or surgical closure is required. The rate of PDA surgery has declined over the last decade, in part due to reports of postoperative complications such as left vocal cord paralysis. The incidence and prevalence of LVCP and outcomes associated with left vocal cord paralysis (LVCP) after neonatal PDA surgery has not been sufficiently described. Aim: The aims of this thesis were to investigate incidence and prevalence of LVCP after surgical PDA closure in EPB subjects, and to study associations between PDA surgery with or without LVCP versus outcomes in the neonatal period and later, focusing on respiratory and voice related symptoms, exercise capacity and lung function. Methods: In Study #I, we conducted a systematical review and meta-analysis to investigate previous reports of LVCP incidence after PDA surgery and associated outcomes using the Newcastle-Ottawa Scale for quality assessment of individual studies. Study #II and #III were both based on a national prospective cohort study, enrolling all infants born at gestational age (GA) <28 weeks or with birthweight (BW) <1000 grams during 1999–2000. In Study #II, we compared parental reports on voice and exercise related respiratory symptoms in three groups of EPB schoolchildren who either underwent neonatal PDA surgery, received other management for PDA or did not have PDA. In Study #III, EPB young adults with a history of neonatal PDA surgery, EPB controls, and term-born controls underwent spirometry, maximal treadmill exercise testing and answered questionnaires including questions about voice and exercise related respiratory symptoms. The PDA surgery-group also underwent laryngoscopy examination at rest and during the exercise test, allowing the scoring of exercise induced laryngeal obstruction. Results: The systematic review showed an overall incidence of LVCP following surgical closure of PDA was 9%, with a wide dispersion (0–67%). The incidence was highest in a subanalysis of studies where all subjects underwent laryngoscopy examinations after PDA surgery (overall: 32%, range 11–67%), and heterogeneity decreased with stratification based on study design. LVCP was associated with dysphonia, stridor, and adverse neonatal outcomes, such as chronic lung disease and feeding difficulties. In Study #II, surgical closure of a PDA was associated with an increased crude odds ratio of parental reports regarding voice and exercise related respiratory symptoms compared to other methods of managing PDA. However, days on mechanical ventilation was identified as a potential confounder in multivariate analyses. Study #III revealed a 53% prevalence of LVCP in the PDA surgery group. LVCP was associated with increased laryngeal obstruction during physical exertion and subjective reports of voice symptoms, but not with lung function (zFEV1), exercise capacity (peakVO2) or subjective reports of exercise related respiratory symptoms. PDA surgery was associated with impaired lung function, also after adjusting for BPD. Exercise capacity was not associated with LVCP nor PDA surgery, but all EPB groups performed poorer compared to term-born subjects, even after adjusting for gender. However, low levels of physical activity among those born EP may have impacted the results. Conclusion and implications: We found that reported incidence of LVCP after PDA surgery in EPB subjects varied across studies and study designs, and that the prevalence of LVCP in our national cohort was high compared to the pooled incidence from the systematic review. Despite associations between LVCP and adverse neonatal outcomes, exercise induced laryngeal obstruction and frequent reports of voice and exercise related respiratory symptoms, LVCP was not associated with poor lung function or exercise capacity. PDA surgery was associated with increased rates of voice- and exercise related respiratory symptoms, but not with exercise capacity. However, the average lung function in the PDA surgery group was below the 5th percentile, and these individuals might represent a group in need of extra pulmonary follow-up in the future. To ensure correct diagnosis and follow-up of patients with LVCP, laryngoscopy examination should be performed routinely after PDA surgery in EPB neonates. Further, EPB adults with a history of PDA surgery who complain of voice problems or respiratory symptoms should undergo laryngoscopy examination to look for LVCP. Despite a nationwide recruitment, relatively low sample size may have contributed to some of the results being inconclusive. To further enlighten our research questions on incidence, prevalence, and outcomes of LVCP after PDA surgery in the EPB population, an international longitudinal multicentre study is warranted to enable recruitment of a sample with power to detect any true between-group differences.Doktorgradsavhandlin

Involvement of Park and Recreation Professionals in Pedestrian Plans

Professionals from many different disciplines are finding innovative ways to work together to increase physical activity to help create healthier communities. One process that can provide a focal point for promoting physical activity by park and recreation professionals, land use and transportation planners, public health practitioners, and other stakeholders is the development and implementation of pedestrian plans. A pedestrian plan is a public document that lays out a community’s vision for future pedestrian activity, identifies the actions required to realize that vision, ties actions to funding sources, and describes implementation and use. The purpose of this study was to explore whether park and recreation professionals were involved in creating pedestrian plans and how park and recreation elements were represented in these plans. To answer this, we identified, collected, and conducted a content analysis of all pedestrian plans in North Carolina. Among the 41 regional, county, and municipal pedestrian plans, park and recreation professionals were mentioned in the plan 56% of the time. Seventy-one percent (n=29) had a vision statement; however, among those only five vision statements mentioned parks or recreation. In all five cases, when a plan contained a vision statement that mentioned parks or recreation, there was a park and recreation member involved in the development of the plan. A higher percent of plans with a park and recreation professional involved were more likely to list parks in their land use analysis (74% vs. 67%). Park master plans were mentioned in the pedestrian plans 29% of the time; however, a lower percent of plans with a park and recreational professional involved mentioned a park master plan (26% vs. 33%). Given the potential importance of pedestrian plans in creating connections for pedestrians, park and recreation professionals are encouraged to become involved in the pedestrian planning process if they are not already. Parks can offer opportunities for residents of diverse ages and cultures to come together to socialize and engage in health-promoting activities. Integrating a park and recreation perspective into a more comprehensive planning process can enhance access to parks, inform programs, support multiple community goals, facilitate efficient use of resources, and promote partnerships for greater sustainabilit

Boliginvesteringer utover boligbehovet

I denne masterutredningen foretas en kvalitativ analyse av eiendomssegmentet sekundærboliger i Oslo. Det fokuseres på hvorvidt investeringer ut over primærboligen kan bidra til å forklare økningen vi har sett i boligprisene i Oslo. For å svare på dette har vi valgt å utforme en overordnet problemstilling og tre underproblemstillinger: Påvirker investeringer i sekundærbolig boligprisen i Oslo? - Er det et problem at det kjøpes boliger til utleie som investeringsobjekter? - Hvilke tiltak (kan) iverksettes av myndighetene for å gjøre denne typen investeringer mindre lukrative? - Hva vil konsekvensene være dersom lønnsomheten ved slike investeringer reduseres? Boligmarkedet i Oslo er i dag presset av en svak tilbudsside som ikke møter etterspørselen. Undersøkelsene viser at investeringer i sekundærboliger i stor grad påvirker boligprisene da etterspørselen preges av en skjerpet konkurranse mellom de som kjøper for å bo og de som kjøper for å investere. Blant hovedfunnene har vi sett at økte investeringer i sekundærboliger har gått på bekostningen av antall primærboliger i Oslo. Undersøkelsene viser også at det som er vektet høyest ved slike investeringer er forventingen om boligprisvekst. Dette har resultert i at mange investerer i boliger uten å leie dem ut, og at de således står tomme store deler av året. Vi mener derfor det bør innføres konkrete tiltak for å redusere etterspørselen etter sekundærboliger dersom man ønsker å profesjonalisere utleiemarkedet og opprettholde andelen selveiere i Oslo.This report describes a qualitative analysis of the market segment for investment property in Oslo. The primary focus of analysis in this report is whether investments in secondary property may be a contributory factor to the significant increase in property prices in Oslo. This thesis is constructed around the main issue of how investments in secondary properties affect property prices in Oslo. In addition, the report discusses: - Whether the practice of buy-to-let and investment property is a problem for a well-functioning property market - If so, what measures are, or may be pursued by relevant authorities in order to make this type of investments less lucrative? - What are the consequences of reducing the attractiveness of this type of investment? The property market in Oslo is currently under pressure by weak supply not meeting an increased property demand. Our analysis indicates that the practice of acquiring investment property significantly affects the property prices, as the demand side is affected by increasingly fierce competition between those who buy to live, and those who buy property solely as a financial investment. Among the findings is that the increase in secondary property investments has led to a negative development in supply in absolute terms of the number of buy-to-live properties in Oslo. Moreover, our analysis shows that the main motivation for this type of investment is the expectation of a price increase. This results in many properties remaining unoccupied for large parts of the year. Our recommendation, therefore, is that measures are taken in order to reduce the attractiveness, and thus demand, of investment property in Oslo in order to achieve a professional lettings market and maintain the traditionally high proportion of freehold properties in the city.M-EUT

Expansion of the New York State Newborn Screening Panel and Krabbe Disease: A Systematic Program Evaluation

The purpose of this study was to conduct a formal program evaluation of the New York State newborn screening for Krabbe disease (KD), a rare neurological disease with variable onset of symptoms to assess 1) the perceptions of stakeholders 2) KD test characteristics, and 3) actual program costs. Using the CDC Framework for Program Evaluation in Public Health, integration of qualitative and quantitative techniques was used to provide a comprehensive evaluation. Stakeholder input was elicited using semi-structured interviews of medical professionals and parents and content analysis of the interview transcripts identified five themes: Legislative/Political, Unintended Consequences, Knowledge and Science, Communication, and Moral Issues. Finally, cost and charge data were used to calculate the cost of the KD screening program from the perspective of the State. Triangulation of the results provided the conclusions for practice and policy recommendations. Using the data from the State annual reports of 9 positive KD screening results, sensitivity was calculated at 100%, specificity was 99%, positive predictive value was 5%, negative predictive value was 100% and prevalence was 1/100,000 births. However, the State reports did not include the 19 infants with low enzyme activity and mutations that could develop into later onset forms of KD. When these 19 infants were included, sensitivity, specificity, and negative predictive value remained unchanged; however, positive predictive value rose to 15%, and prevalence increased to 3/100,000 births. The total annual cost of the program from the perspective of the State was calculated at $750,652. For parents, the cost calculated from initial newborn screen to neurodiagnostic testing was$2669/family. Since 2006, there have been more than 1,000,000 infants screened for KD in New York State. While the screening has identified four infants with the early infantile form of the disease, there have been 24 others identified with low enzyme activity and mutations that may cause later onset forms of the disease, which are poorly understood. This unexpected finding suggests that newborns may be diagnosed with a disease that may not present symptomatically until adulthood. Unfortunately, the current confirmatory enzyme test and neurodiagnostic tests cannot predict onset of disease or severity of symptoms. In addition, the only available treatment, a cord blood transplant, is irreversible, has a high risk of morbidity and mortality, and long term outcomes have not been studied. While the cost of the program from the perspective of the state is not excessive, cost-effectiveness studies are needed to determine the cost of KD screening from the societal perspective, and should include treatment and follow up costs

E-filing users’ satisfaction: A study on Malaysia petroleum upstream taxpayers

E-filing is one of the e-government applications that implement Information and Communication Technology (ICT) to enable e-government to improve the efficiency of government services provided to citizens. The purpose of e-filing service is to encourage every taxpayer to submit their income tax return through online. This study attempted to examine user satisfaction in using e-filing among Malaysia petroleum upstream taxpayers. The data were collected from 80 respondents using survey method from all petroleum upstream taxpayers in Malaysia. User satisfaction was measured by system quality, information quality and service quality. The result indicates that information quality and service quality significantly affect user satisfaction using the e-filing system among Malaysia petroleum upstream taxpayers. Consequently, this finding will assist the Inland Revenue Board of Malaysia (IRBM) in improving their e-filing system

Comparative models for minimizing ergonomic risk in assembly lines

We present a new mathematical model for the assembly line balancing problem with the objective of maximizing the line comfort to operators. Besides minimizing discrepancies between the ergonomic risks of workstations, balancing is subject to temporal and spatial conditions for the workstations. To evaluate the performance of the proposed model, we compare it with other mathematical model whose objective is minimizing the maximum ergonomic risk of a mixed-model assembly line. To compare the models, a case study linked to Nissan’s engine plant in Barcelona (NMISA, Nissan Motor Ibérica – BCN).Postprint (published version

Vertical Color Maps: A Data Independent Alternative to Floor Plan Maps

Location sharing in indoor environments is limited by the sparse availability of indoor positioning and lack of geographical building data. Recently, several solutions have begun to implement digital maps for use in indoor space. The map design is often a variant of floor-plan maps. Whereas massive databases and GIS exist for outdoor use, the majority of indoor environments are not yet available in a consistent digital format. This dearth of indoor maps is problematic, as navigating multistorey buildings is known to create greater difficulty in maintaining spatial orientation and developing accurate cognitive maps. The development of standardized, more intuitive indoor maps can address this vexing problem. The authors therefore present an alternative solution to current indoor map design that explores the possibility of using colour to represent the vertical dimension on the map. Importantly, this solution is independent of existing geographical building data. The new design is hypothesized to do a better job than existing solutions of facilitating the integration of indoor spaces. Findings from a human experiment with 251 participants demonstrate that the vertical colour map is a valid alternative to the regular floor-plan map

Boliginvesteringer utover boligbehovet

I denne masterutredningen foretas en kvalitativ analyse av eiendomssegmentet sekundærboliger i Oslo. Det fokuseres på hvorvidt investeringer ut over primærboligen kan bidra til å forklare økningen vi har sett i boligprisene i Oslo. For å svare på dette har vi valgt å utforme en overordnet problemstilling og tre underproblemstillinger: Påvirker investeringer i sekundærbolig boligprisen i Oslo? - Er det et problem at det kjøpes boliger til utleie som investeringsobjekter? - Hvilke tiltak (kan) iverksettes av myndighetene for å gjøre denne typen investeringer mindre lukrative? - Hva vil konsekvensene være dersom lønnsomheten ved slike investeringer reduseres? Boligmarkedet i Oslo er i dag presset av en svak tilbudsside som ikke møter etterspørselen. Undersøkelsene viser at investeringer i sekundærboliger i stor grad påvirker boligprisene da etterspørselen preges av en skjerpet konkurranse mellom de som kjøper for å bo og de som kjøper for å investere. Blant hovedfunnene har vi sett at økte investeringer i sekundærboliger har gått på bekostningen av antall primærboliger i Oslo. Undersøkelsene viser også at det som er vektet høyest ved slike investeringer er forventingen om boligprisvekst. Dette har resultert i at mange investerer i boliger uten å leie dem ut, og at de således står tomme store deler av året. Vi mener derfor det bør innføres konkrete tiltak for å redusere etterspørselen etter sekundærboliger dersom man ønsker å profesjonalisere utleiemarkedet og opprettholde andelen selveiere i Oslo.This report describes a qualitative analysis of the market segment for investment property in Oslo. The primary focus of analysis in this report is whether investments in secondary property may be a contributory factor to the significant increase in property prices in Oslo. This thesis is constructed around the main issue of how investments in secondary properties affect property prices in Oslo. In addition, the report discusses: - Whether the practice of buy-to-let and investment property is a problem for a well-functioning property market - If so, what measures are, or may be pursued by relevant authorities in order to make this type of investments less lucrative? - What are the consequences of reducing the attractiveness of this type of investment? The property market in Oslo is currently under pressure by weak supply not meeting an increased property demand. Our analysis indicates that the practice of acquiring investment property significantly affects the property prices, as the demand side is affected by increasingly fierce competition between those who buy to live, and those who buy property solely as a financial investment. Among the findings is that the increase in secondary property investments has led to a negative development in supply in absolute terms of the number of buy-to-live properties in Oslo. Moreover, our analysis shows that the main motivation for this type of investment is the expectation of a price increase. This results in many properties remaining unoccupied for large parts of the year. Our recommendation, therefore, is that measures are taken in order to reduce the attractiveness, and thus demand, of investment property in Oslo in order to achieve a professional lettings market and maintain the traditionally high proportion of freehold properties in the city.M-EUT