Abstract
Background
Prehabilitation programs have led to improved postoperative outcomes in several surgical contexts, but there are presently no guidelines for the prehabilitation phase before ...lumbar fusion surgery.
Objective
The objective was to investigate whether a person-centered physical therapy prehabilitation program, based on a cognitive-behavioral approach, is more effective than conventional care in reducing disability and improving functioning after lumbar fusion surgery in patients with degenerative disk disease.
Design
This study was a randomized controlled trial.
Setting
The study took place at 2 private spine clinics and 1 university hospital.
Patients
We prospectively enrolled 118 patients scheduled for lumbar fusion surgery.
Intervention
The active intervention used a person-centered perspective and focused on promoting physical activity and targeting psychological risk factors before surgery. The control group received conventional preoperative care.
Measurements
The primary outcome was the Oswestry Disability Index score. Secondary outcomes were back and leg pain intensity, catastrophizing, kinesiophobia, self-efficacy, anxiety, depression, health-related quality of life, and patient-specific functioning, physical activity, and physical capacity. Data were collected on 6 occasions up to 6 months postoperatively. A linear mixed model was used to analyze the change scores of each outcome.
Results
No statistically significant between-group difference was found on the primary outcome (disability) over time (baseline to 6 months). Among secondary outcome measures, a statistically significant interaction effect (“Group × Time”) was seen for the European Quality of Life 5 Dimensions Questionnaire. The largest between-group difference on the European Quality of Life 5 Dimensions Questionnaire index was seen 1 week prior to surgery and favored the active intervention. The largest between-group effect sizes at the 6-month follow-up favored the active intervention, and were seen for physical activity intensity, steps per day, and the One Leg Stand Test. Both groups reached the minimal important change for the primary outcome and, in several secondary outcomes (pain intensity, back and leg; pain catastrophizing; anxiety; health-related quality of life EQ5D VAS), already at 8-week follow-up.
Limitations
The participants’ preoperative level of disability was lower than normative values, which suggests selection bias.
Conclusions
Both interventions led to clinically important changes, but it is not clear what kind of prehabilitation program is the most effective.
ساهمت كتابات الكاتبة الكندية غابرييل روا (1909-1983) في الإنتاج الأدبي للمهاجرين حتى قبل تشكيل مفهوم "كتابة الهجرة" واعتمادها كتيار أدبي في كيبيك. لعبت الكاتبة أيضا دور المتحدث الرسمي بإسم مجتمعات ...المهاجرين وشهدت حتى تجربة ملموسة لهذه الحياة في طفولتها نظرا لجذورها الفرنسية- المانيتوبانية. في هذا الصدد، تقوم تلك الدراسة على النهج التحليلي لنصوص غابرييل روا الممثلة للمجتمعات الثقافية التي تشكل جزءا كبيرا من "الفسيفساء الكندية" الشهيرة. كما يتم فحص الرؤية النقدية حول السياق المقيد للحياة والسلوكيات التي تسببها في بيئة الأقليات في بدايات القرن العشرين. ومن ثم كيفية كشف الكتابة عن داخلية المهاجر وعلاقته بالآخرين. يطرح اختيار التحليل هذا، في الواقع، أسئلة وقضايا هوية الأقليات التي سيتم الكشف عنها من خلال كتابة روا وذلك من خلال الأعمال التالية: سعادة بالية، شارع ديشامبولت، النهر الهادر- مسبوقة بثلاث قصص اسكيموية، حديقة في نهاية العالم، هو لاء الأطفال في حياتي، أضواء الأرض الهشة والضيق والابتهاج.
The Medical Emergencies in Eating Disorders (MEED) report was first released by the Royal College of Psychiatrists in 2022 (updated 2023) to aid clinicians in recognising medical compromise due to an ...eating disorder and to provide guidance for management.
This study looked at admissions over 5 years to explore whether there is a correlation between MEED medical compromise parameters and three outcomes: length of stay, detainment under the Mental Health Act 1983, and discharge destination.
A retrospective study of 26 patients admitted to a large teaching hospital for an eating disorder between 2018 and 2023. The risk assessment from the MEED report was used to create a score for physical compromise and analysed to determine whether there was a correlation between the score and discharge destination, detainment under the Mental Health Act and length of stay.
Demographic data were comparable with larger studies, with increasing numbers and 19.2% having autism spectrum disorder. There was no correlation between the scoring tool and detainment under the Act, discharge destination or length of stay.
Increasing numbers of patients are presenting with eating disorders. Physical compromise was not a predictor for admission outcomes, but this could be further explored in larger studies.
A search for vectorlike quarks is presented, which targets their decay into a Z boson and a third-generation Standard Model quark. In the case of a vectorlike quark T (B) with charge +2/3e (-1/3e), ...the decay searched for is T -> Zt (B -> Zb). Data for this analysis were taken during 2015 and 2016 with the ATLAS detector at the Large Hadron Collider and correspond to an integrated luminosity of 36.1 fb(-1) of pp collisions at root s = 13 TeV. The final state used is characterized by the presence of b-tagged jets, as well as a Z boson with high transverse momentum, which is reconstructed from a pair of opposite-sign same-flavor leptons. Pair and single production of vectorlike quarks are both taken into account and are each searched for using optimized dileptonic exclusive and trileptonic inclusive event selections. In these selections, the high scalar sum of jet transverse momenta, the presence of high-transverse-momentum large-radius jets, as well as-in the case of the single-production selections-the presence of forward jets are used. No significant excess over the background-only hypothesis is found and exclusion limits at 95% confidence level allow masses of vectorlike quarks of m(T) > 1030 GeV (m(T) > 1210 GeV) and m(B) > 1010 GeV (m(B) > 1140 GeV) in the singlet (doublet) model. In the case of 100% branching ratio for T -> Zt (B -> Zb), the limits are m(T) > 1340 GeV (m(B) > 1220 GeV). Limits at 95% confidence level are also set on the coupling to Standard Model quarks for given vectorlike quark masses.
A new hepatitis E virus (HEV-7) was recently found in dromedaries and 1 human from the United Arab Emirates. We screened 2,438 dromedary samples from Pakistan, the United Arab Emirates, and 4 African ...countries. HEV-7 is long established, diversified and geographically widespread. Dromedaries may constitute a neglected source of zoonotic HEV infections.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, ODKLJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Argentina's Parallel Currency Gomez, Georgina M
2009, 20151006, 2015-10-06, 2009-07-01, 20090101, Letnik:
number 11
eBook
Analyzes the rise and fall of the Red de Trueque (launched in 1995 by a group of environmentalists who exchanged goods and services at their own 'market' using a system of mutual credit) in ...Argentina. This book identifies rules of governance and sustainability for institutional settings in which state regulation is minimal.
The contributors to Journalism After Snowden analyze the implications of the Snowden affair for journalism and the future role of the profession as a watchdog for the public good. Integrating ...discussions of media, law, surveillance, technology, and national security, the book offers a timely and much-needed assessment of the promises and perils for journalism in the digital age.
The 1979 Grenada Revolution, orchestrated by the New Jewel Movement, culminated four-and-a-half years later in the execution of Prime Minister Maurice Bishop and the US-led military invasion which ...threw Grenada onto the international political stage. Though much has been written on the Revolution and its untimely and violent demise, the overwhelming majority of the authors have been non-Grenadian. All the contributors to this volume, except one, are Grenadian. In this regard, it is unique, and captures the voices of persons who were active participants, children, teenagers, young adults, and some yet unborn in the 1979 to 1983 period, illustrative of the continued influence of the Revolution on Grenadians. The essays examine the legality of the Revolution, the historical connections between it and the 1795 Fédon's Rebellion, the nation's collective memory of the Revolution by its second generation, the conflict between religion and the Revolution, the empowerment of women by the revolutionary process, and the role of poetry and art in raising salient and often difficult and painful aspects of the Revolution. This collection of essays captures the Revolution from a Grenadian perspective.
Grenada experienced much turmoil in the 1970s and 1980s, culminating in an armed Marxist revolution, a bloody military coup, and finally in 1983 Operation Urgent Fury, a United States–led invasion. ...Wendy C. Grenade combines various perspectives to tell a Caribbean story about this revolution, weaving together historical accounts of slain Prime Minister Maurice Bishop, the New Jewel Leftist Movement, and contemporary analysis. There is much controversy. Though the Organization of American States formally requested intervention from President Ronald Reagan, world media coverage was largely negative and skeptical, if not baffled, by the action, which resulted in a rapid defeat and the deposition of the Revolutionary Military Council.
By examining the possibilities and contradictions of the Grenada revolution, the contributors draw upon thirty years’ of hindsight to illuminate a crucial period of the Cold War. Beyond geopolitics, the book interrogates but transcends the nuances and peculiarities of Grenada’s political history to situate this revolution in its larger Caribbean and global context. In doing so, contributors seek to unsettle old debates while providing fresh understandings about a critical period in the Caribbean’s postcolonial experience. This collection throws into sharp focus the centrality of the Grenada revolution, offering a timely contribution to Caribbean scholarship and to wider understanding of politics in small developing, postcolonial societies.
In this study, a hybrid method, which simultaneously adjusts structural mass, stiffness, and damping, is proposed to reduce the sloshing of cylindrical tanks under ground motions induced by ...earthquakes. For this purpose, a viscous mass damper (VMD) is used with a rubber bearing to develop the hybrid control system. Modal and time history analyses are conducted for tanks by using the proposed method. In addition, parametric studies are conducted to investigate the effects of aspect ratio, mass, and damping of the VMD. It is observed that the sloshing heights of the liquid, base shears, and overturning moments of the tanks are reduced through the application of the proposed method. For both slender and broad tanks, the sloshing heights are controlled and the sloshing height can be reduced more in a broad tank. Additionally, a larger equivalent mass of the VMD can help in reducing the sloshing height.
•A hybrid control method is proposed to reduce sloshing in the storage tank.•A rotary damper is used with a laminated rubber bearing.•The sloshing height and hydrodynamic pressure of the tank can be reduced.•The sloshing height can be reduced more in a broad tank.•A larger equivalent mass of the rotary damper helps to reduce the sloshing height.
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