The 10 most recently published documents
Background: Stratified care approach involving use of the STarT-Back tool to optimise care for patients with low back pain is gaining widespread attention in western countries. However, adoption and implementation of this approach in low-and-middle-income countries will be restricted by context-specific factors that need to be addressed. This study aimed to develop with physiotherapists, tailored intervention strategies for the implementation of stratified care for patients with low back pain.
Methods: A two-round web-based Delphi survey was conducted among purposively sampled physiotherapists with a minimum of three years of clinical experience, with post-graduation certification or specialists. Thirty statements on barriers and enablers for implementation were extracted from the qualitative phase. Statements were rated by a Delphi panel with additional open-ended feedback. After each Delphi round, participants received feedback which informed their subsequent responses. Additional qualitative feedback were analysed using qualitative content analysis. The criteria for consensus and stability were pre-determined using percentage agreement (≥ 75%), median value (≥ 4), Inter-quartile range (≤ 1), and Wilcoxon matched-pairs test respectively.
Results: Participants in the first round were 139 and 125 of them completed the study, yielding a response rate of 90%. Participants were aged 35.2 (SD6.6) years, and 55 (39.6%) were female. Consensus was achieved in 25/30 statements. Wilcoxon’s test showed stability in responses after the 5 statements failed to reach consensus: ‘translate the STarT-Back Tool to pidgin language’ 71% (p = 0.76), ‘begin implementation with government hospitals’ 63% (p = 0.11), ‘share knowledge with traditional bone setters’ 35% (p = 0.67), ‘get second opinion on clinician’s advice’ 63% (p = 0.24) and ‘carry out online consultations’ 65% (p = 0.41). Four statements strengthened by additional qualitative data achieved the highest consensus: ‘patient education’ (96%), ‘quality improvement appraisals’ (96%), ‘undergraduate training on psychosocial care’ (96%) and ‘patient-clinician communication’ (95%).
Conclusion: There was concordance of opinion that patients should be educated to correct misplaced expectations and proper time for communication is vital to implementation. This communication should be learned at undergraduate level, and for already qualified clinicians, quality improvement appraisals are key to sustained and effective care. These recommendations provide a framework for future research on monitored implementation of stratified care in middle-income countries.
In der seit 2009 andauernden Niedrigzinsphase ging der Anteil der Kapitaleinkommen am Volkseinkommen zurück. Da sich der Anteil des Faktors Arbeit nicht wesentlich veränderte, gewann der Produktionsfaktor Boden an Bedeutung. In der Volkswirtschaftlichen Gesamtrechnung spiegelt sich dies jedoch nicht wider, da der Boden dort nicht gesondert ausgewiesen wird. Mithilfe des Henry-George-Theorems wird versucht, eine Methode zu entwickeln, die den Anteil des Faktors Boden quantifiziert. Der explizite Ausweis des Bodeneinkommens in der Volkswirtschaftlichen Gesamtrechnung könnte dazu beitragen, die Rolle dieses vernachlässigten Faktors zu korrigieren.
This paper describes the project “Visual Knowledge Communication”, a joint project that started recently. The partners are psychologists and computer scientists from four universities of the German state Rhineland-Palatinate. The starting point for the project was the fact that visualizations have attracted considerable interest in psychology as well as computer science within the last years. However, psychologists and computer scientists pursued their investigations independently from each other in the past. This project has as its main goal the support and fostering of cooperation between psychologists and computer scientists in several visualization research projects.
The paper sketches the overall project. It then discusses in more detail the authors' subproject which deals with a peer review process for animations developed by students. The basic ideas, the main goals, and the project plan are described.
This paper is a work-in-progress report. Therefore, it does not contain any results.
This article investigates the representation of the issue of refugees travelling to the Italian coast that was reported by two major Italian newspapers between August 8th and August 19th, 2017. Using analysis tools belonging to communication theory and cognitive sciences, i.e. the concepts of frame and attitude, this article highlights two major points: firstly, the analysis reveals how the two newspapers aimed at establishing a specific relationship with their readers on this topic in the relevant period on the basis of specific interpretative models; secondly, each of these interpretative models relies on the representation of specific emotions which play a central role in the interpretation of reality according to a characteristic facet of the definition of post-truth.
We present the concrete realization of a virtual laboratory equipped with a pedagogical agent. Its functionality and media didactics takes into account the results of an usability test on a prototype system, and the students' demand on such an automated assistance as obtained from a preliminary survey. The pedagogical agent mediates between the content and the learner by activating him or her. To provide information about the learner's skills, we propose a pragmatic and simplified competence model that is based on fundamental representations in physics (experiment, figure, text and equation). Moreover, an automated feedback relates the student's self-assessment with the submitted answer to the correctness of the respective task. In consequence, the pedagogical agent enables mental reflection for a crucial review of the own learning process. Interestingly, learning pathways can be envisioned, thus, giving valuable insight into individual strengths and weaknesses.
One key for successful and fluent human-robot-collaboration in disassembly processes is equipping the robot system with higher autonomy and intelligence. In this paper, we present an informed software agent that controls the robot behavior to form an intelligent robot assistant for disassembly purposes. While the disassembly process first depends on the product structure, we inform the agent using a generic approach through product models. The product model is then transformed to a directed graph and used to build, share and define a coarse disassembly plan. To refine the workflow, we formulate "the problem of loosening a connection and the distribution of the work" as a search problem. The created detailed plan consists of a sequence of actions that are used to call, parametrize and execute robot programs for the fulfillment of the assistance. The aim of this research is to equip robot systems with knowledge and skills to allow them to be autonomous in the performance of their assistance to finally improve the ergonomics of disassembly workstations.
Research in global change ecology relies heavily on global climatic grids derived from estimates of air temperature in open areas at around 2 m above the ground. These climatic grids do not reflect conditions below vegetation canopies and near the ground surface, where critical ecosystem functions occur and most terrestrial species reside. Here, we provide global maps of soil temperature and bioclimatic variables at a 1-km2 resolution for 0–5 and 5–15 cm soil depth. These maps were created by calculating the difference (i.e. offset) between in situ soil temperature measurements, based on time series from over 1200 1-km2 pixels (summarized from 8519 unique temperature sensors) across all the world's major terrestrial biomes, and coarse-grained air temperature estimates from ERA5-Land (an atmospheric reanalysis by the European Centre for Medium-Range Weather Forecasts). We show that mean annual soil temperature differs markedly from the corresponding gridded air temperature, by up to 10°C (mean = 3.0 ± 2.1°C), with substantial variation across biomes and seasons. Over the year, soils in cold and/or dry biomes are substantially warmer (+3.6 ± 2.3°C) than gridded air temperature, whereas soils in warm and humid environments are on average slightly cooler (−0.7 ± 2.3°C). The observed substantial and biome-specific offsets emphasize that the projected impacts of climate and climate change on near-surface biodiversity and ecosystem functioning are inaccurately assessed when air rather than soil temperature is used, especially in cold environments. The global soil-related bioclimatic variables provided here are an important step forward for any application in ecology and related disciplines. Nevertheless, we highlight the need to fill remaining geographic gaps by collecting more in situ measurements of microclimate conditions to further enhance the spatiotemporal resolution of global soil temperature products for ecological applications.
Research integrity (RI) has been a focus of society in recent years as a means to create and to keep trust in science. Higher education institutions (HEIs) play a key role in promoting a culture of RI and responsible conduct of research (RCR). The understanding and practice of RI can vary across cultures. This article aims to outline initial insights into university students’ RI mindsets based on five RI facets: understanding, importance, value-action gap, enforcement approaches, and training. A qualitative exploratory cross-cultural study was conducted with participants from Germany and Bulgaria via semi-structured guided group interviews. An explicit transcultural agreement regarding the significance of RI was categorically indicated. Intercultural differences between the two European countries were revealed and discussed in reference to understanding RI, the value-action gap, enforcement approaches, and training preferences.
Background: Deficiency in musculoskeletal imaging (MI) education will pose a great challenge to physiotherapists in clinical decision making in this era of first-contact physiotherapy practices in many developed and developing countries. This study evaluated the nature and the level of MI training received by physiotherapists who graduate from Nigerian universities.
Methods: An online version of the previously validated Physiotherapist Musculoskeletal Imaging Profiling Questionnaire (PMIPQ) was administered to all eligible physiotherapists identified through the database of the Medical Rehabilitation Therapist Board of Nigeria. Data were obtained on demographics, nature, and level of training on MI procedures using the PMIPQ. Logistic regression, Friedman’s analysis of variance (ANOVA) and Kruskal-Wallis tests were used for the statistical analysis of collected data.
Results: The results (n = 400) showed that only 10.0% of the respondents had a stand-alone entry-level course in MI, 92.8% did not have any MI placement during their clinical internship, and 67.3% had never attended a MI workshop. There was a significant difference in the level of training received across MI procedures [χ2 (15) = 1285.899; p = 0.001]. However, there was no significant difference in the level of MI training across institutions of entry-level programme (p = 0.36). The study participants with transitional Doctor of Physiotherapy education were better trained in MI than their counterparts with a bachelor’s degree only (p = 0.047).
Conclusions: Most physiotherapy programmes in Nigeria did not include a specific MI module; imaging instructions were mainly provided through clinical science courses. The overall self-reported level of MI training among the respondents was deficient. It is recommended that stand-alone MI education should be introduced in the early part of the entry-level physiotherapy curriculum.
Background: The extramuscular connective tissue (ECT) has been shown to play a significant role in mechanical force transmission between musculoskeletal structures. Due to this and owing to its tight connection with the underlying muscle, the ECT may be vulnerable to excessive loading. The present study aimed to investigate the effect of eccentric elbow flexor exercise on the morphology of the biceps brachii ECT. In view of the high nociceptive capacity of the ECT, an additional objective was to elucidate the potential relationship between ECT damage and the occurrence of delayed onset muscle soreness (DOMS).
Methods: Eleven healthy participants (♂ = 7; 24 ± 2 years) performed fatiguing dumbbell elbow flexor eccentric exercise (EE) for one arm and concentric exercise (CE) for the other arm in random order and with random arm allocation. Before, immediately after and 24–96 h post-exercise, maximal voluntary isometric contraction torque of the elbow flexors (dynamometer), pressure pain (algometer), palpation pain (100 mm visual analog scale), biceps brachii ECT thickness and ECT/muscle mobility during passive movement (both high-resolution ultrasound) were examined.
Results: Palpation pain, suggestive of DOMS, was greater after EE than CE, and maximal voluntary isometric contraction torque decreased greater after EE than CE (p < .05). Relative to CE, EE increased ECT thickness at 48 (+ 17%), 72 (+ 14%) and 96 (+ 15%) hours post-exercise (p < .05). At 96 h post-EE, the increase in ECT thickness correlated with palpation pain (r = .68; p < .05). ECT mobility was not different between conditions, but compared to CE, muscle displacement increased at 24 (+ 31%), 72 (+ 31%) and 96 (+ 41%) hours post-EE (p < .05).
Conclusion: Collectively, these results suggest an involvement of the ECT changes in delayed onset muscle soreness.