Supervised walking in comparison with fitness training for chronic back pain in physiotherapy: results of the SWIFT single-blinded randomized controlled trial (ISRCTN17592092)

Effectiveness of brief/minimal contact self-activation interventions that encourage participation in physical activity (PA) for chronic low back pain (CLBP >12 weeks) is unproven. The primary objective of this assessor-blinded randomized controlled trial was to investigate the difference between an individualized walking programme (WP), group exercise class (EC), and usual physiotherapy (UP, control) in mean change in functional disability at 6 months. A sample of 246 participants with CLBP aged 18 to 65 years (79 men and 167 women; mean age ± SD: 45.4 ± 11.4 years) were recruited from 5 outpatient physiotherapy departments in Dublin, Ireland. Consenting participants completed self-report measures of functional disability, pain, quality of life, psychosocial beliefs, and PA were randomly allocated to the WP (n = 82), EC (n = 83), or UP (n = 81) and followed up at 3 (81%; n = 200), 6 (80.1%; n = 197), and 12 months (76.4%; n = 188). Cost diaries were completed at all follow-ups. An intention-to-treat analysis using a mixed between-within repeated-measures analysis of covariance found significant improvements over time on the Oswestry Disability Index (Primary Outcome), the Numerical Rating Scale, Fear Avoidance-PA scale, and the EuroQol EQ-5D-3L Weighted Health Index (P < 0.05), but no significant between-group differences and small between-group effect sizes (WP: mean difference at 6 months, 6.89 Oswestry Disability Index points, 95% confidence interval [CI] -3.64 to -10.15; EC: -5.91, CI: -2.68 to -9.15; UP: -5.09, CI: -1.93 to -8.24). The WP had the lowest mean costs and the highest level of adherence. Supervised walking provides an effective alternative to current forms of CLBP management.

A review of behaviour change theories and techniques used in group based self-management programmes for chronic low back pain and arthritis

Background: Medical Research Council (MRC) guidelines recommend applying theory within complex interventions to explain how behaviour change occurs. Guidelines endorse self-management of chronic low back pain (CLBP) and osteoarthritis (OA), but evidence for its effectiveness is weak. Objective: This literature review aimed to determine the use of behaviour change theory and techniques within randomised controlled trials of group-based self-management programmes for chronic musculoskeletal pain, specifically CLBP and OA. Methods: A two-phase search strategy of electronic databases was used to identify systematic reviews and studies relevant to this area. Articles were coded for their use of behaviour change theory, and the number of behaviour change techniques (BCTs) was identified using a 93-item taxonomy, Taxonomy (v1). Results: 25 articles of 22 studies met the inclusion criteria, of which only three reported having based their intervention on theory, and all used Social Cognitive Theory. A total of 33 BCTs were coded across all articles with the most commonly identified techniques being '. instruction on how to perform the behaviour', '. demonstration of the behaviour', '. behavioural practice', '. credible source', '. graded tasks' and '. body changes'. Conclusion: Results demonstrate that theoretically driven research within group based self-management programmes for chronic musculoskeletal pain is lacking, or is poorly reported. Future research that follows recommended guidelines regarding the use of theory in study design and reporting is warranted.

Facilities management: Tracing its development trajectory

Purpose – The purpose of this paper is to provide facilities management (FM) practitioners and researchers with a better understanding of the FM industry sector by analyzing the trend of its development.
Design/methodology/approach – Semi-structured interview is adopted in this research as the main methodology. In total, 30 FM professionals in the UK were interviewed to explore the past, present and future of FM. The analysis of interview results helps to identify the key areas in which FM has changed, is changing and will change. It also helps to explain the implications of FM development in each key area.
Findings – FM evolves and matures continuously. It is important for FM organizations and practitioners to recognize the dynamic nature of this industry sector, based on which they can develop appropriate strategies to adapt to changing circumstances. This is probably the only way for them to
keep pace with the times.
Originality/value – Both backward looking and forward looking are crucial to the development of an industry sector. However, existing studies on FM development are conducted through either review or outlook. On the other hand, most of these studies focus on one particular management area or one particular industry sector. Based on 30 expert interviews, this research attempts to bridge the knowledge gap and analyze the trend of FM development in a systematic way. A better understanding of the trend provides a possibility and a guide for FM organizations and practitioners to pursue best practice.

A pilot randomised controlled trial (RCT) investigating the effectiveness of reflexology for managing pregnancy low back and/or pelvic pain.

any pregnant women with low back and/or pelvic pain (LBPP) use pain medications to manage this pain, much of which is self-prescribed and potentially harmful. Therefore, there is a need to find effective nonpharmacological treatments for the condition. Reflexology has previously been shown to help nonspecific low back pain. Therefore; a pilot RCT was conducted investigating reflexology in the management of pregnancy-LBPP. 90 primiparous women were randomised to either usual care, a reflexology or footbath intervention. Primary outcome measures were; the Pain Visual Analogue Scale (VAS). 64 women completed the RCT; retention rates for the reflexology group were 80%, usual care group 83.33% and footbath group 50%. The reflexology group demonstrated a Clinically Important Change (CIC) in pain frequency (1.64 cm). Results indicate it is feasible to conduct an RCT in this area, although a footbath is an unsuitable sham treatment. Reflexology may help manage pregnancy-LBPP; however a fully powered trial is needed to confirm this.

A systematic review investigating the effectiveness of Complementary and Alternative Medicine (CAM) for the management of low back and/or pelvic pain (LBPP) in pregnancy

Aim: To evaluate and summarize the current evidence on the effectiveness of complementary and alternative medicine for the management of low back pain and/or pelvic pain in pregnancy.

Background: International research demonstrates that 25-30% of women use complementary and alternative medicine to manage low back and pelvic pain in pregnancy without robust evidence demonstrating its effectiveness.

Design: A systematic review of randomized controlled trials to determine the effectiveness of complementary and alternative medicine for low back and/or pelvic pain in pregnancy.

Data Sources: Cochrane library (1898-2013), PubMed (1996-2013), MEDLINE (1946-2013), AMED (1985-2013), Embase (1974-2013), Cinahl (1937-2013), Index to Thesis (1716-2013) and Ethos (1914-2013).

Review Methods: Selected studies were written in English, randomized controlled trials, a group 1 or 2 therapy and reported pain reduction as an outcome measure. Study quality was reviewed using Risk of Bias and evidence strength the Cochrane Grading of Recommendations and Development Evaluation Tool.

Results: Eight studies were selected for full review. Two acupuncture studies with low risk of bias showed both clinically important changes and statistically significant results. There was evidence of effectiveness for osteopathy and chiropractic. However, osteopathy and chiropractic studies scored high for risk of bias. Strength of the evidence across studies was very low.

Conclusion: There is limited evidence supporting the use of general CAM for managing pregnancy-related low back and/or pelvic pain. However, the restricted availability of high-quality studies, combined with the very low evidence strength, makes it impossible to make evidence-based recommendations for practice.

Improving signal reliability in outdoor body-to-body communications using front and back positioned antenna diversity

It has previously been shown that human body shadowing can have a considerable impact on body-to-body communications channels in low multipath environments. Signal degradation directly attributable to shadowing when one user's body obstructs the main line of sight can be as great as 40 dB. When both people's bodies obstruct the direct line of sight path, the communications link can be lost altogether even at very short distances of a few metres. In this paper, using front and back positioned antennas, we investigate the utility of a simple selection combination diversity combining scheme with the aim of mitigating human body shadowing in outdoor body-to-body communications channels at 2.45 GHz. Early results from this work are extremely promising, indicating substantial diversity gains, as great as 29 dB, may be achieved in a number of everyday scenarios likely to be encountered in body-to-body networking. © 2012 IEEE.

Large scale test of a novel back-pass non-perforated unglazed solar air collector

This paper describes large scale tests conducted on a novel unglazed solar air collector system. The proposed system, referred to as a back-pass solar collector (BPSC), has on-site installation and aesthetic advantages over conventional unglazed transpired solar collectors (UTSC) as it is fully integrated within a standard insulated wall panel. This paper presents the results obtained from monitoring a BPSC wall panel over one year. Measurements of temperature, wind velocity and solar irradiance were taken at multiple air mass flow rates. It is shown that the length of the collector cavities has a direct impact on the efficiency of the system. It is also shown that beyond a height-to-flow ratio of 0.023m/m³/hr/m², no additional heat output is obtained by increasing the collector height for the experimental setup in this study, but these numbers would obviously be different if the experimental setup or test environment (e.g. location and climate) change. An equation for predicting the temperature rise of the BPSC is proposed.

Retro, faux-vintage, and anachronism: When cinema looks back at Its Analogue Past

This article explores the definition of ‘vintage cinema’ and specifically re-evaluates the fetishism for the past and its regurgitation in the present by providing a taxonomy of the phenomenon in recent film production. Our contribution identifies three aesthetic categories: the faux-vintage, the retro and the anachronistic and by illustrating their overlapping and discrepancies, it argues that the past remains a powerful negotiator of meaning for the present and the future. Drawing on studies of memory and digital nostalgia, this article focuses on the latter category: anachronism and unravel the persistence of and the filmic fascination for obsolete analogue objects through an analysis of Only Lovers Left Alive (Jim Jarmusch, 2013).

Back to the city: University-led Regeneration in Belfast

This paper explores the changing relationship between knowledge creation and city centre spaces, focusing on the relocation of Higher Education Institutions (HEIs) into urban centres and the ensuing economic, social and cultural regeneration. Using the Ulster University's relocation to Belfast city centre, the paper highlights the opportunities a new anchor institution can offer a deprived inner city community. This case study draws attention to the drivers of university relocation and the untapped potential for regeneration in city centres such as Belfast, Northern Ireland. The paper looks to the future and questions whether large-scale city projects, such as the university relocation, can truly form connections with their new neighbouring inner city communities while contending with the mounting pressure of reduced government resources.

The validity of classical trajectory and perturbative quantal methods for electron-impact ionization from excited states in H-like ions

To test the validity of classical trajectory and perturbative quantal methods for electron-impact ionization of H-like ions from excited states, we have performed advanced close-coupling calculations of ionization from excited states in H, Li 2+ and B 4+ using the R -matrix with pseudo states and the time-dependent close-coupling methods. Comparisons with our classical trajectory Monte Carlo (CTMC) and distorted-wave (DW) calculations show that the CTMC method is more accurate than the DW method for H, but does not improve with n and grows substantially worse with Z , while the DW method improves with Z and grows worse with n .